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Laureano B, Ringdahl J, Falligant JM. Examination of clinical variables affecting resurgence: A reanalysis of 46 applications. J Appl Behav Anal 2024. [PMID: 38808478 DOI: 10.1002/jaba.1091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 05/07/2024] [Indexed: 05/30/2024]
Abstract
Despite the efficacy of behavioral interventions, resurgence of challenging behavior (e.g., aggression, self-injury) following successful treatment can still occur. Applied work has focused on identifying treatment-related variables thought to affect the occurrence and magnitude of resurgence. The current study describes the relation between several variables (i.e., phase duration, response rates in baseline and treatment, obtained rates of reinforcement, downshift in reinforcement step size) and resurgence in a retrospective consecutive controlled case series of 46 treatment applications for challenging behavior conducted in an inpatient setting. Only the downshift in reinforcement (e.g., schedule-thinning) step size was correlated with the magnitude of resurgence. These results are consistent with recent findings suggesting that treatment duration and other factors have inconsistent effects on resurgence of challenging behavior.
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Affiliation(s)
- Brianna Laureano
- Department of Behavioral Psychology, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
| | - Joel Ringdahl
- Center for Autism and Behavioral Education Research, The University of Georgia, Athens, Georgia, USA
| | - John M Falligant
- Department of Behavioral Psychology, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
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2
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Greer BD, Shahan TA, Irwin Helvey C, Fisher WW, Mitteer DR, Fuhrman AM. Resurgence of destructive behavior following decreases in alternative reinforcement: A prospective analysis. J Appl Behav Anal 2024. [PMID: 38742859 DOI: 10.1002/jaba.1083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 05/02/2024] [Indexed: 05/16/2024]
Abstract
Basic and retrospective translational research has shown that the magnitude of resurgence is determined by the size of the decrease in alternative reinforcement, with larger decreases producing more resurgence. However, this finding has not been evaluated prospectively with a clinical population. In Experiment 1, five participants experienced a fixed progression of reinforcement schedule-thinning steps during treatment of their destructive behavior. Resurgence occurred infrequently across steps and participants, and when resurgence did occur, its clinical meaningfulness was often minimal. In Experiment 2, five new participants experienced these same schedule-thinning steps but in a counterbalanced order. Resurgence occurred most often and was generally largest with larger decreases in alternative reinforcement programmed earlier in the evaluation. Large decreases in alternative reinforcement may be more problematic clinically when they occur earlier in treatment. Whether larger transitions can be recommended in the clinic following the success of smaller ones will require additional research.
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Affiliation(s)
- Brian D Greer
- Children's Specialized Hospital-Rutgers University Center for Autism Research, Education, and Services (CSH-RUCARES), Somerset, NJ, USA
- Rutgers Brain Health Institute, Piscataway, NJ, USA
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | | | - Casey Irwin Helvey
- Children's Specialized Hospital-Rutgers University Center for Autism Research, Education, and Services (CSH-RUCARES), Somerset, NJ, USA
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Wayne W Fisher
- Children's Specialized Hospital-Rutgers University Center for Autism Research, Education, and Services (CSH-RUCARES), Somerset, NJ, USA
- Rutgers Brain Health Institute, Piscataway, NJ, USA
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Daniel R Mitteer
- Children's Specialized Hospital-Rutgers University Center for Autism Research, Education, and Services (CSH-RUCARES), Somerset, NJ, USA
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Ashley M Fuhrman
- Children's Specialized Hospital-Rutgers University Center for Autism Research, Education, and Services (CSH-RUCARES), Somerset, NJ, USA
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
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3
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Van Arsdale A, Ibañez VF, Vollmer TR. Noncontingent reinforcement in the treatment of pediatric feeding disorder: A concise review. J Appl Behav Anal 2024. [PMID: 38566442 DOI: 10.1002/jaba.1073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 03/08/2024] [Indexed: 04/04/2024]
Abstract
This concise review summarizes the literature on noncontingent reinforcement in the treatment of pediatric feeding disorder from 2018 to 2022. We reviewed 15 published behavior-analytic feeding studies to identify how often the term noncontingent reinforcement is used, what form of noncontingent reinforcement is delivered, and what the effects of noncontingent reinforcement are on behavior when it is included in treatment. Implications and directions for future research are discussed.
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Affiliation(s)
- Angie Van Arsdale
- Department of Psychology, University of Florida, Gainesville, FL, USA
| | - Vivian F Ibañez
- Department of Psychology, University of Florida, Gainesville, FL, USA
- University of Florida Health Center for Autism and Neurodevelopment, Gainesville, FL, USA
| | - Timothy R Vollmer
- Department of Psychology, University of Florida, Gainesville, FL, USA
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Kranak MP, Brown KR. Updated Recommendations for Reinforcement Schedule Thinning following Functional Communication Training. Behav Anal Pract 2024; 17:87-106. [PMID: 38405284 PMCID: PMC10891008 DOI: 10.1007/s40617-023-00863-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2023] [Indexed: 02/27/2024] Open
Abstract
Schedule thinning is a necessary treatment procedure following the acquisition of a communication response during functional communication training. In this article, we update and extend the Hagopian et al. Behavior Analysis in Practice, 4, 4-16, (2011) review and recommendations on schedule-thinning procedures following functional communication training. Since their publication, substantial research has been published on the efficacy, efficiency, and social validity of schedule-thinning methods. We provide updated recommendations for schedule thinning based on contemporary literature that has been published since 2011, as well as discuss key areas for future research.
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Affiliation(s)
- Michael P. Kranak
- Oakland University, Rochester, MI USA
- Oakland University Center for Autism, Rochester, MI USA
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Falligant JM, Kranak MP, Piersma DE, Benson R, Schmidt JD, Frank-Crawford MA. Further evidence of renewal in automatically maintained behavior. J Appl Behav Anal 2024; 57:490-501. [PMID: 38239100 PMCID: PMC10984774 DOI: 10.1002/jaba.1055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 01/03/2024] [Indexed: 02/08/2024]
Abstract
Renewal is a relapse phenomenon that refers to the recurrence of a previously reduced behavior following a change in stimulus conditions. Muething et al. (2022) examined the phenomenology of renewal among individuals with automatically maintained challenging behavior treated at an outpatient clinic. We replicated their findings by retrospectively examining renewal across various topographies of automatically maintained behavior treated at an inpatient hospital, and we extended their work by also examining differences across subtypes of automatically maintained self-injurious behavior. The prevalence of renewal was comparable to that observed by Muething et al., supporting the notion that automatically maintained challenging behavior is susceptible to relapse phenomena. Furthermore, renewal was twice as likely to occur for individuals with Subtype 2 versus Subtype 1 self-injurious behavior, providing additional evidence of behavioral differentiation between subtypes. Our findings suggest that even after apparent stability in treatment, practitioners should remain vigilant for the recurrence of automatically maintained behavior during generalization.
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Affiliation(s)
- John Michael Falligant
- Department of Behavioral Psychology, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Science, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
| | - Michael P. Kranak
- Department of Human Development and Child Studies, Oakland University, Rochester, MI, USA
- Center for Autism, Oakland University, Rochester, MI, USA
| | - Drew E. Piersma
- Department of Behavioral Psychology, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Ryan Benson
- Department of Behavioral Psychology, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Jonathan D. Schmidt
- Department of Behavioral Psychology, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Science, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
| | - Michelle A. Frank-Crawford
- Department of Behavioral Psychology, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Science, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
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Shahan TA, Sutton GM, Van Allsburg J, Avellaneda M, Greer BD. Resurgence Following Higher or Lower Quality Alternative Reinforcement. J Exp Anal Behav 2024; 121:246-258. [PMID: 38329150 DOI: 10.1002/jeab.904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 01/24/2024] [Indexed: 02/09/2024]
Abstract
Resurgence is a temporary increase in a previously suppressed target behavior following a worsening in reinforcement conditions. Previous studies have examined how higher rates or magnitudes of alternative reinforcement affect suppression of the target behavior and subsequent resurgence. However, there has been no investigation of the effects of higher versus lower qualities of alternative reinforcement on resurgence. Using a three-phase resurgence preparation with rats, the present experiments examined the effects of an alternative reinforcer that was of higher (Experiment 1) or lower (Experiment 2) quality than the reinforcer that had previously maintained the target behavior. The results of both experiments showed greater reductions in target behavior with a higher quality alternative reinforcer and larger increases in target responding when a higher quality alternative reinforcer was removed. Along with prior findings with higher rates and magnitudes of alternative reinforcement, these findings suggest that variations in reinforcer dimensions that increase the efficacy of alternative reinforcement also tend to increase resurgence when alternative reinforcement is removed. The results are discussed in terms of the resurgence as choice in context model and in terms of potential clinical implications.
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Affiliation(s)
| | | | | | | | - Brian D Greer
- Children's Specialized Hospital-Rutgers University Center for Autism Research, Education, and Services (CSH-RUCARES), Somerset, NJ, USA
- Rutgers Brain Health Institute, Piscataway, NJ, USA
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
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Smith SW, Greer BD. Translational evaluation of on/off alternative reinforcement cycling. J Exp Anal Behav 2023; 120:429-439. [PMID: 37680018 PMCID: PMC10840708 DOI: 10.1002/jeab.879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 08/04/2023] [Indexed: 09/09/2023]
Abstract
Cycling between the availability and unavailability of reinforcement for alternative responding has successfully reduced resurgence in basic laboratory evaluations, but this approach represents a marked departure from current standards of care when treating problem behavior, warranting careful translation before its use clinically. Therefore, with extinction arranged for target responding across groups in Phase 2, we evaluated the effects of cycling between the availability and unavailability of differential reinforcement of alternative behavior (DRA) using a computer-based task with adult humans recruited through Amazon MTurk. Two control groups experienced constant DRA in Phase 2, with one group experiencing a dense DRA schedule and another group experiencing a lean DRA schedule. The cycling DRA group tended to show greater reductions in target responding and improved discrimination in Phase 2 and less target responding across Phases 2 and 3 than the lean DRA and dense DRA groups. These preliminary findings suggest that on/off DRA cycling procedures may produce more desirable treatment outcomes than constant DRA without producing negative side effects; however, further research is needed to confirm these possibilities.
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Affiliation(s)
- Sean W. Smith
- Department of Pediatrics, SUNY Upstate Medical University, Syracuse, NY
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School
| | - Brian D. Greer
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School
- Children’s Specialized Hospital–Rutgers University Center for Autism Research, Education, and Services (CSH–RUCARES)
- Rutgers Brain Health Institute
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Lloveras LA, McKeown CA, Lichtenberger SN, Sellers TP, Vollmer TR. Recommendations Regarding Use of the Term " Ignore" in Applied Behavior Analysis. Perspect Behav Sci 2023; 46:399-408. [PMID: 37425990 PMCID: PMC10322799 DOI: 10.1007/s40614-023-00373-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2023] [Indexed: 07/11/2023] Open
Abstract
Ignore is a common term used in behavioral assessment, behavior intervention plans, textbooks, and research articles. In the present article, we recommend against the typical usage of the term in most applications of behavior analysis. First, we briefly outline some history of the use of the term in behavior analysis. Then, we describe six main concerns about ignore and the implications for its continued use. Finally, we address each of these concerns with proposed solutions, such as alternatives to the use of ignore.
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Kimball RT, Greer BD, Fuhrman AM, Lambert JM. Relapse and its mitigation: Toward behavioral inoculation. J Appl Behav Anal 2023; 56:282-301. [PMID: 36715533 PMCID: PMC10121865 DOI: 10.1002/jaba.971] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 12/03/2022] [Indexed: 01/31/2023]
Abstract
Relapse following the successful treatment of problem behavior can increase the likelihood of injury and the need for more intensive care. Current research offers some predictions of how treatment procedures may contribute to relapse, and conversely, how the risk of relapse can be mitigated. This review describes relapse-mitigation procedures with varying levels of support, the quantitative models that have influenced the research on relapse mitigation, different experimental methods for measuring relapse mitigation, and directions for future research. We propose that by viewing the implementation of relapse-mitigation procedures as a means of producing behavioral inoculation, clinicians are placed in the proactive and intentional role of exposing their client's behavior to an array of reinforcement and stimulus conditions during treatment with the goal of decreasing the detrimental impact of future treatment challenges.
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Affiliation(s)
- Ryan T. Kimball
- Department of Counseling and Applied Behavioral Studies, University of Saint Joseph
| | - Brian D. Greer
- Rutgers Brain Health Institute
- Severe Behavior Program, Children’s Specialized Hospital–Rutgers University Center for Autism Research, Education, and Services (CSH–RUCARES)
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School
| | - Ashley M. Fuhrman
- Severe Behavior Program, Children’s Specialized Hospital–Rutgers University Center for Autism Research, Education, and Services (CSH–RUCARES)
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School
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Kimball RT, Salvetti EL, Day LE, Karis R, Silveira J, Kranak MP. Operant ABA renewal during dense and lean schedules of differential reinforcement. J Exp Anal Behav 2023; 119:529-538. [PMID: 36945863 DOI: 10.1002/jeab.840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 02/09/2023] [Indexed: 03/23/2023]
Abstract
Renewal is a type of relapse that occurs due to a change in context. Previous research has demonstrated that renewal of target responding may occur despite the availability of differential reinforcement for an alternative response (DRA). Nevertheless, the current literature on renewal presents mixed findings regarding the effects of dense and lean schedules of DRA on the magnitude of renewal. We used a translational approach with undergraduate college students and a task on a touchscreen tablet device to study the effects of dense and lean schedules of DRA during repeated renewal tests. All participants experienced two, three-phase ABA renewal arrangements. In the dense and lean renewal arrangements, we differentially reinforced alternative behavior in Context B and the renewal test in Context A on a VI 3-s or a VI 12-s schedule, respectively. Overall, we observed renewal in 31/36 (86%) renewal tests regardless of the density of reinforcement for the alternative response. Furthermore, the results showed that although renewal occurred in both arrangements, we found slightly higher magnitudes of renewal during DRA with lean schedules of reinforcement relative to dense schedules. We discuss the implications of these findings as they relate to the treatment of problem behavior.
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Affiliation(s)
| | - Emily L Salvetti
- University of Nebraska Medical Center's Munroe-Meyer Institute, Omaha, NE, USA
| | | | | | | | - Michael P Kranak
- Oakland University, Rochester, MI, USA
- Oakland University Center for Autism, Rochester, MI, USA
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11
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Fisher WW, Greer BD, Shahan TA, Norris HM. Basic and applied research on extinction bursts. J Appl Behav Anal 2023; 56:4-28. [PMID: 36193974 PMCID: PMC9868065 DOI: 10.1002/jaba.954] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 09/15/2022] [Indexed: 01/26/2023]
Abstract
Discontinuation of the contingency between a response and its reinforcer sometimes produces a temporary increase in the response before its rate decreases, a phenomenon called the extinction burst. Prior clinical and basic studies on the prevalence of the extinction burst provide highly disparate estimates. Existing theories on the extinction burst fail to account for the dynamic nature of this phenomenon, and the basic behavioral processes that control response bursting remain poorly understood. In this paper, we first review the basic and applied literature on the extinction burst. We then describe a recent refinement of the concatenated matching law called the temporally weighted matching law that appears to resolve the above-mentioned issues regarding the extinction burst. We present illustrative translational data based conceptually on the model. Finally, we discuss specific recommendations derived from the temporally weighted matching law regarding procedures clinicians could implement to potentially mitigate or prevent extinction bursts.
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Affiliation(s)
- Wayne W. Fisher
- Rutgers Brain Health Institute
- Children's Specialized Hospital–Rutgers University Center for Autism Research, Education, and Services
- Department of PediatricsRutgers Robert Wood Johnson Medical School
| | - Brian D. Greer
- Rutgers Brain Health Institute
- Children's Specialized Hospital–Rutgers University Center for Autism Research, Education, and Services
- Department of PediatricsRutgers Robert Wood Johnson Medical School
| | | | - Halle M. Norris
- Children's Specialized Hospital–Rutgers University Center for Autism Research, Education, and Services
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12
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Ibañez VF, Peters KP, Bacotti JK, Lloveras LA, Van Arsdale A, Vollmer TR. Teaching behavior analysts in an early intensive behavioral intervention setting to conduct a structured mealtime protocol. BEHAVIORAL INTERVENTIONS 2022. [DOI: 10.1002/bin.1915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Vivian F. Ibañez
- Deparment of Psychology University of Florida Gainesville Florida USA
| | - Kerri P. Peters
- Deparment of Psychology University of Florida Gainesville Florida USA
- Department of Psychiatry University of Florida Gainesville Florida USA
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13
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Conducting Translational Research in the Context of Patient Care. Perspect Behav Sci 2022; 45:383-398. [PMID: 35719871 PMCID: PMC9163257 DOI: 10.1007/s40614-022-00333-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2022] [Indexed: 10/18/2022] Open
Abstract
Although much has been written on the importance of translational research for bridging the continuum of basic science to clinical practice, few authors have described how such work can be carried out practically when working with patient populations in the context of ongoing clinical service delivery, where the priorities for patient care can sometimes conflict with the methods and goals of translational research. In this article, we explore some of the considerations for conducting this type of work while balancing clinical responsibilities that ensure high-quality patient care. We also discuss strategies we have found to jointly facilitate translational research and improve routine, clinical service delivery. A primary goal of this article is to encourage others working in applied settings to contribute to the increasingly important role that translational research plays in our science and practice by helping to better characterize and potentially lessen or remove barriers that may have impeded such investigations in the past.
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