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Improving CM Interventions: Initial Treatment Response and Longer-Term Outcomes

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FIGURE 27–2. Periodic abstinence assessments.Percentages of participants abstinent at each of the periodic assessments conducted with subjects retained in treatment as well as dropouts. Data points represent point-prevalence abstinence at the respective assessments. Abstinence was defined as a self-report of no cocaine use in the past 30 days and cocaine-negative urinalysis results. In categorical modeling, abstinence levels were significantly higher in the high-value than low-value voucher conditions based on assessments during treatment (1.5 and 3.0 months, P = 0.02) and follow-up (6- through 24-month assessments, P = 0.04).Source. Reprinted from Higgins ST, Heil SH, Dantona R, et al: "Effects of Varying the Monetary Value of Voucher-Based Incentives on Abstinence Achieved During and Following Treatment Among Cocaine-Dependent Outpatients." Addiction 102:271–281, 2007. Used with permission.

FIGURE 27–3. Cocaine urinalysis results across consecutive urine samples for individual participants in each of the three experimental conditions.Top, middle, and bottom panels represent data for the take-home plus voucher, take-home only, and usual-care control conditions. The vertical dashed lines divide each panel into three periods, the baseline (left), the intervention (center), and the postintervention (right) periods. Within each panel, horizontal lines represent the cocaine urinalysis results for individual participants across the consecutive scheduled urine collections of the study. The heavy portion of each line represents cocaine-negative urinalysis results, the thin portions of each line represent cocaine-positive urinalysis results, and the blank portions represent missing urine samples. Within each panel, participants are arranged from those showing the least abstinence (fewest cocaine-negative urines) on the bottom of the panel to participants with the most abstinence on the top. The numerals on the ordinates represent participant identification numbers.Source. Reprinted from Silverman K, Robles E, Mudric T, et al: "A Randomized Trial of Long-Term Reinforcement of Cocaine Abstinence in Methadone-Maintained Patients Who Inject Drugs." Journal of Consulting and Clinical Psychology 72:839–854, 2004. Used with permission.

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