Treatment contracting in cognitive-behavior therapy Original Research Article

Consistent with the goal of providing reviews of core strategies and principles used in cognitive-behavior therapy (), this article is devoted to a discussion of the philosophy, elements, and potential benefits of treatment contracting. Treatment contracting is discussed as a way of formalizing the goals, responsibilities, and strategies to be employed in treatment by therapists, patients, and the patientʹs support network. In particular, we discuss the potential value of contracts for enhancing motivation and eliciting adaptive behaviors from patients, particularly at moments of high stress or high risk when these behaviors are most needed. In addition, we comment on how contracts can serve as an agreement of advocacy for patients who may fail to take appropriate action for themselves during acute distress. We provide an example of a treatment contract for use with adults with posttraumatic stress disorder (PTSD). This contract most directly focuses on enhancing motivation for treatment and engendering self-care, and is embedded in the context of an informational worksheet detailing common patterns in PTSD.