"Contingency Management programs (CMP) and non-drug social and recreational activities (NDSRA) are interventions premised on behavior theory that rely on external sources of reinforcement alternative to drug-based forms to decrease drug use. CMP usually employs vouchers as reinforcement for negative toxicologies. Despite research support, CMP alone may be insufficient to achieve abstinence. Although evidence supporting NDSRA is limited, it is promising because it assists patients to employ "fun" real world activities (e.g. films, plays, circus) as alternative sources of reinforcement. Both CMP and NDSRA are currently used at Coney Island Hospital's Outpatient Chemical Dependency Services (CIHCDS) in New York City. The NDSRA program is fairly extensive (greater than 40 events per year) and includes group excursions (868 patient participants in 2009) under the supervision of one or more therapists. A description of program design and clinical observations of its impact follows a brief review of relevant research."