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Contingency contracting as an adjunct to group counseling with substance abusers in the natural setting

The main purpose of this study was to examine, in the natural environment, the relative effects of positive reinforcement and response cost as an adjunct to traditional group counseling in the treatment of substance abusers. While these procedures have been repeatedly reported to be effective in controlled settings, little evidence exists that the results generalize to the natural setting. Further, there is a dearth of research which compares contingency contracting to other modalities in the natural setting. Therefore, a second purpose of this research was to compare the effects of contingency contracting as an adjunct to traditional group counseling versus traditional group counseling alone.Subjects for this study were 45 male enlisted soldiers who were diagnosed as alcohol or drug abusers and were enrolled in an Army Community Drug and Alcohol Assistance Center (CDAAC). Of the subjects, 25 were alcohol abusers and 20 were drug abusers. The mean age was 23 years and the median rank was E4. They were randomly assigned to one of the three treatment conditions.The counselors were six paraprofessional military members of the CDAAC staff. They were given five one-hour training sessions by the experimenter on the use of contingency contracting and reinforcement procedures. They were then randomly assigned to the treatment conditions. All subjects received traditional group counseling. Additionally, subjects in Treatment Condition1 received tokens for, carrying out the contingencies of a two-part weekly contract. Subjects in Treatment Condition 2 received the total possible number of tokens at the onset of treatment and forfeited tokens each week if the contingencies of the contract were not met. Tokens were exchanged at the end of treatment for rewards previously negotiated with each subject. Subjectsin Treatment Condition 3 did no contracting and received no tokens.The dependent variables in this study were the subject's level of depression and hostility. These were measured by the Self-Rating Depression Scale and the Buss-Durkee Inventory, respectively. A counterbalanced pretest-posttest design was used. The instruments were administered in a classroom in the CDAAC to all subjects prior to the first group session and again after the sixth session. The posttest instruments were administered in the reverse order from the pretest.The statistical analyses were accomplished using a one-way multivariate analysis of variance (MANOVA). The analysis of the data revealed no statistical differences between contingency contracting with positive reinforcement or contingency contracting with response cost. Further, there were no differences between contingency contracting as an adjunct to traditional group counseling and group counseling alone.The failure to find significant differences between the groups suggests that contingency contracting may not be a viable therapeutic tool in out-patient settings where the counselor does not have control over all potential reinforcers or where the clients may not have a substantial investment in the reinforcement. If the technique is only successful with highly motivated, voluntary clients, it may be no more effective than the contingencies implicit in other counseling relationships. If the effects of in-patient token economies do not generalize to the natural setting and if these procedures require unrealisitic controls when administered in out-patient settings, the previously reported positive results may have little practical value. Further research should be conducted which compares the effects of contingency contracting to other treatment modalities.

Identiferoai:union.ndltd.org:BSU/oai:cardinalscholar.bsu.edu:handle/177947
Date03 June 2011
CreatorsMahan, Dorothea B.
ContributorsShapiro, Joseph B.
Source SetsBall State University
Detected LanguageEnglish
Format3, viii, 92 leaves ; 28 cm.
SourceVirtual Press

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