Contingency Management, The Carrot of Behavioral Therapies

Last Updated: Sep 20th 2019

Reviewed by Brittany Polansky, MSW, LCSW

Behavioral Therapies

You’ve may have heard of behavioral therapies like cognitive behavioral therapy and slightly lesser known dialectical behavior therapy. Behavior therapies are gaining a name for themselves in the substance abuse disorder recovery scene and for good reason. Behavioral therapy teaches the skills necessary for a recovering drug or alcohol addict to cast aside behaviors or habits that have had consequences in the past that led them to fostering their chemical dependency, often leading a person down a shame spiral and a life lived in pain, unless the path is interrupted by quality treatment. Almost all South Florida rehab centers these days will offer some kind of behavioral therapy in addition to their other forms and methods of treatment.


Behavioral Therapies are especially consequential when used for those struggling with addiction to drugs or alcohol who are also struggling with the dual diagnosis of a mental health disorder like bipolar disorder,  generalized anxiety disorder, or depression. The skills learned that help an addict recognize their behaviors and effect change in those behaviors can also help a person who suffers from bipolar disorder recognize and understand moods better. Because of the difficult nature of a dual diagnosis, any kind of treatment that addresses both mental illness and substance addiction in one go is an enormous step in the right direction as far as treatment goes.


Contingency Management

Contingency management therapy is the kind of therapy that plays out on a reward system. Patients receive positive incentives to become abstinent and stay that way. Kathleen M Carroll in her article Behavioral Therapies for Drug Abuse in The American Journal of Psychiatry says the following about contingency management therapy, “Contingency management, in which patients receive incentives or rewards for meeting specific behavioral goals (e.g., verified abstinence), has particularly strong, consistent, and robust empirical support across a range of types of drug use”  ( She goes on to say that it is based on the “contingency management principles of behavioral pharmacology and operant conditioning.” The whole strategy is based on the idea that positive consequence reinforcement makes it more likely that a person will be  motivated to repeat their positive actions. This kind of therapy has sometimes been used in conjunction with methadone treatment programs.

Critics of contingency management therapy call out the sustainability of the therapy given the costs of programs citing the cost of not only vouchers and various rewards associated but also with the high cost of consistent urine testing for abstinence, for patients in this kind of therapy program.


Treatment For Someone Struggling with Drugs or Alcohol


At 1st Step Behavioral Health behavioral therapies are offered throughout the rehabilitation recovery process. Patients struggling with chemical dependency should first attend our South Florida Detox. Broward county 1st Step Behavioral Health offers medical detox and a world class recovery rehabilitation program with dedicated medical staff on hand and qualified therapists. Call us today to learn more about our programs and what kind of therapies you might take part in during your addiction recovery.

Reviewed for Medical & Clinical Accuracy by Brittany Polansky, MSW, LCSW

Brittany has been working in behavioral health since 2012 and is the Assistant Clinical Director at our facility. She is an LCSW and holds a master’s degree in social work. She has great experience with chemical dependency and co-occurring mental health diagnoses as well as various therapeutic techniques. Brittany is passionate about treating all clients with dignity and respect, and providing a safe environment where clients can begin their healing journey in recovery.