Generalization and Maintenance in Therapeutic Systems: Analysis and Proposal for Change

The position presented is that generalization and maintenance of therapeutic gains are not adequately accounted for in many therapeutic systems. A discussion of the importance of these issues is followed by an analysis of the barriers to programming durable therapeutic change. Preliminary suggestions for enhancing accountability for long-term clinical outcome are provided. I conclude that the profession's internal monitoring of long-term outcome be considered a priority in the optimal delivery of clinical services and in ultimately controlling its own practices.