Carol-Ann Getty

I completed my PhD at the National Addiction Centre, King’s College London. My research focuses on the remote delivery of Contingency Management to promote positive behaviour change in individuals with substance use disorder. More specifically, my research explores the feasibility and acceptability of monitoring substance use behaviours such as abstinence, medication adherence and treatment engagement, and delivering incentives remotely using mobile telephones.

I hold a BSc Hons Psychology degree and MSc in Applied Behaviour Analysis from Ulster University. I have experience of working and volunteering within residential drug and alcohol detox units, substance misuse treatment centres and homeless hostels. More recently, I worked at Johns Hopkins Baltimore, in a Behavioural Research unit implementing and evaluating contingency management behavioural interventions that aim to achieve and maintain abstinence in unemployed refractory drug users and reduce HIV-related risk behaviours in injection drug users.

Exploration of patients’ beliefs, acceptability, and experience of mobile telephone-delivered Contingency Management

Contingency Management’s (CM) growing research base has highlighted the promising role that technology may play in improving the reach of these interventions to promote treatment-related outcomes for individuals with substance use disorder (SUD).

Using a mixed methods approach, this project explored (a) patients’ beliefs and acceptability towards CM and the remote application of CM, and (b) patients’ experience of mobile telephone-delivered CM (mCM). To achieve these aims, the Service User Survey of Incentives (SUSI) was developed and disseminated among patients [N=181] receiving treatment for SUD in 3 UK-based drug and alcohol treatment services. Qualitative interviews, analysed using Framework, were conducted at two-time points with patients [N=9] receiving mCM to encourage adherence to supervised opioid agonist treatment (OAT).

Overall, 81% of patients were accepting of CM and the use of technology to monitor behaviour and deliver incentives remotely. The mCM intervention was well received and had perceived positive impacts on patients’ adherence to their methadone treatment. Qualitative findings suggest the development of a connection with the telephone system, one that in many aspects resembles a therapeutic alliance. These interactions were deemed positive, friendly, and non-critical, with patients expressing confidence, reliance, and trust in the system’s ability to help in their recovery.

In conclusion, the mechanisms underpinning Contingency Management appear to operate in the absence of human interaction. Delivering praise messages and financial incentives remotely also appear sufficient in generating positive behaviour change. These findings are encouraging and support the development and implementation of mCM within UK drug and alcohol treatment services.