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Psychol Addict Behav. 2003 Mar;17(1):73-82.

Cognitive-behavioral therapy plus contingency management for cocaine use: findings during treatment and across 12-month follow-up.

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Clinical Pharmacology and Therapeutics Branch, National Institute on Drug Abuse, Intramural Research Program Treatment Section, Baltimore, Maryland 21224, USA.


Contingency management (CM) rapidly reduces cocaine use, but its effects subside after treatment. Cognitive-behavioral therapy (CBT) produces reductions months after treatment. Combined, the 2 might be complementary. One hundred ninety-three cocaine-using methadone-maintained outpatients were randomly assigned to 12 weeks of group therapy (CBT or a control condition) and voucher availability (CM contingent on cocaine-negative urine or noncontingent). Follow-ups occurred 3, 6, and 12 months posttreatment. Primary outcome was cocaine-negative urine (urinalysis 3 times/week during treatment and once at each follow-up). During treatment, initial effects of CM were dampened by CBT. Posttreatment, there were signs of additive benefits, significant in 3- versus 12-month contrasts. Former CBT participants were also more likely to acknowledge cocaine use and its effects and to report employment.

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