Abstract
BackgroundContingency management (CM) has recently shown efficacy in promoting abstinence and retention in treatment among crack cocaine users in Brazil. However, partially because of unawareness and resistance among health care providers, CM has not been widely employed. The objective of this study was to conduct a secondary analysis in order to evaluate how CM participants perceive their treatment experience.MethodsTwenty-seven crack cocaine users, previously assigned to 12 weeks of CM treatment, were assessed with a structured questionnaire designed to assess their personal opinion of, difficulty in understanding, and acceptance of the CM intervention, as well as their opinion regarding its impact on their treatment responses.ResultsDescriptive analyses showed that 92.6% of the participants found it very easy to understand the CM protocol. All participants reported liking their CM experience quite a bit. For the perceived effects of CM on their treatment response, 81.5% of the participants stated that CM helped them considerably, the mean score for the impact of CM on treatment response (out of a maximum of 10) being 9 (SD = 1.5). When asked if they believed CM could help other people with crack cocaine dependence, 92.6% of the participants stated that CM could help such people a lot and 7.4% stated that it could help them a little.ConclusionsFrom the perspective of the patients, CM was easily assimilated, easily accepted, and had a direct positive effect on treatment response. These findings provide additional support for the incorporation of CM into substance abuse treatment services in Brazil.
Highlights
Contingency management (CM) has recently shown efficacy in promoting abstinence and retention in treatment among crack cocaine users in Brazil
A recent randomized clinical trial conducted in the city of São Paulo, Brazil, presented strong evidence that CM is an effective treatment for crack cocaine dependence [25]
The CM intervention was well accepted by the participants, all of whom responded, “I liked it a lot” to the question “How do you feel about your CM experience?” For the perceived effects of CM on treatment response, 81.5% of the participants reported that the CM
Summary
Contingency management (CM) has recently shown efficacy in promoting abstinence and retention in treatment among crack cocaine users in Brazil. CM interventions are based on operant behavior principles that acknowledge that a specific response will have a greater likelihood of occurring if it is immediately followed by a reinforcing consequence [21, 22]. Under this framework, the CM interventions deliver. CM was significantly more efficacious than was usual care in increasing rates of treatment session attendance and retention in treatment, as well as in reducing crack cocaine use and promoting continuous abstinence from crack cocaine. The authors observed significant secondary effects of CM, including reductions in alcohol and marijuana use, as well as in post-treatment anxiety and depressive symptomatology [25, 26]
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