Strong EvidenceBehaviouralAddictions

Contingency Management(CM)

Last evidence review: January 20263 printable resources

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Overview

Contingency Management is a behavioural intervention that reinforces recovery behaviours (e.g., abstinence, attendance) with tangible rewards. It is primarily used in addiction services with clear protocols.

What this therapy focuses on

Behaviour change through reliable, immediate reinforcement linked to objectively verified targets (e.g., drug test results, attendance records).

What sessions are usually like

Integrated into treatment programmes

Incentives delivered immediately upon verified target behaviour

Structured protocol with escalating and reset schedules

Session profile

Duration: Integrated into treatment
Frequency: Per target behaviour
Typical course: 12–24 weeks typically
Between sessions: Meeting agreed targets (abstinence, attendance)

Common uses and suitability

What problems it is commonly used for

Substance use disorders (stimulants, opioids, cannabis)Treatment attendance reinforcementMedication adherence

Who this therapy may suit best

  • People with substance use disorders where other approaches have not sustained engagement
  • Where objectively verifiable targets are possible

When it may need adapting or may not be suitable

  • Requires governance and ethical frameworks
  • Not suitable without clear behavioural targets
  • Financial sustainability must be planned

Where this therapy may not be enough

CM is for substance use targets. Not a comprehensive mental health treatment.

What happens in therapy

Incentive Delivery

Receiving a reward (voucher, prize draw entry, or privilege) each time you meet your agreed target.

Evidence Base

Guideline support

Strong in specific substance use contexts. Included in some NICE guidance for substance misuse.

Strength of evidence

Strong for stimulant use disorders. Large effect sizes in well-implemented programmes.

Limitations

Implementation and governance challenges. Financial sustainability. Effects may not sustain post-programme without broader recovery support.

Evidence claims by condition

Substance UseStrong EvidenceAdults

CM helps people stay in treatment and reduce drug use by providing rewards for meeting recovery goals.

Resources & Printables

Practitioner & Training Notes

Typical professional background

Addiction service staff with CM training.

Recognised training routes

CM training through addiction service organisations and specialist training providers.

Registration considerations

Delivered within supervised addiction services.

Source Registry

Last evidence review: January 2026. All sources are verified and checked on a scheduled cadence.