Table 1.

HRQ-CM Item Content

Item	Targeted CM Delivery Skill
As Joe sits down in your office, you see that he notices a lock-box on the desk
entitled ‘Starbucks gift-cards.’ After you introduce yourself to him, Joe asks	Informing patient of earned reinforcers
“Are those gift cards for clients?”
You continue the conversation with Joe, and he mentions an interest in the
convenience of obtaining take-home medication doses. He asks you: “How
many of these sessions do I need to attend to get a take-home dose?	Informing patient of prospective reinforcers
Once the point-system has been explained to him, Joe seems torn about which
incentive to try for. He says “I’m just not sure whether I should use my points
toward a take-home dose or to go to Starbucks.”	Assessing patient interest in reinforcers
Later in the conversation, Joe says “The more I think about it, the more I think
I do want to go to Starbucks after this counseling session ends. I’m hungry,
ya know.”	Delivering earned reinforcers
Joe later says “This is a pretty cool incentive program you have here. Out in the	Praising patient efforts to earn reinforcers
real-world, it seems like the only consequences I ever see is someone threatening
to punish me for doing something wrong.”
Later in the session, you and Joe are discussing his long-term goals. Joe says “I
really hope things go well for me in this program, I’d like to get off the streets
and eventually have my own job again.”	Linking reinforced behavior to abstinence and other goals

Notes: Instrument instructions direct the respondent to ‘write the next thing you would say to Joe,’ who is a 28-year old recently assigned patient who is at your office for his 1^st counseling visit; all items scored for their target CM delivery skill, on a 6-point scale (0 = Absent, 5 = Excellent).