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Legacy Program Summary

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IMPORTANT LEGACY NOTICE: Legacy Programs have not been reviewed by the current National Registry of Evidence-based Programs and Practices (NREPP). The programs in this database were reviewed only under the previous National Registry of Effective Prevention Programs system. This section is intended to be used for historical reference only. If you would like more information about a program listed here, please contact the program developer directly. The program developer of each Legacy Program listed here agreed to post program information on this site.

Community Reinforcement Approach (CRA) Plus Vouchers Intervention for Outpatient Treatment of Cocaine Dependence

Brief Program Description

CRA Plus Vouchers Intervention is a behavioral treatment program designed to retain patients in outpatient treatment and achieve initial cocaine abstinence in individuals enrolled in outpatient treatment for cocaine dependence. Patients participate in twice-weekly 1-hour counseling sessions for 12 weeks, then once-weekly sessions during the subsequent 12 weeks, and a recommended 6 months of aftercare. The sessions focus on relationships, recognizing antecedents and consequences of cocaine use, employment counseling, and developing new recreational activities. In addition, urine specimens are collected three times per week during weeks 1-12, and the results are immediately reported to the patient. Patients accumulate points for urinalyses that are negative for cocaine, which can be used towards purchasing retail items and activities. During weeks 13-24, urine specimens are collected two times per week, and patients earn one State lottery ticket for each negative specimen.

The program has been tested in several outpatient treatment centers in Vermont with Caucasian men and women aged 18 years or older meeting the DSM-III-R diagnostic criteria for active cocaine dependence. CRA Plus Vouchers was more effective in retaining patients in treatment and in achieving initial cocaine abstinence than control groups receiving 12-step drug counseling, CRA with no vouchers, or CRA with vouchers not contingent upon negative urinalyses. In addition, the vouchers component of the intervention, wherein patients earn points exchangeable for retail items contingent on objective evidence of abstinence from recent cocaine use, has been examined in approximately 15 controlled studies conducted throughout the United States with diverse populations of cocaine abusers, and was demonstrated to be efficacious in the vast majority of those studies.

Contact Information

For indepth information on this program, please use the contact listed below.

Program Developer

Stephen T. Higgins, Ph.D.
Human Behavioral Pharmacology Laboratory
Department of Psychiatry
University of Vermont
38 Fletcher Place
Burlington, VT 05401
Phone: (802) 656-9615
Fax: (802) 656-5793
Email: Stephen.Higgins@uvm.edu

In May 2004, this program was designated as an Effective Program under SAMHSA's previous National Registry of Effective Prevention Programs system.