Client incentives versus contracting and staff incentives: How care continuity interventions in substance abuse treatment can improve residential to outpatient transition

Shauna P. Acquavita, Sandra Stershic, Rajni Sharma, Maxine L Stitzer

Research output: Contribution to journalArticle


Interventions for improving transition from short-term residential to outpatient treatment were examined. Usual care (UC; n= 114) was referral to a preferred outpatient program with advance appointment optional. Client incentive (CI; n= 97) offered up to $100 in gift cards for intake and attendance during the first 30. days of treatment. Contracting with staff incentives (CSI; n= 49) consisted of meeting with an outpatient counselor prior to residential discharge, signing an attendance contract, receiving an appointment and payment to staff if clients attended. CSI significantly improved rates of successful transition (84%) and admission (74%) compared to UC (64% contact; 49% admitted). CI did not result in significantly improved outcomes (74%; 60%). CSI was likely mediated by the reliability (92 versus 52% in UC) and immediacy (1.0 versus 3.9. days) of appointment scheduling. This study supports use of CSI for improving rates of transition between residential and outpatient continuing care treatment.

Original languageEnglish (US)
Pages (from-to)55-62
Number of pages8
JournalJournal of Substance Abuse Treatment
Issue number1
Publication statusPublished - Jul 2013



  • Contracting
  • Incentives
  • Outpatient treatment
  • Residential treatment
  • Substance abuse treatment
  • Treatment transients

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology
  • Phychiatric Mental Health
  • Medicine (miscellaneous)

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