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Prize‐based contingency management for the treatment of substance abusers: a meta‐analysis
Author(s) -
Benishek Lois A.,
Dugosh Karen L.,
Kirby Kim C.,
Matejkowski Jason,
Clements Nicolle T.,
Seymour Brittany L.,
Festinger David S.
Publication year - 2014
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.12589
Subject(s) - contingency management , abstinence , confidence interval , randomized controlled trial , meta analysis , medicine , contingency , intervention (counseling) , psychiatry , psychology , linguistics , philosophy
Aim To review randomized controlled trials to assess efficacy of a prize‐based contingency management procedure in reducing substance use (where a drug‐free breath or urine sample provides a chance of winning a prize). Methods A meta‐analysis was conducted on papers published from J anuary 2000 to F ebruary 2013 to determine the effect size of studies comparing prize‐based contingency management to a treatment‐as‐usual control condition ( k = 19 studies). Parallel analyses evaluated the efficacy of both short‐ ( k = nine studies) and long‐term outcomes ( k = six studies) of prize‐based contingency management. Results The average end‐of‐treatment effect size ( C ohen's d ) was 0.46 [95% confidence interval ( CI ) = 0.37, 0.54]. This effect size decreased at the short‐term (≤3‐month) post‐intervention follow‐up to 0.33 (95% CI = 0.12, 0.54) and at the 6‐month follow‐up time‐point there was no detectable effect [ d = −0.09 (95% CI = −0.28, 0.10)]. Conclusion Adding prize‐based contingency management to behavioral support for substance use disorders can increase short‐term abstinence, but the effect does not appear to persist to 6 months.