Behavioral Contracting

Description of the Strategy

Behavioral contracting can be used in a wide variety of contexts. Contracting may be used to increase compliance with treatment itself or to increase compliance with a range of targeted behaviors. Contracting is commonplace in behavior therapies; it also has widespread use by clinicians of diverse theoretical orientations.

The goal of the behavioral contract is to increase frequency of a target behavior. Common behavioral contracts include commitments to attend appointments, maintain a diet, and abstain from drinking or drugs. Contracting involves creating a written agreement between the client and therapist to increase a specific client behavior. Many contracts are based on the “A-B-C” approach, which involves identifying antecedents to the behavior, defining the targeted (desired) behavior, and identifying the consequences (or reinforcers) that will shape and maintain the behavior. Contracts usually operate by implementing new reinforcer(s) designed to increase the target behavior or by altering antecedents.

One of the important parts of behavioral contracting is to define the specific behavior that is a target of change. Contracts will be ineffective and confusing if the target behavior and contingencies are not welldefined and documented. A good contract delineates a very clear expectation. The target behavior must be specific. In a contract focused on managing anger, a target behavior of “Expressing anger in appropriate ways” would be too broad. More effective target behaviors would be “Speak in a calm voice” or “State you are going for a walk, then go for a walk.” The behavior should be defined in positive rather than negative terms; people are generally more amenable to increasing a behavior than eliminating one.

To create a behavioral contract, the client may need to first obtain a baseline of the behavior to be changed, that is, the natural frequency with which the problem is occurring. If the baseline is unknown, the client must record each time he or she performs the behavior during a given time period (e.g., hour, day, week). In obtaining a baseline, the client does not try to change the behavior yet; this is a stage of gathering information. Gathering additional information can be helpful, such as documenting the situation in which the behavior occurs and the intensity of the behavior. Sometimes, the baseline is already known; in that case, this step is unnecessary.

The initial goal or target behavior set must be a balance between the client's chance of success and the short-term consequences of not complying. With substance abusers, the initial goal is usually abstinence; noncompliance with this may have severe short-term [Page 107]consequences and will interfere with treatment. In other situations, a contract is designed to increase the target behavior slowly from the baseline so that the client may have an experience of success early on in the treatment. This will increase the likelihood that the client will be motivated to continue to adhere to the contract. For example, in a weight loss program, short-term consequences are not dire; specific target behaviors for diet and exercise may be implemented in a progressive, stepwise manner.

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