Department of Psychology, University of Oviedo, Asturias, Spain.
Eur Addict Res. 2011;17(3):139-45. doi: 10.1159/000324848. Epub 2011 Mar 29.
The community reinforcement approach (CRA) with vouchers is a well-established program developed for the treatment of cocaine addiction. It involves an incentive program in which patients earn vouchers that can be exchanged for goods or services contingent upon abstinence from cocaine use.
To examine the contributions of incentives to retention, abstinence, and psychosocial outcomes in the CRA+vouchers program at the 12-month follow-up.
58 cocaine addicts were randomly assigned to CRA treatment with or without an added incentive program in a community setting for cocaine dependence in Spain.
65.5% of patients in the group with vouchers completed 12 months of treatment, versus 48.3% in the no-voucher group. In the CRA+vouchers group, mean percentage of cocaine-negative samples was 95.76%, versus 79.31% in the group without vouchers. There were significant improvements in psychosocial functioning in both treatments, but when differences were observed, they supported CRA with vouchers over CRA alone.
Combining CRA with incentives improves treatment outcomes in cocaine-dependent outpatients. Additive benefits of vouchers remain 6 months after the incentive program ends.
凭券的社区强化治疗（CRA）是一种成熟的可卡因成瘾治疗方案，它涉及一个激励计划，患者可凭戒断可卡因使用的记录获得凭证，凭券可兑换商品或服务。
在西班牙的社区环境中，为可卡因依赖患者提供 CRA 治疗，考察该治疗中加入激励方案对 12 个月随访时的保留率、戒断和心理社会结局的影响。
58 名可卡因成瘾者被随机分配到 CRA 治疗加或不加额外激励方案组。
有券组 65.5%的患者完成了 12 个月的治疗，而无券组为 48.3%。在 CRA+券组，可卡因阴性样本的平均比例为 95.76%，而无券组为 79.31%。两种治疗方法都显著改善了心理社会功能，但当观察到差异时，CRA+券组优于 CRA 组。
CRA 与激励措施相结合可改善可卡因依赖门诊患者的治疗结局。激励方案结束后 6 个月，券的附加益处仍然存在。
