Reinforcement of counseling attendance and alcohol abstinence in a community-based dual-diagnosis treatment program: a feasibility study.

This study evaluated the effectiveness of a community-based contingency management (CM) protocol reinforcing punctual dual-diagnosis group counseling attendance and negative breath alcohol levels. Participants were 20 dual-diagnosis patients. The A-B-A within-subjects reversal design included a 4-week baseline phase (BL), a 12-week CM intervention, and a 4-week return-to-baseline phase (R-BL). Group counseling was provided twice weekly, with breath tests before each session. CM attendance rates were significantly higher (65%+-28%) than BL (45%+-32%, p<.05) and remained elevated in the R-BL phase (68%+-29%). Despite clinical reports of frequent intoxication, during the study all breath test results were negative, regardless of study phase. Thus, no contingency effect on alcohol use could be determined. Results suggest that CM interventions can be effective in increasing attendance in a community treatment program for the dually diagnosed.