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HYPOTHESIS AND THEORY article
Front. Psychiatry
Sec. Addictive Disorders
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1420763
This article is part of the Research Topic Substance Use Disorder: Above and Beyond Addiction, Volume II View all 25 articles
What Does a Dollar Mean to You? Utilizing Intrinsic Rewards within Contingency Management
Provisionally accepted- 1 University of California, San Diego, La Jolla, United States
- 2 VA San Diego Healthcare System, Veterans Health Administration, United States Department of Veterans Affairs, San Diego, California, United States
- 3 University of California, Los Angeles, Los Angeles, California, United States
Substance Use Disorders (SUDs) pose a significant public health challenge. Medications used for treatment of SUDs are limited in their efficacy, particularly in cannabis and stimulant use disorders, and non-pharmacological interventions have shown, at most, moderate effectiveness, leaving a continuing need for improved treatments. Contingency management (CM) is an evidence-based treatment with promising results, operationalized in SUD treatment programs by using monetary rewards to help patients achieve target behaviors such as abstinence. Several factors limit the viability of CM as a sustainable, effective treatment, suggesting insufficiency of monetary reinforcement alone. Implementation can be costly, requiring increased monetary reinforcers over time to reach target behaviors, and effects do not endure. We propose an integrative model of CM that explicitly incorporates intrinsic rewards into CM to enhance its effectiveness. This model involves redirecting salience attribution of monetary rewards towards goals and activities that are personally relevant and motivating for the individual that do not involve substance use. This integrative model of CM may address current challenges of and some of the barriers to implementation of CM in clinical practice.
Keywords: Contingency management (CM), Integrative treatment approaches, substance use disorder, Addiction, Intrinsic Reward
Received: 21 Apr 2024; Accepted: 24 Feb 2025.
Copyright: © 2025 Shirazi, Carley, Ghahremani, Brody and Lang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Anaheed Shirazi, University of California, San Diego, La Jolla, United States
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