Response cost: The removal of conditioned reinforcers for therapeutic change

Abstract

Response cost (RC), a punishment procedure in which conditioned reinforcers (points, tokens, or money) are withdrawn to suppress a response, has been used as a behavior therapy technique on its own and in conjunction with reinforcement in token economies. Studies in both laboratory and clinical settings are reviewed. The following conclusions are made: (1) RC has suppressed a variety of behaviors (e.g., smoking, overeating, stuttering, psychotic talk) with diverse clinical populations (e.g., psychotics, sociopaths, retardates, school children); (2) Behaviors suppressed with RC often do not recover when the punishment contingency is withdrawn; and (3) Undesirable side effects frequently associated with punishment typically are not found with RC. The paucity of studies with long-term followup periods and careful examination of side effects makes the last two conclusions tentative. Aspects of RC which may contribute to its efficacy are discussed. These include cost magnitude, instructions, and informative feedback. Recommendations are made for increased use of RC as a behavior therapy technique.