Date: Thursday 14th January
Time: 16:00 - 17:00
Location: Town Hall Committee Room 2
Location: Town Hall Committee Room 2
Title: Contingency Management in UK Drug Treatment Services
Biography: 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 re-enforcement). The 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.
Abstract: 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.
The 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.
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