The Efficacy of Contingency Management for Adolescent Cannabis Use Disorder: A Controlled Study

ABSTRACT

Background: This study was performed to investigate the efficacy of a voucher-based reinforcement therapy (VBRT) rewarding drug-free urine for adolescents with cannabis use disorder. Methods: A controlled 10-week study where 59 adolescents aged 14–18 years were assigned by cohorts into groups of either an integrated cognitive-behavioral therapy (CBT) and VBRT or CBT with attendance-based reward program. Substance use was monitored by twice-weekly urinalysis. Other measures were collected at pre- and posttreatment and at 3-month follow-up. Results: There was no significant difference in the linear change between conditions for cannabis use either from Sessions 1 to 10 or between end-of-treatment to 3-month follow-up. Also, self-efficacy and coping response did not show improvement during treatment. Conclusions: In this study, the addition of contingency management (CM) to CBT in youth was not found to be more efficacious than similar compensation rewarding attendance only. Continued examination of the efficacy of CM and its interaction with the associated mechanisms of behavior change of CBT in youth is necessary. Examination of the effect of the magnitude of the reward as well as considering the emotional and cognitive developmental differences from adults is warranted.

Keywords:

• Adolescent
• cannabis use disorder
• cognitive-behavioral therapy
• contingency management
• treatment

ACKNOWLEDGMENTS

The authors thank Dr. John Roll from the Washington State University, Spokane, Washington, for his contribution to the design of the study and feedback on the manuscript.

FUNDING

This study was supported by grant 04–033 from the Donaghue Foundation, West Hartford, Connecticut, to Dr. Kaminer. The funding agency was not involved in the work reported or in the composition of the manuscript.

AUTHOR CONTRIBUTIONS

Dr. Kaminer conducted the study, participated in the analysis and the interpretation of the data, and took leadership in writing the paper. Dr. Burleson analyzed, interpreted the data, and participated in writing the paper. Ms. Burke collected and entered the data, participated in data interpretation, and in writing the paper. Dr. Litt participated in the interpretation of the data and contributed to writing the paper.