Community Reinforcement + Vouchers Approach (CRA + Vouchers)
Problems addressed
Drug abuse
Effectiveness

Effective

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Effective

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Life periods served
Adults (18 to 59 years)
Where the program was applied
Ambulatory - Health service centers
Country of application
Spain
Description

This is a treatment and rehabilitation program for adults diagnosed as cocaine dependent.
The program consists of two components:
1) Community empowerment approach, with an intensive psychotherapeutic intervention for behavioral change and occupational, social, and emotional skills training; and
2) Voucher approach, through a contingency management intervention in which participants receive material rewards for remaining in treatment and maintaining abstinence (verified by toxicology testing).
Material benefits are given to participants after approval by therapists, who judge whether those items are in line with the program participant’s treatment and actual needs.

Impact evaluations

An impact evaluation showed an increase in cocaine use abstinence rates in intervention groups compared to control groups. However, there was also a significant increase in cannabis use [1].
Another impact evaluation evinced that the intervention is more effective to achieve abstinence than classic methadone treatment methods [2].

Bibliographic reference

[1] Higgins, S. T., Budney, A. J., Bickel, W. K., Hughes, J. R., Foerg, F., & Badger, G. (1993). Achieving cocaine abstinence with a behavioral approach. The American Journal of Psychiatry, 150(5), 763–769. https://doi.org/10.1176/ajp.150.5.763

[2] Bickel, W. K., Marsch, L. A., Buchhalter, A. R., & Badger, G. J. (2008). Computerized behavior therapy for opioid-dependent outpatients: a randomized controlled trial. Experimental and clinical psychopharmacology, 16(2), 132., 16(2), 132–143. https://doi.org/10.1037/1064-1297.16.2.132

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