Microsoft word - community reinforcement approaches annotated bib.doc

1. Subject Area: Community Reinforcement Approaches
Manual Two of Therapy Manuals for Drug Addiction. A Community Reinforcement Plus Vouchers Approach: Treating
Cocaine Addiction
Author/s

Individualized or Group Outcome/s
Subjects Info
Randomized Controlled
Generalizable to Iowa?
Intervention?
Measures
interventions are involved is a treatment
Citation
Budney, A., & Higgins, ST. (1994). A community reinforcement plus vouchers approach: treating cocaine addiction (NIDA Publication No. 98-4309 ed.).
Rockville, Maryland: National Institute on Drug Abuse. Abstract/Results/Notes: This NIDA curriculum is a psychosocial treatment that follows the Community Reinforcement Approach (CRA) introduced by Myers
and Smith in 1995. Early CRA development included: a prescription for disulfiram; reciprocity marriage counseling; job club support; social skills training;
social and recreational advice; and help with controlling urges to drink. The NIDA curriculum integrates the Community Reinforcement Approach and includes
a voucher program for creating an abstinence contract, urinalysis monitoring, and contingency rewards based on clean UAs. It is designed as a 24-week
program. Randomized controlled trials by Silverman and Higgins provide support that vouchers increased cocaine and other drug abstinence.
Current clinical literature supports the component interventions for improved social support, social skills, employment training, risk management and family involvement regardless of the use of a voucher/reward contingency for remaining clean and sober. The curriculum can be adapted to shorter periods of treatment time. 2. Subject Area: Community Reinforcement Approaches
The Community Reinforcement Approach
Author/s

Individualized or Group Outcome/s
Subjects Info
Randomized Controlled
Generalizable to Iowa?
Intervention?
Measures

Citation
Sisson, R. W., & Azrin, N. H. (1989). The community reinforcement approach (Chapter 16) . R. Hester, & W. Miller Handbook of Alcoholism Treatment
Abstract/Results/Notes: Chapter Sixteen in this handbook examines early Community Reinforcement Approach development by Azrin and Hunt (1973) with
alcoholic populations. The chapter provides a good review of the basic components of CRA.
3. Subject Area: Community Reinforcement Approaches
A Community Reinforcement Approach to Addiction Treatment
Author/s

Individualized or Group Outcome/s
Subjects Info
Randomized Controlled
Generalizable to Iowa?
Intervention?
Measures
rewards and sanctions for negative UAs are not used in Iowa.
Citation
Meyers, R. J., & Miller, W. R. (2001). A community reinforcement approach to addiction treatment (International Research Monographs in the Addictions . UK:
Abstract/Results/Notes: This text provided extensive information regarding the comparisons of Community Reinforcement Approaches (CRA) with other
traditional treatment approaches. Chapter 5 described trials that supported CRA use with drug abusers. The science quality for the alcohol research in Chapter 5
was weak. Careful examination of the tables indicated that the abstinence rates are not that much better over time.
Much of the resistance for CRA approaches is connected to the cost of vouchers or rewards for negative UAs or for positive behavior changes. There is science
available by Nancy Petry that argues the point about cost, suggesting that the cost benefits will become clear over the long-term. More time is needed for data
collection and science to be able to show the value.
This book would be a good resource for anyone trying to ascertain what would be involved in developing a CRA intervention.

4. Subject Area: Community Reinforcement Approaches
Increasing opiate abstinence through voucher-based reinforcement therapy
Author/s

Individualized or Group Outcome/s
Subjects Info
Randomized Controlled
Generalizable to Iowa?
Intervention?
Measures

Citation
Silverman, K., Wong, C. J., Higgins, S. T., & et al. (1996). Increasing opiate abstinence through voucher-based reinforcement therapy. Drug and Alcohol
Abstract/Results/Notes: This was a small sample study that examined the effectiveness of voucher-based abstinence reinforcement in reducing opiate use by
patients receiving methadone maintenance treatment. Using within-subject reversal design, subjects were given vouchers for negative screens for opiate use and
later in treatment were assessed for opiate use with the vouchers removed from the method. The percentage of positive screens for opiates decreased
significantly when the voucher program was in place and increased when the voucher program was discontinued.

5. Subject Area: Community Reinforcement Approaches
Achieving Cocaine Abstinence with a Behavioral Approach
Author/s

Individualized or Group Outcome/s
Subjects Info
Randomized Controlled
Generalizable to Iowa?
Intervention?
Measures

Citation
Higgins, S. T., Budney, A. J., Bickel, W. K., & et al. (1993). Achieving cocaine abstinence witha behavioral approach. American Journal of Psychiatry, 150,
Abstract/Results/Notes: Fifty-eight percent (58%) of those receiving the behavioral Community Reinforcement Approach (CRA) plus incentive program
finished 24 weeks of treatment vs. 11% of those receiving standard drug abuse counseling.
Sixty-eight percent (68%) vs. 11% achieved 8 weeks of continuous cocaine abstinence. 42% vs. 5% achieved 16 weeks of continuous cocaine abstinence.
The behavioral treatment (CRA) is well received by cocaine users as is the use of incentives. Cost of the incentives ($12.00/per day per client for the first twelve
weeks) and cost of the monitoring with drug screens and UAs.
6. Subject Area: Community Reinforcement Approaches
Low-Cost Contingency Management for Treating Cocaine- and Opioid-Abusing Methadone Patients
Author/s

Individualized or Group Outcome/s
Subjects Info
Randomized Controlled
Generalizable to Iowa?
Intervention?
Measures

Citation
Petry, N., & Martin, B. (2002). Low-cost contingency management for treating cocaine-and opioid-abusing methadone patients. Journal of Consulting and
Abstract/Results/Notes: Subjects were randomly assigned to twelve weeks of standard treatment (control) or standard treatment plus contingency management
(CM) procedures. Clients in both groups participated in a random drug screen plan. The plan was to offer low-cost prizes/rewards for positive behaviors. Prices
ranged from $1 to $100 for negative drug tests for cocaine and opioids.
Patients in the standard plus CM assignment achieved longer continuous abstinence lengths, and the effects were maintained through a 6-month follow-up.

Petry’s research was an effort to support behavioral interventions like CRA and posit that less expensive and manageable contingency management used as
reinforcers are possible in community-based treatment settings.
7. Subject Area: Community Reinforcement Approaches
Fishbowls and Candy Bars: Using Low-Cost Incentives to Increase Treatment Retention
Author/s

Individualized or Group Outcome/s
Subjects Info
Randomized Controlled
Generalizable to Iowa?
Intervention?
Measures

Citation
Petry, N., & Bohn, M. J. (2003). Fishbowls and candy bars: using low-cost incentives to increase treatment retention. Science and Practice Perspectives, 2, 55-61.
Abstract/Results/Notes: A preliminary and yet interesting discussion of research demonstration in support of contingency management incentives and the
particular uses and benefits perceived in clinical settings. The article addressed the issues of cost effectiveness arguing that retention in treatment and increasing
the time before “return to using” may provide considerable cost effectiveness over the long term. The article was a call for more carefully monitored research.
8. Subject Area: Community Reinforcement Approaches
A systematic review of the effectiveness of the community reinforcement approach in alcohol, cocaine, and opioid addiction.
Author/s

Individualized or Group Outcome/s
Subjects Info
Randomized Controlled
Generalizable to Iowa?
Intervention?
Measures

Citation
Roozen, H. G., Boulogne, J. J., van Tulder, M. W., van den Brink, W., De Jong, C. A., & Kerkhof, A. J. (2004). A systematic review of the effectiveness of the
community reinforcement approach in alcohol, cocaine and opioid addiction. [Review] [70 refs]. Drug & Alcohol Dependence, 74(1), 1-13. Abstract/Results/Notes: The article is a review of eleven high-quality randomized controlled trial studies focusing on substance abuse. The objective was to
compare the effectiveness of CRA compared to usual care and CRA versus CRA with contingency management. There is considerable evidence that CRA is
more effective than treatment as usual when related to number of drinking days and less clear evidence regarding continuous abstinence. Moderate evidence is
available that CRA with disulfiram is more effective related to number of drinking days and no difference for continuous abstinence. CRA’s with incentives are
more effective for opioid detox programs, and limited evidence to support that CRA is more effective in methadone maintenance programs. Abstinence-
contingent incentives are more effective than non-contingent incentives in treatments aimed at cocaine abstinence.

Source: http://iconsortium.subst-abuse.uiowa.edu/SKIPBiblios/AnnoBibCommunityReinforcement.pdf

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