"There was a debate between the scientific and the traditional worlds of drug treatment," says Kellogg. "At first, the traditionalists were not able to take in a behavioral perspective as they saw addiction as an innate disease; therefore external circumstances should not affect an addicted person's behavior. But those ideas are changing now, and that change is part of our story."

The National Institute of Drug Addiction (NIDA) developed the Clinical Trials Network to both test and publicize various science-based addiction treatments, and the contingency management program was one of the first chosen to study. At a conference sponsored by NIDA, Kellogg, who is the scientific director for the contingency management intervention in New York, met Peter Coleman and Marylee Burns, from the Office of Behavioral Health at the HHC, who are contributing authors to the paper. Their meeting produced one of the largest adoptions ever done of contingency management, which involved five addiction clinics in New York City.

"The Health and Hospitals Corporation was already preparing to apply something similar to the contingency management approach," Kellogg says. "They were thinking of giving people rewards when they reached significant treatment benchmarks, such as holding a job for six months. Using the science of operant conditioning, we suggested to them that you could achieve a better outcome if you don't simply reward the attainment of goals, but, instead, you reinforce all of the steps along the way."

"Scott developed the concept of a modified, practical but formal contingency management intervention within a community-based treatment sett
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Contact: Kristine Kelly
kkelly@rockefeller.edu
212-327-7146
Rockefeller University
1-Apr-2005