SURVEY ASSESSMENT OF METHADONE TREATMENT SERVICES AS REINFORCERS

Offering incentives contingent on behavioral change can be an effectiv e method for improving treatment outcome in methadone maintenance. Fur ther, there are several incentives available within the daily operatio n of methadone clinics that can be used in this way. This study descri bes patient preferences for clinic service incentives as identified by three types of survey methodologies: multiple choice procedures, visu al analog scales, and rank ordering. Methadone patients (n = 111) rate d preference for three service incentives (take-home medication, dose increase, counseling sessions) using each survey. Mean and individual responses were highly consistent across surveys and indicated that, in general, take-homes were the most preferred, followed by dose increas es and then counseling. The rank order survey also assessed an additio nal 18 service items (e.g., rent, food or gas payments; employment ass istance; medical care). Consistent with other measures, most patients (64%) placed take-homes within their top five rankings, indicating a h igh level of preference, but this survey also revealed wide individual differences in preference ranking. The surveys described can be used to identify preferred incentives for clinic-wide use in contingency ma nagement programs or can be used to select individualized incentives f or each patient. This is useful information for maximizing utilization of clinic resources.