Kirby Kimberly C, Benishek Lois A, Dugosh Karen Leggett, Kerwin Marylouise E
Treatment Research Institute, 600 Public Ledger Building, 150 S. Independence Mall West, Philadelphia, PA 19106, USA.
Drug Alcohol Depend. 2006 Oct 15;85(1):19-27. doi: 10.1016/j.drugalcdep.2006.03.010. Epub 2006 May 2.
Contingency management (CM) interventions are among the most effective methods for initiating drug abstinence, but they infrequently have been adopted by community drug and alcohol treatment programs. The primary purpose of this investigation was to determine the prevalence of specific beliefs that community treatment providers hold regarding contingency management interventions. We surveyed 383 treatment providers from three geographical areas of the United States regarding moral or ethical objections, negative side effects, practicality, limitations and positive opinions regarding tangible and social CM interventions. Results indicate that positive beliefs were surprisingly prevalent, with providers agreeing with an average of 67% of the positive statements regarding CM using tangible incentives and 54% indicating that they would be in favor of adding a tangible CM intervention to their treatment program. The most prevalent objections to incentive programs were that they cost too much, fail to address the underlying problems of addiction, and do not address multiple behaviors. Social incentives were viewed more favorably than tangible incentives and both were viewed more positively by providers who were supervisors, had advanced degrees, had more addictions experience, and had previous experience with tangible incentives. These findings have implications for improving the dissemination of this empirically-supported treatment.
应急管理（CM）干预措施是促使戒毒的最有效方法之一，但社区戒毒和戒酒治疗项目却很少采用。本调查的主要目的是确定社区治疗提供者对应急管理干预措施持有的特定信念的普遍程度。我们对来自美国三个地理区域的383名治疗提供者进行了调查，内容涉及道德或伦理方面的反对意见、负面副作用、实用性、局限性以及对物质和社会CM干预措施的积极看法。结果表明，积极信念出奇地普遍，提供者平均同意67%关于使用物质奖励的CM的积极陈述，54%表示他们会赞成在其治疗项目中增加物质CM干预措施。对奖励计划最普遍的反对意见是成本太高、未能解决成瘾的根本问题以及未涉及多种行为。社会奖励比物质奖励更受青睐，而且主管、拥有高级学位、有更多成瘾治疗经验以及曾有过物质奖励经验的提供者对两者的评价都更积极。这些发现对改进这种经实证支持的治疗方法的推广具有启示意义。
