Computerized Contingency Management for Motivating Behavior Change: Automated Tracking and Dynamic Reward Reinforcement Management

Contingency management has been successfully used to reinforce abstinence in drug-dependent patients. The major challenge associated with this technique, however, is its likely prohibitive cost especially when the reinforcement follows an escalating amount schedule. At our clinic, we have implemented a less costly approach involving prize draws as the reinforcer. Workflow challenges of such an implementation are extensive considering varying conditions concurrently used in various protocols for meeting inclusion criteria, stratifying into various groups, tracking categories of prizes, determining eligibility for bonus draws based on laboratory results, etc. To address these challenges we implemented the automated contingency management (ACM) decision support system for dynamic reward reinforcement in the study of treatment of cocaine and opiates. A discussion of the results of our research as well as possible insight into some of our findings provided by ACM is presented in this paper.