Given the complexity of human behavior, treating problems like addiction and alcoholism requires integrated solutions. Behavior contracting is one of the latest developments in rehabilitation, and it is helping some alcoholics find the inner strength to change their lifestyles.
Behavior contracting is sometimes called contingency management, and it has applications across several disciplines. At its core is an official – albeit legally unbinding – contract written up between two parties in an attempt to curb undesirable habits or behavior. Parents may use a behavior contract with their children, and employers use them in the workplace. Counselors specializing in addiction therapy are also finding these contracts useful in helping alcoholics overcome addictive behavior.
The contract should be drawn up collaboratively between the counselor and the alcoholic. A witness is often present for the signing of the contract. Ideally, this person will be someone close to the addict or alcoholic, with a vested interest in their recovery. It is a creative way for alcoholics or problem drinkers to pinpoint negative behaviors in their lives, and it offers them powerful incentive to reform.
In fact, studies indicate that entering into a contract with a counselor is much more effective than simple warnings or admonishments. This is especially true when a witness is involved. A contract is tactile – can be handled and referenced – which presumably gives it more weight than mere spoken words.
Accountability is also a major driver in contracted behavior modification. An alcoholic can say that they want to change their lifestyle, but finding the resolve to live this out on a daily basis is a great challenge. With their name attached to a formal contract, a recovering alcoholic has greater incentive to stick to their resolutions.
One of the major blockades to proper alcohol rehabilitation is clients’ reluctance to stay in treatment. A study conducted at Rockefeller University and reported in the Journal of Substance Abuse Treatment found that behavior contracting increases clients’ motivation. Its success hinges on setting goals and rewarding their fulfillment.
Goals can take many forms. They may begin with something as baseline as staying sober for a day or a week. As the client continues to meet goals, their counselor may suggest loftier, more complex benchmarks. At this point, the goal may be to continue to seek treatment on a weekly basis or hold down a job for six months.
Incentives take many forms. An alcohol-free test result may warrant a miniature celebration at a group meeting. Gifts certificates or movie passes may awarded when other milestones are met. All of this is clearly outlined in the behavior contract. Rewards like this may seem insignificant compared to the positive life changes that result from setting and meeting goals. However, an incentive system can be highly effective in recognizing and encouraging small-step improvement.
Consequences of breaching contract are equally varied. Sometimes, simply not receiving the outlined reward is the consequence. In cases where the problem behavior is destructive or detrimental to treatment, the client may be discharged from rehab. Of course, this is reserved for severe breaches.
Behavior contracts are particularly useful for alcoholics who have relapsed after an initial round of rehabilitation. When a relapse occurs, the client may wish to reenter rehab. At this point, it may be prudent to draw up a contract outlining expectations for this round of therapy.
The key is to reinforce small steps on the road to holistic recovery. One of the major hurdles to overcoming alcoholism or addiction is finding the resolve to stay clean on a daily basis. The benchmarks laid out in a behavior contract are essentially mile markers on a road map to recovery. Signs of success are laid out in advance, and they can be charted along the way.
This sort of alcohol rehabilitation treatment is particularly effective in a community environment. The other members can help with accountability, and marking the successes of others can be motivation in itself.
With that in mind, behavioral contracting is not a panacea for alcohol rehab. It is, however, an effective tool in encouraging clients to continue rehabilitation. To this end, the practice is widely being used in alcohol rehab centers.
One innovative approach to behavior contracting is the use of an alcohol contracting tool. This is a software platform that guides clients through a series of questions in order to establish behavioral problem areas. The user answers questions about the role alcohol plays in their lives, and the computer tabulates the results.
The software then prompts the user to think about their drinking problem and set recovery goals. The client can layout their goals or accept suggestions from the software. Incentives are agreed upon, and the program prints out a behavior contract.
This is where real human interaction takes precedence. Defining problem behaviors is sometimes easier to get through in privacy, which is what makes software like this effective. However, once the contract has been printed, the client signs with their counselor in the presence of a witness. This is where accountability steps in.
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