Evaluating the reinforcement value of clinic-based privileges through a multiple choice procedure

A novel multiple choice procedure was utilized to evaluate the potential reinforcement value of three clinic-based incentives available during routine methadone treatment: methadone take-homes, methadone dose increases, and extra counseling. Fourteen methadone maintenance patients who were not earning any of these incentives completed a multiple choice form in which they made choices between pairs of incentives and subsequently between each incentive and a series of monetary values. Choice behavior was intermittently reinforced by randomly awarding to patients one of their chosen preferences. Results demonstrated that take-homes were worth US$20.24 and were rated as more desirable than dose increases (US$13.89) and extra counseling (US$7.47). The study updates and extends past research in this area and provides a methodology for establishing both a monetary value for clinic-based incentives and an absolute magnitude between preferences. The procedure could be used to examine a larger number of potential reinforcers and to understand individual differences in responding to incentive-based treatment programs.