The comparison of the effectiveness of contingency management and trans-theoretical model on the risk of sexual behaviors in cocaine users: A short report study

A transtheoretical model (TTM) can be considered as a cognitive and motivational view, a component which plays a significant role in addiction. Further, the theoretical basis of contingency management (CM) treatment is the origin of behaviorism and relies on operant conditioning. The present study is performed aiming to determine the effectiveness of TTM and CM on cocaine use and sexual risk behaviors in cocaine users.

In this randomized clinical trial with 6-month follow-up, which was performed from 15 December 2014 to 20 November 2015, 75 male cocaine users were selected based on a respondent-driven sampling (RDS) method and were randomly divided into three groups by block randomization. The experimental group received a 12-week CM protocol and TTM and the control group was placed on the waiting list. Pre-test, post-test (after 12 weeks of training), and follow-up (six months) were administered. Data analysis was carried out using repeated measures analysis of variance (ANOVA), Scheffe’s post hoc test, and chi-square test through SPSS software.

The mean age of the CM group, TTM group, and control group was estimated 26.12, 25.31, and 23.91, respectively. The primary outcome showed that CM and TTM had a significant effect on decreasing the sexual thoughts, sexual hyperactivity, and high risk behaviors. This effectiveness was stable until six months (P = 0.008), however there was not a significant difference between the two treatments (P = 0.200). The secondary outcome showed that in the changing stages, TTM (F-72%) and CM (F-60%) had a significant effectiveness which maintained until the follow-up stage.

The findings more enhance the hope to integrate the theoretical approaches into the clinical interventions.