Using Behavior Contracts in Drug and Alcohol Treatment

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At Northbound we use a host of behavior contracts for our clients. We believe in using behavior contacts in addiction treatment because it helps set clear boundaries and lets clients know where they stand. Our consequences at Northbound are designed in a three-tier system. For example, a First Tier Consequence would be given to a client for not making their bed a few days in a row, or showing up late to a meeting. A Second Tier Consequence is used for a little more serious rule infraction such as missing a 12-Step meeting or being disruptive in groups. A Third Tier Consequence involves mandatory attendance at our Friday Accountability Group and usually a behavior contract. Third Tier Consequences are administered for repetitive offenses or serious rule violations.
Here Are Some of the Behavior Contracts We Use:
Relationship Ban Contract: This contract is used when two clients start to conspire together, encourage each other to act out, or we think that one particular client with another particular client is not a good idea. Both clients will be put on a relationship ban contract and those two clients are not allowed to talk to each other at all for a certain period of time.
Relapse or Reentry Contract: These contracts are administered to people who have relapsed and been discharged from the program and wish to come back into the program. They will be placed on a strict reentry contract that addresses particular behaviors that led to their discharge/relapse and places consequences on them for breaking any further rules.
Clothing Contracts: For consistently wearing inappropriate clothing.
Anger Contract: For angry outbursts in groups or with staff.
Staff Splitting Contract: For going from one staff member to the next after the first staff member gave the client an answer they didn’t like.
Chores Contract: For consistently not doing chores.

As you can see we have created contracts for every form of behavior that is contrary to rehabilitation that we could think of. Usually, the consequence for breaking a behavior contract is an assessment for discharge, discharge, or going through behavior detox.

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Written by: Ryan Snodgrass, LMFT, LPCC

— Reviewed by: Paul Alexander, CEO

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