What is the primary purpose of contingency management in substance use treatment?

• A. To punish relapse.
• B. To reinforce positive behaviors through tangible rewards.
• C. To provide long-term psychotherapy.
• D. To isolate individuals.

Answer: (B)

Contingency management is based on operant conditioning: positive behaviors are reinforced with tangible rewards to increase how often they occur. In substance use treatment, clients earn incentives—such as vouchers, prizes, or privileges—when they meet targets like providing drug-free urine samples, attending sessions, or following prescribed medications. Because the reinforcement is immediate, it strengthens abstinence by making the reward more immediate than the effects of drug use. It’s a behavioral tool, not punishment, and it’s used alongside other therapies to support engagement and ongoing abstinence. For example, small rewards might be given for a negative test, with the opportunity for larger rewards for consecutive negative tests, encouraging sustained effort.