Town Hall, Committee Room 2, Middlesex University, The Burroughs, London NW44BT
Within addictions, evidence-based treatments exist (e.g. opiate substitution treatment, OST), but do not generate their full patient benefit because of poor adherence and high progressive drop-out. Building on the behavioural principles of operant conditioning, contingency management (CM) involves the systematic application of positive reinforcement (utilising financial or material incentives) to promote adherence to treatment and/or patient behaviours consistent with treatment goals. In this way the effectiveness of existing treatment may be amplified. There is a strong US evidence for the effectiveness of CM, and considerable interest in its application in the UK, but until recently no evidence base for its effectiveness in UK treatment settings.
Over the past 5 years a team of UK researchers has been investigating the effectiveness of CM in UK drug services undertaking two large randomised controlled trials. The first of these trials – completed and published in 2014 – demonstrated that contingency management could be used to promote increased completion of hepatitis B vaccination amongst people receiving opiate substitution treatment. The second trial, the PRAISE trial, is investigating the effectiveness of contingency management in promoting abstinence from street heroin and is expected to report in 2016.
This seminar will briefly describe the basic principles and practice of contingency management and review the evidence base. However, the primary focus will be on the recent programme of research undertaken within the UK – its rationale, its aims, trial design and results achieved to date. The seminar will also focus on the potential next steps as the emphasis shifts to implementation in routine practice.
About the speaker
Dr Tim Weaver is Associate Professor of Mental Health Services Research. He also holds honorary positions at Imperial College and Kings College London. Dr Weaver is a social scientist with over 25 years' experience of health services research in a range of substance misuse and mental health treatment settings. He is co-principal investigator on the first two UK trials of contingency management (voucher-based positive reinforcement). His seminar will describe these trials and the findings to date. Dr Weaver's current research interests also include the community management of severe mental illness, personality disorder, and populations in whom mental illness and substance misuse co-occur, service user involvement in research, and the management of forensic mental health services. He has developed particular expertise in evaluative research that combines qualitative and quantitative methods to investigate the process and outcome of complex health interventions.