Challenges and Possible Solutions for Implementing Contingency Management for Adolescent Substance Use Disorder in Community-Based Settings

Although more than 35years of research demonstrates some favorable outcomes for Contingency Management (CM) treatment for adolescent substance use disorder, CM has been significantly underutilized by clinicians in community settings. The primary purpose of this article is to describe potential barriers to community-based clinicians implementing CM treatment for adolescent substance use disorder along with possible solutions. Barriers discussed in this article include negative clinicians' and/or administrators' attitudes regarding CM's efficacy; community-based clinicians' inadequate knowledge of CM; high implementation costs; missed appointments by adolescent clients; community-based clinicians' lack of incentives to implement CM with fidelity; and impractical measures of treatment fidelity that require a high level of resources.