CRA + vouchers integrates a community reinforcement approach originally developed as an effective treatment for alcohol dependence, with an incentive program (vouchers) wherein patients can earn points exchangeable for retail items by remaining in treatment and cocaine abstinent. This multicomponent treatment as a whole and several of its components have been shown to be effective in controlled clinical trials conducted with cocaine- dependent adults in outpatient clinics. Its applicability to younger individuals and in other settings has not been tested. The authors' group has conducted five controlled clinical trials that examined the efficacy of CRA + vouchers. In two trials, it was superior to standard drug abuse counseling in retaining patients in treatment and documenting significant periods of continuous cocaine abstinence. After providing a program overview, the manual discusses the clinical approach, which encompasses counseling style, techniques, and structure. A section on the voucher program addresses objective monitoring, urinalysis schedule, specimen collection, laboratory analysis, and the presentation of results. Other sections of the manual address intake, early counseling sessions, drug avoidance skills, lifestyle change components, relationship counseling, other substance abuse, other psychiatric problems, and clinical supervision. 53 references