Contingency Management for Persons With Severe Mental Illness

Contingency management is efficacious for treating cocaine abuse, but contingency management
interventions have rarely been applied to patients with severe and persistent mental health
problems. This pilot project will estimate effect sizes of contingency management for
reducing cocaine use in patients receiving psychiatric care at a large community based
mental health program. In total, 30 cocaine abusing patients will be randomized to one of
two 8-week treatment conditions: standard care or standard care with contingency management.
Patients in both conditions will provide breath and urine samples for toxicology testing
twice per week. In the contingency management condition, patients will receive the
opportunity to win prizes for submitting cocaine negative urine samples. The investigators
expect that patients receiving contingency management will evidence reductions in cocaine
use and may show improvements in psychiatric symptoms and psychosocial functioning relative
to patients in standard care. Effect size estimates obtained from this study will be used to
guide larger scale and longer duration evaluations of contingency management for dually
diagnosed patients.