Behavioral assessment allows a clinician to identify environmental events that are contributing to challenging behavior to inform effective treatment. Recent developments in behavioral assessment and treatment have been devoted to creating practical procedures that can be conducted by clinicians in socially relevant settings. However, the extent to which these procedural modifications affect treatment outcomes has yet to be fully explored. We conducted a consecutive case series with 13 individuals admitted to an outpatient program to address their challenging behavior. The patients experienced a behavioral package conducted in three phases (practical functional assessment [PFA], behavioral treatment, extension). Results demonstrated near elimination of challenging behavior for all patients after extending the treatment to include denials to reinforcement and instructions to complete other tasks.