Figure 5-4. Checklist for Designing CM Programs

1. Choose a behavior• One that is objectively quantifiable, occurs frequently, and is considered to be most important.
• Set reasonable expectations.
2. Choose a reinforcer• Determine available resources (in-house rewards or donations of cash or services from local businesses such as movie theaters and restaurants).
• Identify intangible rewards, such as frequent positive reports to parole officers, flexibility in methadone dosing, and increased freedom (smoke breaks, passes, etc.).
3. Use behavioral principles• Develop a monitoring and reinforcement schedule that is optimized through application of behavioral principles.
• Keep the schedule simple so staff can apply principles consistently and clients can understand what is expected.
4. Prepare a behavioral contract• Draw up a contract for the target behavior that considers the monitoring system and reinforcement schedule.
• Be specific and consider alternate interpretations; have others review the contract and comment.
Include any time limitations.
5. Implement the contract• Ensure consistent application of the contract; devise methods of seeing that staff understands and follows procedures.
• Remind the client of behaviors and their consequences (their “account balance” and what is required to obtain a bonus) to increase the probability that the escalating reward system will have the desired effect.

Source: Petry 2000a .

From: 5 Strategies for Working With Clients With Co-Occurring Disorders

Cover of Substance Abuse Treatment for Persons With Co-Occurring Disorders
Substance Abuse Treatment for Persons With Co-Occurring Disorders.
Treatment Improvement Protocol (TIP) Series, No. 42.
Center for Substance Abuse Treatment.

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