Contracting, Prompting, and Reinforcing Substance Use Disorder Continuing Care: A Randomized Clinical Trial

Steven J. Lash, Robert S. Stephens, Jennifer L. Burden, Steven C. Grambow, Josephine M. DeMarce, Mark E. Jones, Brian E. Lozano, Amy S. Jeffreys, Stephanie A. Fearer, Ronnie D. Horner

Research output: Contribution to journalArticlepeer-review

41 Scopus citations

Abstract

Although continuing care is strongly related to positive treatment outcomes for substance use disorder (SUD), participation rates are low and few effective interventions are available. In a randomized clinical trial with 150 participants (97% men), 75 graduates of a residential Veterans Affairs Medical Center SUD program who received an aftercare contract, attendance prompts, and reinforcers (CPR) were compared to 75 graduates who received standard treatment (STX). Among CPR participants, 55% completed at least 3 months of aftercare, compared to 36% in STX. Similarly, CPR participants remained in treatment longer than those in STX (5.5 vs. 4.4 months). Additionally, CPR participants were more likely to be abstinent compared to STX (57% vs. 37%) after 1 year. The CPR intervention offers a practical means to improve adherence among individuals in SUD treatment.

Original languageEnglish (US)
Pages (from-to)387-397
Number of pages11
JournalPsychology of Addictive Behaviors
Volume21
Issue number3
DOIs
StatePublished - Sep 2007
Externally publishedYes

Keywords

  • adherence
  • aftercare
  • alcohol dependence
  • reinforcement
  • substance dependence

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Clinical Psychology
  • Psychiatry and Mental health

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