Australian clinician attitudes towards contingency management: Comparing down under with America

Abstract

Background Contingency management (CM) is an efficacious treatment intervention. Research from the US indicates that clinicians have both positive and negative attitudes towards CM. Concerns about the practicalities of implementation and potential philosophical differences have been identified in American samples. To date, no research has examined Australian clinicians attitudes towards CM nor assessed the extent to which Australian clinicians share the concerns of American clinicians. Method The Provider Survey of Incentives was completed by 102 Australian drug and alcohol treatment providers. The survey assesses both positive and negative attitudes towards tangible and social incentives. Comparisons are made with published data on American samples. Results The proportion of respondents agreeing with positive opinions about CM in this Australian sample was lower than that reported in the American sample. The average percentage agreement for positive aspects of tangible rewards was 41% whereas the average percent agreement for social rewards was 51% indicating more positive views towards social rewards. Objections to CM were similar between the two samples, but American respondents more strongly agreed with the idea that it would not be right to give incentives when clients are still using drugs, whereas the Australian sample had much less difficulty with this concept. Conclusions There appears to be broad support for CM from about half of the clinicians surveyed. The areas of concern were highly similar between the Australian sample and published American data. Many Australian clinicians expressed neutral views about CM, indicating that the environment may be ripe for implementation of programs.