Getty Carol-Ann, Metrebian Nicola, Neale Joanne, Weaver Tim, Strang John
National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Department of Mental Health & Social Work, Faculty of Health, Social Care and Education, Middlesex University, London, UK.
Drug Alcohol Rev. 2025 May;44(4):946-960. doi: 10.1111/dar.14046. Epub 2025 Mar 18.
Contingency management (CM), based on the principles of operant conditioning, uses positive reinforcement to promote behaviour change in individuals with substance use disorder. Research on CM has grown exponentially, with technology being used to expand the reach and scope of these interventions. The views of policy professionals and treatment providers on the remote delivery of CM are likely to play an important role in the development and application of these interventions.
Semi-structured qualitative interviews, analysed using framework analysis, were conducted with 22 UK-based addiction specialists to explore their views on digital CM, including its place within UK drug and alcohol services and future developments. Participants included commissioners, policy professionals and clinicians.
CM was widely acknowledged as an effective, scientifically grounded and appropriate treatment approach for drug treatment and recovery. While addiction specialists see CM as a powerful tool in a comprehensive addiction treatment toolkit, they identify the barriers impeding its implementation, including a lack of awareness among treatment providers, commissioning challenges, resource constraints and ethical concerns. Remote delivery of CM was considered a promising approach for overcoming some of these barriers and enhancing CM delivery and engagement.
Technology needs to be integrated into clinical practice to expand the reach of treatment. While current evidence supports digital CM, concerns about digital literacy, technological barriers, resource constraints, public acceptability and political hesitancy highlight the need for further research to validate its feasibility and to explore the extent to which it should complement, rather than replace, in-person treatment options.
应急管理（CM）基于操作性条件反射原理，运用正强化来促进物质使用障碍患者的行为改变。关于CM的研究呈指数级增长，技术被用于扩大这些干预措施的覆盖范围和适用范围。政策专业人员和治疗提供者对CM远程交付的看法可能会在这些干预措施的开发和应用中发挥重要作用。
对22名英国成瘾专家进行了半结构化定性访谈，并采用框架分析法进行分析，以探讨他们对数字CM的看法，包括其在英国毒品和酒精服务中的地位以及未来发展。参与者包括专员、政策专业人员和临床医生。
CM被广泛认为是一种有效、有科学依据且适用于药物治疗和康复的治疗方法。虽然成瘾专家将CM视为综合成瘾治疗工具包中的有力工具，但他们也指出了阻碍其实施的障碍，包括治疗提供者缺乏认识、委托方面的挑战、资源限制和伦理问题。CM的远程交付被认为是克服其中一些障碍并加强CM交付和参与度的一种有前景的方法。
需要将技术整合到临床实践中，以扩大治疗范围。虽然目前的证据支持数字CM，但对数字素养、技术障碍、资源限制、公众接受度和政治犹豫的担忧凸显了进一步研究的必要性，以验证其可行性，并探索其应在多大程度上补充而非取代面对面治疗选择。
