Integrating contingency management with relapse prevention skills: Comment on Silverman et al. (2001)

The study by K. Silverman, D. Svikis, E. Robles, M. L. Stitzer, and G. E. Bigelow (2001) demonstrates the effectiveness of a voucher-based reinforcement intervention in the treatment of pregnant women in treatment for substance abuse. The effects of prolonged initial abstinence as a form of "sobriety sampling" may serve to enhance long-term recovery by providing patients with rewards for maintaining abstinence. Several limitations to the study are addressed, including selection of the treatment sample and the absence of any follow-up data on drug use or relapse following completion of the 24-week treatment program. Recommendations are made to enhance maintenance of abstinence by providing coping-skill training for relapse prevention as an addition to the contingency management approach.