Use of behavioral contingency contracting with heart transplant candidates.

For many years, behavioral contingency contracting has been useful in increasing compliance in a variety of patient populations. More recently, this type of contracting has been used to facilitate communication and motivate behavioral change among patients referred for transplantation. This article discusses the theoretical basis of behavioral contingency contracting and describes the development and implementation of a multipurpose behavioral contract for patients receiving heart transplants. The scarcity of donor organs and the stringent posttransplant regimen mandates that psychosocial as well as medical variables be considered during the transplant evaluation process. Behavioral contingency contracting is useful in identifying those individuals with the potential to maintain a transplanted organ capably.