Counselor Incentives to Improve Client Retention in an Outpatient Substance Abuse Aftercare Program

  • Donald S. Shepard
  • Jeanne A. B. Calabro
  • Craig T. Love
  • James R. McKay
  • Jill Tetreault
  • Hyong S. Yeom
OriginalPaper

Abstract

Pay for performance, the provision of financial incentives for favorable performance, is increasingly under study as an evidence-based practice. This study estimated the improvement in client retention from offering incentives to 11 substance abuse counselors providing outpatient aftercare treatment. During the incentive period, a counselor could earn a bonus of $100, in addition to his regular compensation, for each client who completed at least five aftercare sessions (the “milestone” which we considered the minimum adequate dose of the aftercare curriculum). We evaluated this and a similar, 12-session incentive using a logistic regression in which the retention “milestone” was the dependent variable and the proportion of time in the incentive condition was the independent variable. Among the 123 clients offered this aftercare program, their probability of completing at least 5 sessions was 59% with the incentive compared to 33% beforehand (odds ratio 4.1, P<.01). These findings suggest that counselor incentives are an effective strategy to improve client retention in substance abuse treatment.

Keywords

Incentives Substance abuse Retention 

Notes

Acknowledgments

The authors gratefully acknowledge ongoing support from the Bureau of Substance Abuse Services of the Massachusetts Department of Public Health, support of the Brandeis/Harvard NIDA Center (P50 DA010233), and assistance from NIDA grant R01 DA08739.

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Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Donald S. Shepard
    • 1
  • Jeanne A. B. Calabro
    • 1
  • Craig T. Love
    • 2
    • 3
  • James R. McKay
    • 4
  • Jill Tetreault
    • 5
    • 6
    • 7
  • Hyong S. Yeom
    • 6
    • 8
  1. 1.Schneider Institute for Health Policy, Heller School, MS 035Brandeis UniversityWalthamUSA
  2. 2.Brown UniversityProvidenceUSA
  3. 3.Westat, Inc.RockvilleUSA
  4. 4.Department of PsychiatryUniversity of Pennsylvania Medical SchoolPhiladelphiaUSA
  5. 5.Spectrum Inc.WestboroughUSA
  6. 6.Brandeis UniversityWalthamUSA
  7. 7.North American Family InstituteDanversUSA
  8. 8.Department of Social WorkJames Madison UniversityHarrisonburgUSA

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