Skip to main content
Top
Published in: International Journal of Mental Health and Addiction 1/2012

01-02-2012

Incorporating Nondrug Social & Recreational Activities in Outpatient Chemical Dependency Treatment

Authors: Sheldon Siporin, Lisa Baron

Published in: International Journal of Mental Health and Addiction | Issue 1/2012

Login to get access

Abstract

“Contingency Management programs (CMP) and non-drug social and recreational activities (NDSRA) are interventions premised on behavior theory that rely on external sources of reinforcement alternative to drug-based forms to decrease drug use. CMP usually employs vouchers as reinforcement for negative toxicologies. Despite research support, CMP alone may be insufficient to achieve abstinence. Although evidence supporting NDSRA is limited, it is promising because it assists patients to employ “fun” real world activities (e.g. films, plays, circus) as alternative sources of reinforcement. Both CMP and NDSRA are currently used at Coney Island Hospital’s Outpatient Chemical Dependency Services (CIHCDS) in New York City. The NDSRA program is fairly extensive (>40 events per year) and includes group excursions (868 patient participants in 2009) under the supervision of one or more therapists. A description of program design and clinical observations of its impact follows a brief review of relevant research.”
Footnotes
1
Practical problems may even include legal issues. See e.g. Advisory Opinion of the Inspector General, September 2008 regarding applicability of Federal Anti-kickback Statutes to motivational incentive programs (URL: http://​oig.​hhs.​gov/​fraud/​docs/​advisoryopinions​/​2008/​AdvOpn08-14.​pdf).
 
2
Such patients have usually been excluded from CM studies (see Budney et al., supra).
 
3
At first several staff members felt that the evening patients would not be interested in an incentives program since most work and so would not “need” gift cards. This has not proven to be true. Patients report they feel good about bringing home rewards earned from being clean and it is different than earning money at work.
 
Literature
go back to reference Ahmed, S. H. (2005). Imbalance between drug and nondrug reward availability: a major risk factor for addiction. European Journal of Pharmacology, 526, 9–20.PubMedCrossRef Ahmed, S. H. (2005). Imbalance between drug and nondrug reward availability: a major risk factor for addiction. European Journal of Pharmacology, 526, 9–20.PubMedCrossRef
go back to reference Budney, A. J., Higgins, S. T., Radonovich, K. J., & Novy, P. L. (2000). Adding voucher-based incentives to coping skills and motivational enhancement improves outcomes during treatment for marijuana dependence. Journal of Consulting and Clinical Psychology, 68, 1051–1061.PubMedCrossRef Budney, A. J., Higgins, S. T., Radonovich, K. J., & Novy, P. L. (2000). Adding voucher-based incentives to coping skills and motivational enhancement improves outcomes during treatment for marijuana dependence. Journal of Consulting and Clinical Psychology, 68, 1051–1061.PubMedCrossRef
go back to reference Carroll, M. E., Lac, S. T., & Nyguard, S. I. (1989). A concurrently available nondrug reinforcer prevents the acquisition or decreases the maintenance of cocaine reinforced behavior. Psychopharmacology, 97, 23–29.PubMedCrossRef Carroll, M. E., Lac, S. T., & Nyguard, S. I. (1989). A concurrently available nondrug reinforcer prevents the acquisition or decreases the maintenance of cocaine reinforced behavior. Psychopharmacology, 97, 23–29.PubMedCrossRef
go back to reference Correia, C. J., Benson, T. A., & Carey, K. B. (2005). Decreased substance use following increases in alternative behaviors: A preliminary investigation. Addictive Behaviors, 30, 19–27. Correia, C. J., Benson, T. A., & Carey, K. B. (2005). Decreased substance use following increases in alternative behaviors: A preliminary investigation. Addictive Behaviors, 30, 19–27.
go back to reference Correia, C. J., Carey, K. B., & Borsari, B. (2002). Measuring substance-free and substance-related reinforcement in the natural environment. Psychology of Addictive Behaviors, 16, 28–34. Correia, C. J., Carey, K. B., & Borsari, B. (2002). Measuring substance-free and substance-related reinforcement in the natural environment. Psychology of Addictive Behaviors, 16, 28–34.
go back to reference Cosgrove, K. P., Hunter, R. G., & Carroll, M. E. (2002). Wheel running attenuates intravenous cocaine self administration in rats: sex differences. Pharmacology, Biochemistry & Behavior, 73, 663–671.CrossRef Cosgrove, K. P., Hunter, R. G., & Carroll, M. E. (2002). Wheel running attenuates intravenous cocaine self administration in rats: sex differences. Pharmacology, Biochemistry & Behavior, 73, 663–671.CrossRef
go back to reference Dennis, M., Godley, S. H., Diamond, G., Tims, F. M., Babor, T., Donaldson, J., et al. (2004). The Cannabis youth treatment (CYT) study: main findings from two randomized trials. Journal of Substance Abuse, 27, 197–213.CrossRef Dennis, M., Godley, S. H., Diamond, G., Tims, F. M., Babor, T., Donaldson, J., et al. (2004). The Cannabis youth treatment (CYT) study: main findings from two randomized trials. Journal of Substance Abuse, 27, 197–213.CrossRef
go back to reference Heyman, G. (2009). Addiction: A disorder of choice. Boston: Harvard University Press. Heyman, G. (2009). Addiction: A disorder of choice. Boston: Harvard University Press.
go back to reference Higgins, S. T., Budney, A. J., Bickel, W. K., Foerg, F. E., Donham, R., & Badger, G. J. (1994). Incentives improve outcome in outpatient behavioral treatment of cocaine dependence. Archives of General Psychiatry, 54, 568–576.CrossRef Higgins, S. T., Budney, A. J., Bickel, W. K., Foerg, F. E., Donham, R., & Badger, G. J. (1994). Incentives improve outcome in outpatient behavioral treatment of cocaine dependence. Archives of General Psychiatry, 54, 568–576.CrossRef
go back to reference Hunt, G. & Azrin, N. (1973). Cited in R. J. Meyers & W. R. Miller (eds, 2001) A community reinforcement approach to adult treatment. Chapter 2: Practice & promise, the Azrin studies. Cambridge Unversity Press: Cambridge, England. Hunt, G. & Azrin, N. (1973). Cited in R. J. Meyers & W. R. Miller (eds, 2001) A community reinforcement approach to adult treatment. Chapter 2: Practice & promise, the Azrin studies. Cambridge Unversity Press: Cambridge, England.
go back to reference Kanarek, R. B., Marks-Kaufman, R., D’Anci, K. E., & Przypek, J. (1985). Exercise attenuates oral intake of amphetamine in rats. Pharmacology, Biochemistry and Behavior, 51, 725–729.CrossRef Kanarek, R. B., Marks-Kaufman, R., D’Anci, K. E., & Przypek, J. (1985). Exercise attenuates oral intake of amphetamine in rats. Pharmacology, Biochemistry and Behavior, 51, 725–729.CrossRef
go back to reference Lash, S. J., Stephens, R. S., Burden, J. L., Grambow, S. C., DeMarce, J. M., Jones, M. E., Lozano, B. E., Jeffreys, A. S., Fearer, S. A., & Horner, R. D. (2007). Contracting, prompting, and reinforcing substance use disorder continuing care: A randomized clinical trial. Psychology Addictive Behaviors, 21(3), 387–97. Lash, S. J., Stephens, R. S., Burden, J. L., Grambow, S. C., DeMarce, J. M., Jones, M. E., Lozano, B. E., Jeffreys, A. S., Fearer, S. A., & Horner, R. D. (2007). Contracting, prompting, and reinforcing substance use disorder continuing care: A randomized clinical trial. Psychology Addictive Behaviors, 21(3), 387–97.
go back to reference Lussier, J. P., Heil, S. H., Mongeon, J. A., Badger, G. J., & Higgins, S. T. (2006). A meta-analysis of voucher-based reinforcement therapy for substance use disorders. Addiction, 101, 192–203.PubMedCrossRef Lussier, J. P., Heil, S. H., Mongeon, J. A., Badger, G. J., & Higgins, S. T. (2006). A meta-analysis of voucher-based reinforcement therapy for substance use disorders. Addiction, 101, 192–203.PubMedCrossRef
go back to reference MacPhillamy, D. J., & Lewinsohn, P. M. (1976) Manual for the Pleasant Events Schedule. Unpublished manuscript, University of Oregon. MacPhillamy, D. J., & Lewinsohn, P. M. (1976) Manual for the Pleasant Events Schedule. Unpublished manuscript, University of Oregon.
go back to reference McLellan, A. T., Lewis, D. C., O’Brien, C. P., & Kleber, H. D. (2000). Drug dependence, a chronic medical illness: Implications for treatment, insurance, and outcomes evaluation. JAMA, 284, 1689–1695.PubMedCrossRef McLellan, A. T., Lewis, D. C., O’Brien, C. P., & Kleber, H. D. (2000). Drug dependence, a chronic medical illness: Implications for treatment, insurance, and outcomes evaluation. JAMA, 284, 1689–1695.PubMedCrossRef
go back to reference Meyers, R. J., & Miller, W. R. (Eds.). (2001). A community reinforcement approach to adult treatment. Cambridge: Cambridge University Press. Meyers, R. J., & Miller, W. R. (Eds.). (2001). A community reinforcement approach to adult treatment. Cambridge: Cambridge University Press.
go back to reference Petry, N. M., Tedford, J., & Martin, B. (2001). Reinforcing compliance with nondrug related activities. Journal of Substance Abuse Treatment, 20, 33–44.PubMedCrossRef Petry, N. M., Tedford, J., & Martin, B. (2001). Reinforcing compliance with nondrug related activities. Journal of Substance Abuse Treatment, 20, 33–44.PubMedCrossRef
go back to reference Rogers, R. E., Higgins, S. T., Silverman, K., Thomas, C. S., Badger, G. J., Bigelow, G., et al. (2008). Abstinence-contingent reinforcement and engagement in non-drug-related activities among illicit drug abusers. Psychology of Addictive Behaviors, 22, 544–550.PubMedCrossRef Rogers, R. E., Higgins, S. T., Silverman, K., Thomas, C. S., Badger, G. J., Bigelow, G., et al. (2008). Abstinence-contingent reinforcement and engagement in non-drug-related activities among illicit drug abusers. Psychology of Addictive Behaviors, 22, 544–550.PubMedCrossRef
go back to reference Smith, J. E., Meyer, R. J., & Delaney, H. D. (1998). The community reinforcement approach with homeless alcohol-dependent individuals. Journal of Consulting & Clinical Psychology, 66, 541–548.CrossRef Smith, J. E., Meyer, R. J., & Delaney, H. D. (1998). The community reinforcement approach with homeless alcohol-dependent individuals. Journal of Consulting & Clinical Psychology, 66, 541–548.CrossRef
go back to reference Vuchinich, R. E., & Tucker, J. A. (1996). The molar context of alcohol abuse. In: L. Green, & J. Kagel (Eds.), Advances in behavioral economics, vol. 3 (pp. 133–162). Norwood, NJ: Ablex Press. Vuchinich, R. E., & Tucker, J. A. (1996). The molar context of alcohol abuse. In: L. Green, & J. Kagel (Eds.), Advances in behavioral economics, vol. 3 (pp. 133–162). Norwood, NJ: Ablex Press.
go back to reference Wang, Z.-X., Zhang, J. X., Wu, Q.-L., Liu, N., Hu, X., & Chan, R. C. K. (2010). Alterations in the processing of non-drug-related affective stimuli in abstinent heroin addicts. NeuroImage, 49, 971–976.PubMedCrossRef Wang, Z.-X., Zhang, J. X., Wu, Q.-L., Liu, N., Hu, X., & Chan, R. C. K. (2010). Alterations in the processing of non-drug-related affective stimuli in abstinent heroin addicts. NeuroImage, 49, 971–976.PubMedCrossRef
go back to reference Weinstock, J., Barry, D., & Petry, N. M. (2008). Exercise-related activities are associated with positive outcome in contingency management treatment for substance use disorders. Addictive Behavior, 33, 1072–1075.CrossRef Weinstock, J., Barry, D., & Petry, N. M. (2008). Exercise-related activities are associated with positive outcome in contingency management treatment for substance use disorders. Addictive Behavior, 33, 1072–1075.CrossRef
go back to reference Wolfe, B. L., & Meyers, R. J. (1999). Cost-effective alcohol treatment: the community reinforcement approach. Cognitive and Behavioral Practice, 6, 105–109.CrossRef Wolfe, B. L., & Meyers, R. J. (1999). Cost-effective alcohol treatment: the community reinforcement approach. Cognitive and Behavioral Practice, 6, 105–109.CrossRef
Metadata
Title
Incorporating Nondrug Social & Recreational Activities in Outpatient Chemical Dependency Treatment
Authors
Sheldon Siporin
Lisa Baron
Publication date
01-02-2012
Publisher
Springer-Verlag
Published in
International Journal of Mental Health and Addiction / Issue 1/2012
Print ISSN: 1557-1874
Electronic ISSN: 1557-1882
DOI
https://doi.org/10.1007/s11469-010-9302-5

Other articles of this Issue 1/2012

International Journal of Mental Health and Addiction 1/2012 Go to the issue

EditorialNotes

Editorial