What Is Contingency Management Therapy and Does it Work?

Contingency management therapy is a type of treatment for patients with addiction. It’s a good fit for addicts who haven’t yet found a way to overcome their addiction.

Some people are resistant to treatment or haven’t found something that works well. In any case, contingency management therapy (CM) may be effective. You can receive CM therapy from a professional. Or a trusted family member can implement this approach. 

Read on to learn more about how CM works and whether it may be a good fit for you or a loved one. 

Contingency Management Overview 

CM tends to be effective because you get rewarded when meeting a specific treatment goal. Or, if you fall off the wagon, you experience a negative consequence. In most cases of CM, positive rewards involve cash, a gift card, or something similar. 

The more rewards you receive, the more likely you will stay away from alcohol or drugs. When you reach this stage, it’s a form of “behavioral conditioning.” 

It depends on the CM program you use. But some programs include having negative consequences for making the wrong choices. For example, say a person gets a DUI. Instead of them going to jail, they have certain conditions they must follow. They must stay at home and no longer drink. However, if they test positive for alcohol at the end of the period, they have to go to jail for a particular time. 

Contingency Management Therapy

Why Does it Work?

Contingency management therapy mimics the natural drug conditioning mechanisms of the brain. It counterbalances your urges to use drugs or drink with positive rewards for not using. The main two methods used in CM therapy are “token reinforcement” and “surprise exposure.” 

Token Reinforcement

Token reinforcement is when you receive tokens for ignoring triggers. It’s described as a form of positive reinforcement and a symbol of recognition. 

The more tokens you receive, the better. Later, you can exchange your tokens for a reward or prize. You and your therapist decide on the rewards before the therapy takes place. The reward must be big enough to encourage you to reach your goals. 

Your therapist will set a certain number of tokens that you must earn. As you get rewarded with prizes, you have an incentive to continue making more. 

Surprise Exposure 

Surprise exposure involves getting exposed to certain stimuli. The stimuli chosen make you crave using drugs or drinking You’re either scared or surprised when you encounter this trigger when exposed.

A few examples of exposure are: 

  • Seeing or smelling the drug or alcohol
  • Hearing about it
  • Having it referenced in conversation

Your therapist will work with you to develop specific triggers that in the past caused drug or alcohol use.

Contingency Management Therapy

Token reinforcement is a part of this treatment plan. You receive tokens for refraining from using. Getting exposed to something out in public is vital to your success. It’s a positive reinforcement that you can overcome your addiction. Receiving a reward should be considered a bonus.


Another aspect of this type of treatment is extinction. Extinction involves replacing a craving with a pleasant experience instead. 

For example, if you used to look forward to using drugs on a certain day, you have another option. For example, if you ignore the drugs, you get to attend your favorite movie the next Friday instead. 

Other Treatment Options

There are also many other types of treatment options available for addiction. Again, as stated, you may have tried everything. But coupling CM with other forms of treatment is often effective. 

Other recovery treatments options include:

  • Faith-based or secular 12-step programs are effective.
  • Nutraceuticals (such as the drug Naltrexone) inhibit the effects of drugs.
  • Anticonvulsant medications such as Depakote, Topamax, and Neurontin can help control cravings. Furthermore, they can also lessen your addictive behaviors. 
  • Group therapy is also an option. Attending group therapy has many benefits. You may enjoy group therapy if you need insights from your peers going through similar trials.

If you decide to go to a recovery center, find out if they offer CM therapy. Many centers do, or they can work with you to find the best treatment plan. Recovery centers are an integral part of your recovery. 

If you live in California, for example, there are many excellent inpatient centers. Hollywood Hills Recovery offers various treatment plans suitable for all stages of the recovery process. 


Contingency management therapy receives mixed reviews from the scientific community for its effectiveness. However, CM addiction recovery treatment is highly successful in the United States. 

It is often used with other drug treatment programs, such as 12-step programs. When used effectively, it can help you stay abstinent and overcome your addiction.

also read:

Leave a Reply

Your email address will not be published. Required fields are marked *