Bonuses for Therapists Increase Thoroughness of Teen Substance Abuse Treatment

Therapists who treat adolescents for drug and alcohol abuse deliver more complete treatment when they are offered monetary rewards based on the quality and quantity of care they deliver, suggests a new study.

However, the study did not find more thorough treatment by therapists resulted in better results for teens. Those who saw therapists participating in the “pay-for-performance” program were not any more likely to stop using drugs and alcohol, compared with their peers whose therapists did not participate in the program.

Pay-for-performance rewards are becoming more common throughout the healthcare system, according to Reuters.

The study included 29 community-based drug treatment organizations, which were chosen to start using a teen behavioral treatment program. Some of the programs were given monetary incentives for therapists who thoroughly implemented the program’s strategies.

About 100 therapists and more than 900 teenagers were included in the study. Most of the teens were boys being treated for alcohol or marijuana use.

Therapists in the financial incentives group were given $50 for each month they demonstrated their treatment met program guidelines. They received an additional $200 for each patient with whom they discussed specific topics and used a range of treatment tools, such as talking about the teens’ social life, and their progress toward treatment goals.

Therapists who received the incentives tended to deliver more complete care, compared with their colleagues who did not receive incentives. While pay-for-performance therapists gave 17 percent of patients the full recommended amount of treatment, less than 3 percent of therapists not receiving incentives did so. “Relatively small incentives led to very large improvements in performance,” said lead researcher Bryan Garner of Chestnut Health Systems in Normal, Illinois.

Between 41 and 51 percent of patients seen by both groups of therapists improved during the study, and had not used drugs or alcohol for at least a month before their last check-in, the researchers reported in the Archives of Pediatrics & Adolescent Medicine.