Behavioral strategies to improve treatment participation and retention by pregnant drug-dependent women

The present study examined the utility of behavioral incentives for improving early treatment participation and retention in a sample of 91 pregnant opiate and/or cocaine dependent women enrolled in an urban, university-based drug user treatment program between 1996 and 1997. An escalating voucher incentive system was compared to standard care. The relationship between treatment participation and retention and maternal and infant outcomes were examined using logistic regression, chi-square analyses, and t-tests. Behavioral incentives did not decrease rates of very early dropout from residential treatment, although improved outpatient treatment participation and retention during the transition from residential care was noted. Behavioral strategies demonstrate utility as adjuncts to counseling for high-risk substance dependent patients. They appear ineffective, however, for improving early residential treatment participation and retention, suggesting other variables (e.g., psychiatric comorbidity) may be operating during the first 24-48 hours post treatment admission.