context that can be so powerful in altering or maintaining the harmful behavior. Treatment programs continue to stress insight into personal bases for harmful behaviors, or self-management skills for controlling those behaviors, or empowerment to encourage the individual's confidence in forgoing them, but fail to emphasize the development of pleasing, healthy, available alternatives. Thus, the status of the behavioral economic concept of substitutability might be summarized as widely applicable, widely understandable, but all too narrowly appreciated and applied.
Preparation of this chapter was facilitated by grant MH55308 from the National Institute of Mental Health and by NIH grants DK20579, DK48400, CA6863301, and ES08711.
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