BACKGROUND: Substance misuse in Scotland is increasing and with the price of illicit drugs
decreasing, this makes experimentation more attractive and affordable. This has led to a need for
services to expand approaches designed to tackle substance misuse. Psychosocial interventions,
particularly those based on behavioural approaches, are thought to be a useful adjunct to
pharmacological approaches. One intervention, with a strong evidence base is Contingency
Management (CM) however it is poorly implemented in services. Research in the United States and
Australia indicate that one of the main barriers to implementation is the beliefs and views of service
providers on the principles and practices of CM.
AIMS: To explore the views of service providers in the statutory and voluntary /community sectors
on CM and to gain an insight into service users' views of CM. The study looked at comparing
Scottish service providers' views of CM against those of the American (Kirby et al„ 2006) and
Australian (Ritter and Cameron, 2007) samples.
DESIGN AND METHOD: The study adopted both a quantitative and qualitative approach. Service
providers' views on CM were gathered using the Provider Survey of Incentives (PS1) questionnaire
and service users' views on CM were gathered via a qualitative focus group and analysed through a
General Inductive Approach. PSI questionnaires were sent out to statutory (n=48) and
voluntary/community agencies (n=22) working with individuals, currently or previously using
substances. The focus group comprised members of a service-user involvement group from the
Scottish Drug's Forum (SDF). Participants were both male (n=7) and female (n=2) and at varying
stages of abstinence. The process of analysis involved generating codes from the thematic content of
the data, to produce overall themes that arose from the group.
RESULTS & CONCLUSIONS: Quantitative analysis involved carrying out mixed model ANOVAs to
determine if there were differences between statutory and voluntary responses to unique tangible and
social items and overall tangible and social incentives. In keeping with the analysis of the comparison
papers, frequency results are reported for responses to the parallel tangible and social items and
compared against responses from published data from the United States and Australia. The qualitative
process of analysis involved generating codes from the thematic content of the data, to produce
overall themes that arose from the focus group. Overall, the Scottish sample showed less concern
regarding CM approaches than the Australian sample, but more concern than the American sample.
The main concern in the Scottish, American and Australian samples was that incentive programmes
do not address the underlying causes of addiction. This was also highlighted by service users, who
felt that incentive programmes do not address the other needs of the individual. It was also found that
issues service providers felt were not problematic were raised as particular concerns by service users,
such as the artificial nature of social praise and the potential for tangible incentives to be sold. It was
concluded that it would be beneficial for service providers to collect the views of service users, should
they wish to implement CM approaches.