Contingency Management

Description of the Strategy

The origins of contingency management lie within the work of B. F. Skinner, the pioneer of behavior analysis. In the early 1950s, Skinner proposed that the same learning principles used as a paradigm for animal research could be adapted to human applications. By the mid 1960s, behavior modification was applied to children with mental retardation, hyperactive behavior, delinquency, and autism. These populations previously were thought of as “resistant” to treatment, and the use of behavior modification greatly improved the quality of care for these children. By the late 1960s, several texts regarding the application of contingency management to education and parenting applications were published, and contingency management has been a key feature of behavioral treatments targeting childhood disorders since that time.

Contingency management can be defined as a process through which the reinforcement and punishment of child behavior are assessed and the environment's responses to the child's behavior (i.e., the contingency structure) are altered to effect behavior change. The dual purpose of contingency management is to decrease maladaptive behavior and increase [Page 784]adaptive behavior. Behaviorists suggest that a breakdown in the environmental contingency structure underlies a child's maladaptive behavior or absence of appropriate behavior. The goal, then, of contingency management is to restructure the child's environment to include consistent consequences so that the child can learn how to behave appropriately as a result of the new environmental structure. Intervention can target any aspect of the child's environment but most often involves the child's home, school, and the clinic setting.

Contingency management can be a component of a larger treatment protocol or can be used on its own to effect behavior change. One of the unique aspects of contingency management is that the therapist can teach a number of individuals in the child's environment (parent, teacher, sibling, peer, nurse, community volunteer) to serve as contingency managers. Behavior therapists typically serve as consultants regarding children's behaviors, and contingency managers (usually a parent or teacher) implement the plan under the advisement of a therapist. The plan may include contingent rewards, punishment, or a combination of these techniques. Older children may serve as their own contingency managers; however, parents and teachers are more frequently chosen as the managers. The design and implementation components most common to contingency management plans include (a) reinforcement assessment, (b) measurement of the target behavior, (c) contingency contracting, and (d) implementation of the contingency management plan.