Going "all out" pharmacologically? A re-examination of Berkman and Meyer's "alternative strategies and multiple outcomes in remediation of severe self-injury: going 'all out' nonaversively".

Berkman and Meyer (1988) is frequently cited as evidence of the effectiveness of positive-oriented programming approaches and in opposition to aversive procedures. In that report, Berkman and Meyer attributed reductions in a client's self-injurious behavior to their intervention. They appeared to rule out the possibility that medication could have been responsible for behavior changes by reporting that medication was held constant during their intervention. We have recently obtained medication records indicating that (a) Berkman and Meyer incorrectly reported their client's medication status during their intervention and (b) there appears to have been a relation between the introduction of Thorazine (with subsequent increases in dosage) and reductions in the client's self-injurious behavior.