Affirmations and Rewards Help People to Quit Drugs

If you are addicted to alcohol or drugs, would receiving various rewards or payments for not using be enough to help you to stop? Contingency Management (CM) is an approach to supporting people with addictions operating on the premise that such rewards can play an important role in change. The rewards are immediate and may increase in size the longer someone is involved with CM. Why would receiving positive affirmations, a chance to win prizes and gift cards, or money upon a “clean” drug test directly help a person to change? Is it the size of the reward or the fact a person shows herself that she can set goals, reach them, and both be given and accept praise and reward? I suspect it is the latter.

That CM does work as part of a program to help people change their relationships with addictive substances has a good deal of scientific support behind it. Granting that, the why question remains: why does CM work? It might be tempting to focus on the value of the prize; a $50.00 gift certificate or $50.00 cash is a lot of money. It feels good to have money to spend or save; it brings a sense of pleasure. This may be true to some degree, but not all the rewards are monetary. A positive affirmation of “good job,” or “keep it up,” also brings pleasure of a sort. There is pleasure in seeing something you have done—especially when it is quite difficult—acknowledged by others. While pleasure might be part of the reason CM works, I suspect there are other immaterial values at work here.

Setting a goal and reaching it are both achievements in their own rights. One of the important abilities people who are in the worst throes of addiction lose is the ability to set realistic and appropriate goals. We often overshoot possibility and land squarely in the realm of the impossible, which may fan the flames of resentment or be taken as yet more evidence of our myriad failures. Setting realistic and reasonable goals is something CM encourages: have one clean drug test. CM also provides the context for meeting this goal; part of a program for change may involve other sorts of support such as counseling for individuals and their families. The rewards for having a clean test aren’t just the affirmations or gift cards. There is an even greater and immediate award: someone who has an interest in their wellbeing and success witnesses this achievement.

A sense of achievement is an important immaterial value. For people who may believe themselves to have failed in epic proportions, it may be impossible for them to believe they were able to follow through and meet a goal. Achievement may feel utterly alien to them. A speck of pride may perch for a split second in their hearts. Most importantly, successfully setting and meeting goals help to inculcate a sense of self-worth. Self-worth is often depleted if not decimated as addictions progress. It may be equally hard for them to accept that others see them as having worth and dignity. CM works because it restores important moral goods such as self-worth, dignity, and respect.