History of CM
Since time immemorial
Early Ideas on Habit Formation​​​
The idea that behavior can be shaped by rewards and consequences has roots in many cultures and historical traditions that emphasized learning through repetition, practice, and environmental influence.
Late 1800s
The Law of Effect
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Edward Thorndike's Law of Effect (1898), which states that behaviors followed by positive outcomes are more likely to be repeated, is a foundational idea in reinforcement-based therapies.
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Thorndike used puzzle boxes to study how animals (primarily cats) learned through trial and error, reinforcing behaviors that led to rewards.
1950s-1960s
Operant Conditioning​​​
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BF Skinner built on the Law of Effect to develop Operant Conditioning, the idea that behaviors followed by rewards are more likely to be repeated.
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Skinner's work laid the scientific foundation for CM’s use in addiction treatment and behavior change.
1970s-1980s
Contingency Management in Addiction Treatment
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Researchers begin applying Skinner’s principles of reinforcement to substance use treatment.
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Early studies show that providing vouchers, prizes, or privileges for drug-free urine samples leads to better treatment retention and abstinence rates.
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Influential studies in the 1970s and 1980s demonstrate CM’s effectiveness, particularly in cocaine, opioid, and alcohol use disorder treatment.
1990s-early 2000s
Contingency Management Gains Scientific Validation​​
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Planting seeds for future CM implementation, the 1990s was a time when CM became a recognized evidence-based treatment for substance use disorders (SUDs) as clinical trials demonstrate its effectiveness.
What Happened?
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Studies on CM focused on cocaine use show that monetary-based incentives significantly improve abstinence rates.
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Researchers refine protocols for different substance use disorders.
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The National Institute on Drug Abuse (NIDA) funds studies to explore CM’s effectiveness in real-world settings.
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CM becomes recognized as a best practice for stimulant use disorder treatment.
2010-Present
From Research to Reality: CM in Practice
The early seeds of CM take root, expanding from research to real-world practice.​​
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CM moves from research settings into mainstream addiction treatment and public health programs.
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The Veterans Health Administration begin supporting CM as an evidence-based intervention.
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States begin developing Medicaid "waivers" (e.g., California, Washington, Montana) to start covering CM for stimulant use disorder.
