If you’re a parent and trying to understand how best to help your child with a stimulant use problem, there’s a treatment method called contingency management (CM) that might sound new and unfamiliar—but it’s actually backed by a lot of research. In this article, we’ll break it down for you in plain language, explaining what it is, why it works for stimulants, and how you can support your child through it.
What are stimulants?
First, let’s talk about “stimulants.” Stimulants are drugs that speed up brain activity — making someone feel more awake, energetic. Some stimulants are prescribed (for example for ADHD or narcolepsy). Others are misused (taken without a prescription, taken in larger amounts than prescribed, and/or for the “high”). This misuse can lead to serious problems including addiction.
If a young person is using stimulants in a way that they’re not supposed to (or illegally) and it’s causing major problems (in school, socially, at home), that can become what’s called a stimulant-use disorder. Because there aren’t widely accepted medications to treat a stimulant addiction like there are for some other substance use disorders, therapies that can help change behavior are especially important.1
What is contingency management (CM)?
Contingency Management (CM) is a treatment approach that uses rewards to help someone stop using stimulants and make healthier choices. Here’s how it works, in simple terms:
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- A goal is set: for example, “I will have a negative urine test (i.e., no stimulant showing) this week.”
- If the goal is met, the person gets a reward (like a voucher, small gift card, or prize).
- If the goal is not met, the reward is not given. And sometimes the reward resets. In CM, rewards often build up or increase over time. For example, a person might earn $5 for the first clean test, $10 for the next, $15 for the next, and so on — increasing as they stay drug-free. If a test comes back positive for stimulants, or if they miss a test, the increasing reward structure resets to $5.
- Over time the reward helps build momentum: the person keeps getting rewarded for staying off stimulants.
- It is designed to replace the “reward” the brain gets from the stimulant with a healthy reward.
It’s based on the psychology idea of “positive reinforcement” (rewarding what you want to happen) rather than only punishing what you don’t want.2
According to the American Society of Addiction Medicine CM is the proven health-care intervention for stimulant use disorders.3
What a CM program might look like
If your child is in a CM‐type program (or you’re discussing it with a treatment provider), this is what it might involve:
- Baseline setup: The program will tell them what behavior is rewarded (for example: clean urine tests, attending therapy sessions, no stimulant use for a set period).
- Testing and verification: Frequently the program will use urine drug screens to check whether the person has used stimulants.
- Rewards: If the test is negative—and the goal is met—the reward is given. Rewards might be vouchers, a gift card, a prize, etc. If you’re involved, rewards from you could include time off from chores, use of a car, small “extras” at home, or something else negotiated in the treatment plan.
- Escalating incentives: Often the reward grows or the “value” of the reward increases with continued success, or additional perks are given for longer periods of no use. If there’s a relapse, the reward structure may reset as described above.
- Other supports: CM doesn’t usually stand alone; it’s often paired with counseling, therapy, family support, and coping‐skills training.
How you as a parent can support the CM process
Your role is important. Here are ways you can help:
- Understand the plan: Ask the provider: What exactly are the target goals (negative urine tests, attendance, etc.)? What are the rewards? What happens if there’s a slip?
- Be a cheerleader: Celebrate successes. Be sure to notice when your child meets a goal. Positive reinforcement from family helps.
- Maintain a supportive environment: Help reduce triggers at home (unsupervised access to stimulants, stress, bad sleep, isolation). Encourage a healthy routine: sleep, healthy food, hobbies, exercise.
- Stay engaged: Attend family sessions if offered, check in about how your child is doing, keep communication open. Do not assume it’s “easy” or “done” quickly.
- Prepare for setbacks: Relapse or slip‐ups are common in substance use. Rather than blame, help your child get back on the plan quickly. Ask: What do we learn? How can we adjust?
- Coordinate with the treatment team: Ask questions like: How long is the CM part of the plan? What happens after the rewards taper off? What’s the long‐term plan?
Questions to ask and keep in mind
- How long will the CM program run? (Some are 3-6 months or more).
- What happens after the heavy reward phase ends? How do we support maintenance?
- Are the rewards meaningful to your child (i.e., motivating)? If not, they may not work as well.
- Is the frequency of testing/reward close enough to the behavior? (The closer the reward to the behavior the better).
- Is the plan realistic for home life and for your child’s schedule?
- Are there other therapies running alongside CM (therapy, family work, peer support)?
- Is the provider experienced with CM? Poorly designed CM (low or vague rewards, infrequent follow-up) may not work well.4
Why this matters for you and your child
- It gives you an active strategy instead of just waiting and hoping that your loved one will get better. You can work with the treatment team, be part of the plan, help reinforce positive behavior.
- For your child: it brings structure and immediate reward, which can help counter the strong pull stimulants have.
- For your family: it helps move toward hope. It shifts from “What’s going wrong?” to “Here’s what’s going right, and how we keep building on it.”
If your teen or young adult is struggling with stimulant use, remember — you don’t have to handle this on your own. Treatments like contingency management give structure, hope, and clear steps forward, but recovery is often a long journey that requires patience and support.
As a parent, your encouragement, steady presence, and willingness to learn make a real difference. Take time to connect with others who understand what you’re going through — it can ease the stress and help you stay strong for your child.
The Partnership to End Addiction offers free, confidential support for parents and caregivers through online parent coaching, discussion groups, and a helpline where you can talk with trained specialists. You can find these resources here. Reaching out for help doesn’t mean you’ve failed. Rather, it means you’re taking an important step toward healing for both you and your child.