Rewarding teens for staying sober works. Here’s how.

June 09, 2016 | by Edward-Elmhurst Health
Categories: Healthy Driven Minds

Parents use rewards for positive behavior all the time:

  • “If you do your chores, you get an allowance.”
  • “If you get straight A’s, you can pick out a video game.”
  • “If you behave yourself during this family function, we’ll go to that concert next month.”

If the child does something positive, the child gets a reward. This is the foundation of positive reinforcement. And professionals around the world have observed the effectiveness of positive reinforcement — from psychologists and teachers to medical doctors and more.

But this sort of approach isn’t just effective for getting your teen to take out the trash or turn in homework on time. It’s also effective for motivating teens to stop using drugs.

And we should know. We’ve had success with this approach in Naperville as part of our substance use treatment program for teens. We’ve been amazed at the effect a bag of colored beads and some gift certificates can have on a teen’s resolve to abstain from drugs. These simple rewards have worked wonders to substitute the pleasure of participating in a healthier lifestyle for the pleasure they used to feel when using a drug. And it’s something parents can continue after their teens come home from treatment.

How does contingency management fit into substance abuse treatment?

When we talk about positive reinforcement in a clinical setting, we often refer to it as contingency management. The term may sound complicated, but it’s actually very simple. Everyone deserves to be rewarded and recognized for hard work and victories — no matter how small they may seem to others.

Contingency management is a type of therapy that rewards positive behavior. It’s centered on the principle that people act based on perceived consequences. If an action is followed by a positive consequence, you’ll likely do it again; if an action is followed by a negative consequence, you probably won’t do it again.

Multiple studies have shown that contingency management is effective in helping people — especially adolescents — maintain sobriety for longer periods of time. For example, a 2009 study looked at two groups of teens in treatment for marijuana use, one of which used a sobriety-based incentive program. The researchers found that 50 percent of the participants enrolled in the incentive program achieved more than 10 weeks of abstinence, compared to 18 percent of participants in the control group.

Negative reinforcement techniques can be effective at modifying behavior also. However, when you only use negative reinforcement, you run the risk of creating an unpleasant environment. It’s difficult to continue to work on your substance abuse problem when the people and the place helping you only recognize when you take a step back.

The teen years are critical for brain development, and substance abuse can wreak havoc on the brain. By using positive reinforcement to help teens stay clean, we allow their brains time to heal. It also reinforces their confidence that they can live without the drug. They begin to think, “You know what? I don’t have to use every day. I haven’t used in three weeks. I can do this.”

How does positive reinforcement work?

We use positive reinforcement as a way to reward teens in our program for staying sober. Every week, we have the teens whose drug tests came back clean pull a colored bead from a bag. Each colored bead is associated with a gift card of a certain value. For example, we may have $1, $5, and $15 gift cards to places such as Starbucks or Chipotle. And each bag has one or two big prizes, such as a $100 gift card for Target. We don’t use cash as a prize because we don’t want them to potentially use it to buy drugs, but we’ve found the gift cards to be big motivators to stay clean.

We make a big deal out of choosing the beads — we do it in a group setting with lots of cheering! It’s our way of saying, “We recognize that this is really difficult for you. The people around you may not be as supportive as you’d like, but you’re making this change. We are proud of the good work you’re doing, and we celebrate you for it.”

Many of these teens have been labeled as “bad kids,” but we are reminding them that they are good people. It’s exciting to watch their faces light up as they pull their bead from the bag.

These teens know the benefit they get from using drugs. While a gift certificate may seem like a simple thing, along with the public recognition of their effort, it’s enough to keep many of them from using. There’s something about having earned the chance to win a prize. They made a choice that allowed them that opportunity. In this way, contingency management also teaches them about accountability and consequences.

I’ve seen this method work time and time again. For example, we had a teen who had been in and out of multiple residential treatment facilities come to us and really respond to contingency management. It helped him stay sober for the longest period of time in years.

How can parents continue positive reinforcement therapy at home?

Positive reinforcement shouldn’t end when a teen leaves a treatment facility. We encourage parents to continue to apply this method at home.

When teens leave our program, parents can work with their pediatricians, area labs, or local pharmacies to arrange regular drug screenings, just like the teens get as part of treatment. You can even buy over-the-counter drug screenings to do at home. If your teen tests negative for drugs, that’s cause for a positive reward, such as a gift card, candy, extra privileges, or some other small (non-cash) reward.

Your teen needs to understand the behavior that is expected of them, and to face the consequences if they do not act in that manner. However, it’s equally important to reward them for putting in the work to reach their goals, whether it’s in the form of gift certificates or additional privileges at home.

Some parents wonder why they should reward their teen for doing what they should be doing in the first place. They think it sounds like a prize for behaving badly. However, their teen is making a big change. Parents need to recognize that the work they’re doing to stay clean is a big deal, and it’s not just something that should be expected.

Confronting substance abuse is not easy. It’s a daily battle. And every sober day your teen achieves is a victory worth celebrating.

To learn more about how contingency management is used in our substance abuse treatment programs, fill out a form online or call 630-305-5027.

Get support from Linden Oaks Behavioral Health.

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