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We wanted our younger colleagues to understand this However, when reading the full paper, Strober appears to contend that FBT advocates are a radical bunch of contentious people, who are young and would benefit from his worldly wisdom about how treatment should be.īut as we began to write, we felt that a discussion focused on benchmarks alone would not suffice because while they can be plausibly described, implementing them at a point in treatment when symptoms are worsening or progress has stalled is a unique challenge and as our key point argues, not many challenges in AN can be managed without convincing insights and strong clinical skills. This article is a clinical perspective on these issues Instead, the knowledge void has been taken up recently by a host of misguided notions about etiology, blatantly dismissive attitudes toward psychological concepts, and ill-conceived beliefs about therapy priorities. Unfortunately, many in the eating disorder field seem to know little of this work or the implication it holds for treatment philosophy. But the potential for new insights has been advancing, largely as a result of elegant research in the neurosciences that has modeled behavioral processes resembling key features of the illness. The Need for Complex Ideas in Anorexia Nervosa: Why Biology, Environment, and Psyche All Matter, Why Therapists Make Mistakes, and Why Clinical Benchmarks Are Needed for Managing Weight Correction by Michael Strober and Craig Johnsonĭue to be published in the IJED and, I believe, is the last article that Dr Strober has written before retiring.Īnorexia nervosa remains an enigma and its clinical challenge is intimidating. Please note that extinction should not be used with difficult or dangerous behaviors.I have recently been asked to review an advance copy of : If a teacher chooses to use extinction, it should be paired with positive interventions, as described later in this module. Is susceptible to spontaneous recovery, instances in which previously extinguished behavior reappears unexpectedly.The talking-out behavior may even escalate to yelling or other extreme behaviors. In an extinction burst, the initial ignoring is followed by an increase in the rate of talking out as the student tries even harder to get the teacher’s attention. A teacher who decided to put this behavior on extinction would refrain from responding to the student’s comments. Consider a student who yells out answers to the teacher’s questions without raising her hand.
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Often results in an extinction burst, a situation in which the behavior gets worse before it gets better.Depends on the ability to control all sources of reinforcement (e.g., peer laughter).Does not produce a quick change in behavior.Extinction is often difficult to use on its own in a classroom because it:
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