| Summary: | Contingency management (CM), an intervention that typically provides financial incentives for abstinence, has also been applied to treatment engagement. However, little is known about the magnitude of treatment effects when financial incentives are provided for attendance. A systematic search was conducted to identify studies that included incentives for attendance, either in isolation or in combination with incentives for abstinence. Meta-analysis was used to estimate the effect sizes on treatment attendance and abstinence. A total of 10 studies including 12 CM treatments (6 incentives for attendance only and 6 incentives for both attendance and abstinence) with 1,673 participants were identified. Results indicated a moderate effect (d = 0.47, 95% confidence interval (CI) [0.24, 0.68]) on attendance relative to non-reward active comparison conditions, p <.001. Frequency of incentives for attendance was significantly associated with larger effect sizes. Results also indicated a small effect (d = 0.22, 95% CI [0.11, 0.32]) on abstinence relative to non-reward comparisons, p <.001. Overall, this meta-analysis supported financial incentives for attendance to increase treatment engagement, with smaller effects on abstinence compared to those observed in meta-analyses on financial incentives for abstinence. Although financial incentives for attendance increased clients' attendance, the impact on abstinence was weaker than conditions that included both incentives for attendance and abstinence. Clinics implementing CM should consider these differential effects in the selection of reinforcement targets.
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