Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington 98104-2499, USA.
Am J Addict. 2013 Sep-Oct;22(5):432-6. doi: 10.1111/j.1521-0391.2013.00333.x.
Emerging evidence supports the effectiveness of contingency management (CM) for addictions treatment among individuals with co-occurring serious mental illness (SMI). Addiction treatment for people with SMI generally occurs within community mental health centers (CMHCs) and it is not known whether CM is acceptable within this context. Client views regarding CM are also unknown.
This study is the first to describe CM acceptability among CMHC clinicians, and the first to explore client views. Clinician-level predictors of CM acceptability are also examined.
This study examined views about CM among 80 clinicians and 29 clients within a CMHC within the context of a concurrent CM study.
Three-quarters of clinicians reported they would use CM if funding were available. Clinicians and clients affirmed that incentives enhance abstinence motivation. Clinician CM acceptability was related to greater years of experience, and identifying as an addictions or co-occurring disorders counselor, more than a mental health clinician.
The findings provide preliminary evidence that CMHC clinicians, serving clients with addictions and complicating SMI, and client participants in CM, view CM as motivating and a positive tool to facilitate recovery.
As an evidence-based intervention, CM warrants further efforts toward funding and dissemination in CMHCs.
越来越多的证据支持应急管理(CM)在同时患有严重精神疾病(SMI)的个体的成瘾治疗中的有效性。SMI 患者的成瘾治疗通常在社区心理健康中心(CMHC)进行,目前尚不清楚在这种情况下 CM 是否可行。关于 CM 的客户意见也不得而知。
本研究首次描述了 CM 在 CMHC 临床医生中的可接受性,也是首次探索了客户的意见。还研究了临床医生对 CM 接受程度的预测因素。
本研究在 CMHC 内进行的一项同时进行的 CM 研究背景下,检查了 80 名临床医生和 29 名客户对 CM 的看法。
四分之三的临床医生表示,如果有资金,他们将使用 CM。临床医生和客户都肯定激励措施增强了戒除动机。临床医生对 CM 的接受程度与更多的工作年限以及将自己认定为成瘾或共病障碍顾问有关,而不是心理健康临床医生。
这些发现初步表明,为成瘾患者提供服务的 CMHC 临床医生和患有 SMI 的患者,以及接受 CM 的患者,将 CM 视为一种激励和促进康复的积极工具。
作为一种循证干预措施,CM 需要进一步努力获得资金和在 CMHC 中传播。