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Voucher-Based Incentives for Naltrexone Treatment Attendance in Schizophrenia and Alcohol Use Disorders

OBJECTIVE: This study assessed the feasibility of voucher-based incentives for attendance for directly observed naltrexone treatment in a controlled trial for alcohol use disorders in schizophrenia. METHODS: Cash-value voucher-based incentives were contingent on attendance at three research visits per week over 12 weeks for 61 participants. Vouchers increased in value based on consecutive attendance. Missed visits resulted in reduction of voucher value. RESULTS: Participants attended 82% of all research visits. Average value of vouchers earned was $330 (78% of the maximum possible). Psychotic symptom severity at baseline did not affect the utilization of vouchers, and 94% of participants perceived the incentive system as helpful. CONCLUSIONS: The incentive system was well accepted and used despite psychosis severity, and the attendance rate was high, although causality between incentives and attendance could not be examined. A voucher-based incentive system for attendance can be successfully applied in a clinical trial for alcohol dependence treatment in schizophrenia.

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