Punishment vs. Positive Reinforcement in Addiction Treatment

There are two broad methods of changing behavior: punishment and positive reinforcement. Punishment is when someone receives a negative consequence for doing something bad, while positive reinforcement occurs when a person is rewarded for doing something good. Contingency management is one form of positive reinforcement that is used in rehabilitation programs. It often yields better results than punishment. Here is a brief look at why punishment doesn’t always work, and how contingency management can help with the rehabilitation process.

The Problem with Punishment

People with substance use disorders are used to society trying to motivate them to get and stay sober using punishment. Jail, probation, fines, being kicked out of one’s home, and being fired from one’s job are just a few examples of the punishments people with substance use disorders may experience as a consequence of their addiction. The problem with punishment is that oftentimes people with substance use disorders are either not thinking of the potential consequences of their actions, or feel the rewards of using a substance outweigh the punishment that will result.

Why Positive Reinforcement?

Society rarely uses positive reinforcement to encourage people with substance use disorders to get and stay sober. However, research shows that positive reinforcement can be a very effective tool in a person’s recovery. One type of positive reinforcement used by treatment programs is called contingency management. Contingency management involves giving clients rewards when they perform behaviors associated with sobriety like passing drug screens and going to therapy.

What does contingency management look like? Some treatment programs used a voucher-based system in which clients receive vouchers when they pass drug screens. They can redeem their vouchers for rewards like movie passes, gift cards, or gym memberships. In order for contingency management to be successful, the rewards should be attainable to people who are complying with the treatment expectations and should also be consistent with a healthy lifestyle.

Using Contingency Management in Your Home

If you have a loved one who is affected by a substance use disorder, you may consider using contingency management in your home. First, identify the behaviors you want to see your loved one engage in. This may include anything from negative drug screens to attending 12-step meetings to helping out with chores around the house. The behaviors should be clearly defined and measurable. Next, develop a reward system. Ask your loved one what would motivate him or her to perform these behaviors. They will be much more likely to participate if they had a role in developing the rewards system.

If you or a loved one is trying to maintain sobriety, Rehab After Work can help. We have flexible outpatient programs for adults and teens that allow you to keep working or attending school.

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Article Written by Shaylyn Forte, LPC, CAADC


  1. https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral-0
  2. https://www.sciencedirect.com/science/article/pii/0005796775900054