A systematic review of enhanced resurgence paradigms

King et al. (2024) looked at every lab study that changed both the room cues and the payoff for good behavior at the same time. They wanted to see if doing both together makes problem behavior come back stronger than doing just one.

The team pulled papers from 1970 to 2022. They only kept studies that tested two or more relapse tricks together, like thinning rewards while also moving the client back to the old room.

When the context and the reinforcement both get worse at the same time, relapse is big. But almost no study pulled the two factors apart, so we still do not know if the effect is truly additive.

The review shows a gap: labs love to mix triggers, yet they rarely test each one alone. That leaves BCBAs guessing how much each piece matters.

Podlesnik et al. (2023) came first. That review listed every basic resurgence method but never asked if combined triggers stack. King et al. (2024) narrows the lens and therefore supersedes the older work by focusing on combo paradigms.

Single-case studies echo the warning. Liggett et al. (2018) saw bigger relapse in autistic children when both reinforcer loss and reinforcer return hit at once. Greer et al. (2024) showed the same pattern: a sudden big drop in alternative reinforcement sparked the most resurgence.

The papers do not clash; they just zoom in from different heights. The 2024 review ties the loose lab facts into one story: double changes, double trouble.

You already guard against relapse, but now plan for the one-two punch. If you must move a client back to the old classroom and cut token value on the same day, expect a larger spike. Split the changes when you can: move first, thin later, and keep alternative reinforcement strong during each shift.