Contingency Management Research Articles

General Principles of Contingency Management for Smoking Cessation

General Principles of Contingency Management for Smoking Cessation

Innovation in the treatment of persistent pain in adults with Neurofibromatosis Type 1 (NF1): Implementation of the iCanCope mobile application

Neurofibromatosis Type 1 (NF1) is a genetic disorder presenting with chronic pain symptoms that has limited treatment options for addressing the pain. The utilization of a mobile application allows for greater reach and scalability when using empirically valid psychosocial self-management treatments for pain. The iCanCope mobile application has been utilized in several different populations dealing with pain symptoms and has demonstrated initial effectiveness. To address the need for this population, we have customized the iCanCope mobile application for the NF1 population and included additional tailored features. We describe the rationale and design of a pilot randomized control study with a sample of 108 adults with NF1, in which two groups will receive access to the mobile application, of which one group will be incentivized to engage in the mobile application and the third group will treatment as usual over the course of 8-week period with a six-week follow-up. Outcomes will focus on the acceptability of the iCanCope-NF mobile application within the NF1 population and the impact of pain related activity on psychometric evaluations to determine if the contingency management will impact the engagement of mobile application, as well as to identify the participants’ experiences in relationship to their treatment satisfaction and perceived support.

Homelessness and publicly funded substance use disorder treatment in California, 2016–2019: Analysis of treatment needs, level of care placement, and outcomes

IntroductionBoth homelessness and substance use have increased in recent years. People experiencing homelessness (PEH) are at increased risk for health problems and early mortality, both of which can be exacerbated by substance use disorders (SUD). Specialty SUD treatment is likely needed to address substance use among PEH, and more than 232,000 PEH received treatment from U.S. publicly funded SUD programs in 2015. The objective of this paper is to develop a better understanding of the SUD services that PEH receive in publicly funded treatment programs by (1) describing the characteristics and needs of the PEH population served in publicly funded SUD treatment programs, compared to non-PEH populations; (2) determining if differences exist in treatment placement (level of care) for PEH and non-PEH; and (3) gauging how successful programs are in treating PEH compared to non-PEH. MethodsObservational study using a two-way fixed effect model to determine associations among homelessness, retention, and outcomes among Medicaid beneficiaries receiving SUD treatment in California from 2016 to 2019 (n = 638,953). The study team used ordinary least squares (OLS) regression to measure the degree to which homelessness was associated with baseline characteristics, SUD services received, and treatment outcomes. ResultsPEH were significantly more likely than non-PEH to be having methamphetamine or heroin as their primary substance. PEH had greater frequency of primary substance use prior to entering treatment, greater ER and hospital utilization, more criminal justice involvement, and greater prevalence of mental health diagnoses and unemployment. PEH were 9.82% more likely than non-PEH to receive residential treatment and 7.11% less likely than non-PEH to receive treatment intensive outpatient modalities. Homelessness was associated with an 11.90% decrease in retention, and a 19.40% decrease in successful discharge status. These trends were consistent across outpatient, intensive outpatient, and residential modalities. ConclusionsDeveloping SUD treatment capacity and housing supports can improve treatment outcomes for PEH. Potential strategies to improve SUD services for PEH include providing more contingency management, opioid pharmacotherapies, programming designed to treat individuals with co-occurring mental health disorders, and resources for housing options that can support PEH in their recovery.

Alcohol Use Intensity Decreases in Response to Successful Smoking Cessation Therapy.

Smokers frequently drink heavily. However, the effectiveness of smoking cessation therapy for those with comorbid alcohol abuse is unclear, and the content of smoking cessation programs often does not address comorbid alcohol consumption. In order to achieve a better understanding of the relationship between changes in rate of smoking to the change in intensity of alcohol consumption, and the necessity for alcohol-specific programming for dual users, we quantified cigarette and alcohol consumption in 39 subjects undergoing a 3-month contingency management smoking cessation program using recently developed DNA methylation tools. Intake alcohol consumption, as quantified by the Alcohol T Score (ATS), was highly correlated with cg05575921 smoking intensity (adjusted R2 = 0.49) with 19 of the 39 subjects having ATS scores indicative of Heavy Alcohol Consumption. After 90 days of smoking cessation therapy, ATS values decreased with the change in ATS score being highly correlated with change in cg05575921 smoking intensity (adjusted R2 = 0.60), regardless of whether or not the subject managed to completely quit smoking. We conclude that alcohol consumption significantly decreases in response to successful smoking cessation. Further studies to determine whether targeted therapy focused on comorbid alcohol use increases the success of smoking cessation in those with dual use should be explored.

Contingency management for alcohol use disorder reduces cannabis use among American Indian and Alaska Native adults

ObjectiveDetermine whether a culturally tailored contingency management (CM) intervention targeting alcohol abstinence resulted in secondary effects on cannabis use among American Indian and Alaska Native (AI/AN) adults. MethodsThe research team conducted this secondary data analysis to examine cannabis abstinence using data from a randomized control trial of CM for alcohol use among three AI/AN-serving organizations. One hundred and fifty-eight adults met the randomization criteria (i.e., submission of 50% or more urine samples and one alcohol-positive urine test during a 4-week, pre-randomization, observation period). For 12 weeks after randomization, participants received incentives for submitting a urine test negative for ethyl glucuronide (EtG < 150 ng/mL, CM group) or incentives for submitting a urine sample regardless of abstinence (Non-contingent [NC] Control group). Generalized linear mixed effects models assessed group differences in cannabis abstinence during the intervention, verified by urine tetrahydrocannabinol negative tests (11-nor-delta-9-tetrahydrocannabinol-9-carboxylic acid <50 ng/mL). ResultsAt baseline, 42.2% (n = 35) of participants in the NC group and 40.0% (n = 30) of those in the CM group had a cannabis positive urine test. An overall intervention by time interaction was detected for a cannabis negative urine test (χ2 = 13.40, p = 0.001). Compared to the NC group, the CM group had 3.92 (95% CI:1.23–12.46) times higher odds of having a cannabis negative urine test during the intervention period and 5.13 (95% CI:1.57–16.76) times higher odds of having a negative cannabis test at the end of intervention period. ConclusionCM addressing alcohol misuse may be an effective strategy for decreasing cannabis use among AI/AN adults. Trial registrationClinicalTrials.gov number, Identifier: NCT02174315

A Smartphone-Smartcard Platform for Implementing Contingency Management in Buprenorphine Maintenance Patients With Concurrent Stimulant Use Disorder.

Background and Objectives: Opioid agonist pharmacotherapies are effective in the treatment of opioid use disorder (OUD) but concurrent stimulant use is common and can lead to relapse and treatment drop out. Contingency management in combination with opioid agonist pharmacotherapy has broad beneficial effects in polysubstance users, including promoting drug abstinence and treatment retention, but clinic-based implementation can be burdensome. The present study was conducted to evaluate a contingency management intervention delivered via a smartphone-smartcard platform in OUD patients who had concurrent stimulant use disorder.Methods: Retrospective comparison of (n = 124) patients; half received the contingency management intervention and half were matched controls. Drug use and clinic attendance outcomes over four consecutive 30-day periods were analyzed with regression.Results: The intervention group showed consistently higher rates of drug abstinence and clinic attendance which were significant at the latter two timepoints.Discussion: Smartphone-smartcard platforms can facilitate dissemination of contingency management by surmounting or obviating key barriers to adoption. They appear to be convenient for all stakeholders, are easy to use, and facilitate high-fidelity implementation. Delivering contingency management via a smartphone-smartcard platform produces effects consistent with those observed when the intervention is delivered with substantially costlier and more burdensome in-person procedures.

Classic psychedelics in the treatment of substance use disorder: Potential synergies with twelve-step programs.

Several pilot studies have provided evidence supporting the potential of classic psychedelics like psilocybin in the treatment of substance use disorders (SUDs). If larger trials confirm efficacy, classic psychedelic-assisted psychotherapy may eventually be integrated into existing addiction treatments such as cognitive behavioral therapy, contingency management, and medication-assisted therapies. Many individuals seeking treatment for SUDs also join twelve-step facilitation (TSF) programs like Alcoholics Anonymous (AA), which are among the most widely available and accessed treatments for alcohol use disorder worldwide. For such individuals, engaging in classic psychedelic-assisted psychotherapy could be seen as controversial, as members of AA/TSF programs have historically rejected medication-assisted treatments in favor of a pharmacotherapy-free approach. We argue that classic psychedelics and the subjective experiences they elicit may represent a special, more compatible case than conventional medications. In support of this claim, we describe Bill Wilson's (the founder of AA) little known experiences with psychedelics and on this basis, we argue that aspects of classic psychedelic treatments could complement AA/TSF programs. We provide a review of clinical trials evaluating psychedelics in the context of SUDs and discuss their potential large-scale impact should they be ultimately integrated into AA/TSF.

Quality of life during a randomized trial of a therapeutic-workplace intervention for opioid use disorder: Web-based mobile assessments reveal effects of drug abstinence and access to paid work

BackgroundEmployment and improved quality of life (QOL) are, separately, valued outcomes of substance use disorder (SUD) treatment. It is also important to understand QOL changes caused by employment itself; therefore, we assessed QOL during a randomized trial of a contingency-management-based Therapeutic Workplace for people with opioid use disorder. MethodsFor 12 weeks, participants (n = 61) responded to QOL questionnaires in a mobile web app accessed with study-issued smartphones. At enrollment, participants were randomized to work in the Therapeutic Workplace immediately (immediate work group, IWG) or after a 3-week waitlist delay (delayed work group, DWG). Once both groups could work, wage-resetting contingencies were introduced for their opiate- and cocaine-urinalysis. Data were analyzed by (1) access to work with and without contingencies and (2) overall urinalysis-verified opiate- and cocaine-abstinence. ResultsDWG and/or IWG reported improvements in several QOL areas (sleep, transportation, recreation); however, they also reported increased money-related difficulties and less time spent with friends/family. These changes did not coincide with DWG's work access, but some (more sleep, money-related difficulties) coincided with the urinalysis contingencies. Greater opiate- and/or cocaine-abstinence was also associated with several improvements: sleep, paying bills, time spent with friends/family, and exercising. Surprisingly, intermediate cocaine abstinence was associated with reductions in work-capacity satisfaction and recreation. ConclusionsParticipants reported complex QOL differences during their experimental employment and associated with drug abstinence. Future work should help participants address issues that may be relevant to employment generally (e.g., time with friends/family) or contingency management specifically (e.g., money-related issues for non-abstinent participants).

Sustainment of contingency management within opioid treatment programs: COVID-related barriers and innovative workflow adaptations

IntroductionContingency Management (CM) is one of the most effective interventions for persons with opioid use disorder, but one of the least available interventions in community settings, including opioid treatment programs. Project MIMIC is a NIDA-funded cluster randomized trial that is measuring CM implementation and sustainment across 30 opioid treatment programs in the New England region of the United States. The advent of the COVID-19 pandemic occurred in the midst of Project MIMIC's first cohort of eight opioid treatment programs, presenting a natural opportunity to document and analyze novel challenges to CM sustainment. Utilizing both quantitative and qualitative data collection, we aimed to identify both COVID-related barriers to CM sustainment and innovative workflow strategies to mitigate these barriers. MethodsQuantitative analysis was conducted using data collected from a study-specific CM tracker tool on various CM implementation metrics over three distinct, successive time intervals: prior to COVID-19 social distancing orders with active support; during COVID-19 social distancing orders with active support; and during COVID-19 social distancing orders after removal of support. Semi-structured qualitative interviews were conducted with a representative from each of the eight opioid treatment programs. Using a reflexive team approach, transcripts were coded by independent raters to identify both COVID-related barriers to sustainment and innovative workflow adaptations. ResultsQuantitative data revealed a substantial decrease in the number of CM encounters following social distancing orders from 31.8 encounters weekly across eight programs to 6.9 encounters weekly across five programs. A further decline to 1.8 weekly encounters across three programs was observed after implementation support was removed. Four COVID-related barriers were identified via thematic analysis: fear of contagion; difficulty engaging patients remotely; challenges re-defining the CM attendance target due to changing regulations; and staff shortages. Potential adjustments discussed to help address one or more of these barriers included an electronic prize generator; use of technology to promote engagement; brief individual remote check-ins; and expansion of training to non-counseling staff. ConclusionAlthough CM implementation challenges emerged during the pandemic, associated workflow adaptations also emerged. The feedback solicited in this study will inform multi-level strategies to aid with CM sustainment post-pandemic.

Optimizing outpatient treatment outcomes among methamphetamine-using gay and bisexual men through a computerized depression intervention

Introduction: Depression is a common sequelae of frequent methamphetamine use, and may influence rates of engagement in sexual risk-taking among methamphetamine-using cisgender gay, bisexual, and other men who have sex with men (GBMSM). The study team hypothesized that layering a brief, computerized depression intervention (i.e., MoodGym; based on Cognitive Behavioral Therapy [CBT] and Interpersonal Therapy) on top of a long-running outpatient methamphetamine treatment program (based on CBT and Contingency Management) for GBMSM could optimize reductions in methamphetamine use and sexual risk-taking among program participants. Methods: This pilot study, which also included analysis of historical data, employed nearest-neighbor matching algorithms to match current pilot study participants (N = 39) to prior participants of an outpatient methamphetamine treatment program (N = 703) and employed treatment effects analyses to determine the observed effects of adding depression intervention content to GBMSM-specific methamphetamine treatment. Results: Pilot study participants who received the MoodGym intervention were significantly less likely to submit methamphetamine-metabolite positive urine samples (Adjusted Treatment Effect [ATE] = −0.72; p < 0.01), and evidenced significantly greater reductions in receptive condomless anal intercourse with non–primary partners in the past 30 days (ATE = −1.39; p < 0.05), relative to prior participants of the outpatient methamphetamine treatment program who did not receive depression intervention content. Conclusion: Preliminary results suggest layering a brief computerized depression intervention onto outpatient methamphetamine treatment for GBMSM may optimize reductions in methamphetamine use and/or sexual risk-taking.

SAMHSA keeps $75/$15 CM limits despite methamphetamine epidemic, OIG ruling

The rule that patients can only get $75 a year as part of contingency management (CM) treatment is, in fact, nonexistent, as of last year's ruling by the Department of Health and Human Services Office of Inspector General (OIG) (see “CM for stimulant use disorder: No limit imposed by OIG,” ADAW Nov. 8; https://onlinelibrary.wiley.com/doi/full/10.1002/adaw.33255). However, the Substance Abuse and Mental Health Services Administration (SAMHSA) still has that rule for all of its funding.

CM for stimulant use disorder: No limit imposed by OIG

The oft‐stated assumption that the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) bans any gifts of $75 or more as a contingency in the treatment of stimulant use disorder is incorrect. From the Federal Register announcement: “Gifts that implicate the Beneficiary Inducements CMP that exceed these dollar limits are not prohibited but are analyzed on a case‐by‐case basis for compliance under the statute,” according to the OIG December 2020 Federal Register final rule (https://www.federalregister.gov/documents/2020/12/02/2020‐26072/medicare‐and‐state‐health‐care‐programs‐fraud‐and‐abuse‐revisions‐to‐safe‐harbors‐under‐the). “We highlight, however, that this nominal value guidance applies to the value of in‐kind items and services, not to the value of incentive payments in the form of cash or cash equivalents. In other words, cash and cash‐equivalent payments under $75 would not be covered by this guidance. Moreover, this guidance applies only with respect to the Beneficiary Inducements CMP and not to the Federal anti‐kickback statute. Furthermore, we are aware that some industry stakeholders may be under a misimpression that OIG prohibits contingency management program incentives above $75. There is no OIG‐imposed $75 limitation on contingency management program incentives. Rather, the Federal anti‐kickback statute may constrain the ability of individuals or entities to offer contingency management program incentives of any value to Federal health care program beneficiaries, depending on the facts of the arrangement. Moreover, in‐kind incentives above the $75 annual, aggregate limit, and all cash or cash‐equivalent incentives regardless of the amount, must be analyzed on the basis of their specific facts for compliance with the Beneficiary Inducements CMP.”

Pharmacotherapy treatment of stimulant use disorder.

Stimulant use disorder (SUD) is a public health problem in the United States that is associated with increased morbidity and mortality. Psychosocial interventions, such as cognitive behavioral therapy and contingency management, are the main treatment modality for SUDs and no pharmacotherapy is currently FDA approved for this indication. Although some medications show promising data for the treatment of SUD, the evidence remains inconsistent, and the clinical application is limited due to the heterogenicity of the population and the lack of studies in patients with various comorbidities. Selection of pharmacotherapy treatment for methamphetamine intoxication, persistent methamphetamine-associated psychosis with methamphetamine use disorder, and cocaine use disorder in patients with co-occurring OUD are discussed in 3 patient cases.

Improving Communication Ability of a Child with Selective Mutism Through “Kita Semua Sahabat” Training

Selective Mutism (SM) is characterized by failure to speak at some period of time in specific social situations (e.g., at school), but can talk in other familiar situations (home). This study aimed to determine the effectiveness of ‘Kita Semua Sahabat’ in improving communication skills in children with SM. The subject was a 5 year-old boy who had been diagnosed based on DSM-V. The research design was a single case experimental design. Interventions were performed using the technique of stimulus fading and contingency management which were packed through the training of ‘Kita Semua Sahabat’. The result showed that there was a significant increase, and communication with stimulus (prompts) had a greater increase than communication without stimulus (child’s initiation). The research showed that Training ‘Kita Semua Sahabat’ is effective to increase communication among children with SM, and more frequent verbal communication happens if more stimuli were given to the child.

Quantifying supply chain disruption: a recovery time equivalent value at risk approach

ABSTRACT The global pandemic COVID-19 has disrupted supply chains in many industries all over the world. If not well contained and managed at an early stage, such unprecedented disruptions may lead to even more serious consequences in the era of supply chain reglobalization. The attendant challenge for research and practice is on how to readily measure and quantify the disruption risk. To address the plethora of concerns, this article presents a recovery time equivalent (RTE) disruption risk measurement model using Value at Risk (VaR). We consider a disruption recovery model comprising abrupt, normal, fast, and slow modes. To demonstrate the practical relevance of our study, we establish a case study with a multinational corporation from the IT sector. Decision makers and supply chain managers can use the model to conduct ‘what-if' analyses on their supply chain vulnerabilities and risks for a more proactive business continuity planning and contingency management.

How Confirmation Bias Influences Risk and Contingency Management

Abundant research has documented the negative effects of confirmatory bias in a broad range of managerial decision-making contexts. However, insufficient research has been conducted on the effect of confirmatory bias on risk and contingency management. This article addresses the research gap by examining how confirmatory bias may affect global leaders’ responses to the COVID-19 pandemic. Based on a comprehensive literature review of prior research and empirical evidence, the authors illustrate the relationship between confirmatory bias and organizational performance in disaster management and identify several important mediators and moderators, which influence the relationship between confirmatory bias and the performance of human collectives in disaster management.

Project MIMIC (Maximizing Implementation of Motivational Incentives in Clinics): A cluster-randomized type 3 hybrid effectiveness-implementation trial

BackgroundOpioid-related overdoses and harms have been declared a public health emergency in the United States, highlighting an urgent need to implement evidence-based treatments. Contingency management (CM) is one of the most effective behavioral interventions when delivered in combination with medication for opioid use disorder, but its implementation in opioid treatment programs is woefully limited. Project MIMIC (Maximizing Implementation of Motivational Incentives in Clinics) was funded by the National Institute on Drug Abuse to identify effective strategies for helping opioid treatment programs improve CM implementation as an adjunct to medication. Specific aims will test the impact of two different strategies on implementation outcomes (primary aim) and patient outcomes (secondary aims), as well as test putative mediators of implementation effectiveness (exploratory aim).MethodsA 3-cohort, cluster-randomized, type 3 hybrid design is used with the opioid treatment programs as the unit of randomization. Thirty programs are randomized to one of two conditions. The control condition is the Addiction Technology Transfer Center (ATTC) Network implementation strategy, which consists of three core approaches: didactic training, performance feedback, and on-going consultation. The experimental condition is an enhanced ATTC strategy, with the same core ATTC elements plus two additional theory-driven elements. The two additional elements are Pay-for-Performance, which aims to increase implementing staff’s extrinsic motivations, and Implementation & Sustainment Facilitation, which targets staff’s intrinsic motivations. Data will be collected using a novel, CM Tracker tool to document CM session delivery, session audio recordings, provider surveys, and patient surveys. Implementation outcomes include CM Exposure (number of CM sessions delivered per patient), CM Skill (ratings of CM fidelity), and CM Sustainment (number of patients receiving CM after removal of support). Patient outcomes include self-reported opioid abstinence and opioid-related problems (both assessed at 3- and 6-months post-baseline).DiscussionThere is urgent public health need to improve the implementation of CM as an adjunct to medication for opioid use disorder. Consistent with its hybrid type 3 design, Project MIMIC is advancing implementation science by comparing impacts of these two multifaceted strategies on both implementation and patient outcomes, and by examining the extent to which the impacts of those strategies can be explained by putative mediators.Trial registration: This clinical trial has been registered with clinicaltrials.gov (NCT03931174).Registered April 30, 2019. https://clinicaltrials.gov/ct2/show/NCT03931174?term=project+mimic&draw=2&rank=1

Psychotherapeutic interventions for cannabis use disorder. What do we know and what should we do?

BackgroundCannabis use disorder is the most commonly reported illegal substance use disorder and demand for treatment is growing worldwide. ObjectivesOur aim was to compare the two last Cochrane systematic reviews of the literature concerning psychotherapeutic and psychosocial interventions for cannabis use disorder to determine what new evidence emerged and how craving was considered as a treatment mediator. MethodWe extracted raw data from both reviews regarding their titles, objectives, methods and results. This information was analyzed by face validity to distinguish apparent differences from real differences. It enabled us to describe similarities and differences between reviews. We also screened both reviews looking for craving or related words. ResultsThe objective and methods of both reviews were mostly similar. Although the second review covered a wider range of psychotherapies, including drug counseling and mindfulness-based meditation as an intervention group and minimal treatment as a control group. Five of the six studies included in the first review were also included in the second review. One study excluded from the first review was included in the last review that included an additional 17 studies published after the first review. The 2016 review performed a meta-analysis whereas the first review was descriptive. Both reviews supported the efficacy of motivational enhancement therapy and cognitive and behavioral therapy interventions with adjunction of contingency management for abstinence when possible. There was no relevant mention of craving in the 2006 review and very few in the 2016 review. ConclusionThe methods and results of the last two Cochrane reviews on psychosocial interventions for cannabis use disorder were mostly similar. Consistent with other reviews on the same subject and reviews of psychotherapies for other substance use disorders, the 2016 review confirmed evidence already available in the 2006 review. Instead of confirming already confirmed evidence, future research is needed to determine if craving focused treatment would increase efficiency and how to maintain initial treatment outcomes long-term.

Contingent workforce management: a holistic overview

Purpose This paper aims to illustrate a simple, holistic overview of contingent workforce management. Design/methodology/approach This paper’s viewpoint outlines benefits and challenges that employers and employees encounter with contingent work arrangements and highlights relevant human resource (HR) practices to effectively manage contingent workforce. Findings Benefits to employers are cost-effective hiring solutions, filling-up skill requirements, increasing numerical flexibility and diversity and broadened talent pool. Challenges include legal ramifications, hidden costs, confidentiality and security issues, low organisational commitment and productivity. For employees, benefits are working flexibility and financial gain and gaining work experience. Challenges include dependence on economy, irregular work hours, health risks and exploitation and differential treatment by employers. “Value-adding” practices of holistic hiring, onboarding, performance management, workplace training and developing resilient organisational culture can effectively manage contingent workforce. Research limitations/implications This paper provides a broader outline of benefits and challenges, both from employers’ and employees’ perspectives, linked with precarious employment. Further investigations on employers’ and employee’s perspectives based on specific types of contingent work arrangements (e.g. temporary agency workers and gig workers) can give in-depth insights. Originality/value This paper provides a simplified framework of pros and cons of contingent employment, along with practical HR remedies to manage contingent workforce.

Child neurocognitive functioning influences the effectiveness of specific techniques in behavioral teacher training for ADHD: Moderator analyses from a randomized controlled microtrial.

Childhood attention-deficit/hyperactivity disorder (ADHD) is associated with several neurocognitive impairments. Whether these impairments influence the effectiveness of techniques that are commonly used in behavioral teacher training for ADHD has not been investigated so far. In this microtrial, teachers of 90 children with ADHD symptoms (6-12years) were randomly assigned to a short intervention consisting of either antecedent-based (stimulus-control) techniques or consequent-based (contingency management) techniques, or to a waitlist control condition. Primary outcome was the daily assessment of individually selected problem behavior, assessed pre- and post-intervention. Potential neurocognitive moderators of treatment effect included teacher ratings of cognitive control, reward, and punishment sensitivity, and measures derived from computerized neurocognitive tasks, including attentional lapses, interference control, visuospatial working memory, and emotional functioning. Intervention condition by moderator interactions were assessed in separate multilevel mixed models. Lapses of attention, working memory, and emotional functioning interacted with intervention effectiveness. Antecedent-based techniques were effective independent of these neurocognitive functions; consequent-based techniques were (more) effective when these functions were more impaired. The effectiveness of techniques was neither related to interference control nor to teacher-rated neurocognitive functioning. This study showed that child neurocognitive functioning influences the effectiveness of behavioral teacher techniques for children with ADHD symptoms. Findings suggest that antecedent-based techniques may be effective for all children, while consequent-based techniques have added value particularly for children who suffer from low visuospatial working memory, low emotional functioning, and/or large numbers of attentional lapses.