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Case Reports in Psychiatry
Volume 2012 (2012), Article ID 731638, 7 pages
http://dx.doi.org/10.1155/2012/731638
Case Report

Contingency Management for Patients with Cooccurring Disorders: Evaluation of a Case Study and Recommendations for Practitioners

1Department of Health Disparities Research-Unit 1440, P.O. Box 301402, Houston, TX 77230-1402, USA
2Department of Medicine, University of Connecticut Health Center, Farmington, CT 06030-3944, USA
3G.V. (Sonny) Montgomery VA Medical Center, Jackson, MS 39216, USA
4Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS 39216, USA

Received 1 September 2011; Accepted 10 October 2011

Academic Editors: L. Dell'Osso, T. Hyphantis, and E. Schramm

Copyright © 2012 Claire E. Adams et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Research indicates that contingency management (CM) has potential to improve a number of outcomes (e.g. substance use, treatment attendance, quality of life) among individuals with substance use and cooccurring disorders. However, multiple factors must be considered on a case-by-case basis in order to promote optimal treatment effects. The present study describes an individualized CM protocol for a US Veteran with substance dependence and cooccurring severe mental illness. CM targeted attendance at outpatient appointments and appropriate use of hospital resources. Effects of CM were assessed by comparing the 3-month baseline and CM periods. The CM intervention marginally reduced unnecessary hospital admissions, resulting in cost savings to the medical center of over $5,000 in three months for this individual. However, CM did not affect outpatient attendance. Several complications arose, highlighting challenges in using CM in populations with substance use and cooccurring disorders. Practical suggestions are offered for maximizing the effects of CM.