Aversive Intervention: Research and Reflection.

Introduction Anyone who has watched police drama NCIS: Navel Criminal Investigative Service on CBS network has witnessed aversive intervention (Bellisario, 2010). Mark Harmon's character, Jethro Gibbs, as a course of practice, swats his team members on side of head he judges them to have engaged in wrongful thinking or action. One does not know his intent but can assume swat is a punisher, used to stop action or thinking and prevent it from happening in future. In many forms, people engage in aversive intervention as they interact with their families and friends: removing access to gaming systems, grabbing a child's hand to prevent her from getting burned, or withholding affection from one's partner. At first glance, aversive intervention may seem benign, but one does not have to look very far to see need for concern clinicians choose to use aversive intervention as part of a behavior modification plan. Aversive intervention by definition is the systematic use of stimuli or other treatment which a is known to find painful or unpleasant for purpose of discouraging undesirable behavior on part of [person] (Washington School for Deaf, 2004). Methods used implementing aversive intervention include but are not limited to shock, aromatic ammonia, noxious tastes, physical aversives (e.g., spanks, slaps, and hair tugs), water mist, overcorrection, time-out, contingent exercise, visual screening, response cost, and extinction (Gerhardt, Holmes, Alessandri, and Goodman, 1991, p. 267). This paper will review literature on aversive intervention used to modify human behavior and conclude with a reflection on use of aversive intervention. A Look at History In 1247 oldest psychiatric hospital in world was founded. Priory of St. Mary of Bethlehem became a royal hospital in 1375 where term patient care was synonymic for chaining patients to walls, whipping, and dunking in water. When a new facility was built in 1673, a local artist made a pair of gates to depict plight of inmates, and Melancholy Madness. Raving was chained in his cell while Melancholy had a look of defeat. Treatment policies did not change until mid-19th century when hospital came under regular government inspection.... After two inquires which were severely critical of system, treatment rather than punishment began (British Broadcast Corporation, 2004). The Handbook of Behavior Modification and Behavior Therapy, edited by Harold Leitenberg and published in 1976, recommended aversive intervention as a viable treatment option for several behaviors. Stunkard and Mahoney (1976) discussed use of electric shock and use of aversive odors as part of classical conditioning for treatment of obesity. The use of aversive conditioning in forms of electric shock, chemical, and imagery were found to be beneficial paired with non-aversive interventions for treatment of alcoholism (Nathan, 1976). When planning intervention for children with psychological disabilities who were self-injurious, Lovaas and Newsom (1976) reasoned that primary moral justification for use of a relatively small pain in present to prevent a relatively large pain in future (p. 316). Aversive interventions used in treatment of sexual deviants (i.e. homosexuals, exhibitionists, pedophiles) included injected chemicals, electric shock, unpleasant covert fantasies, unpleasant smells, and social shaming situations (Marks, 1976, p. 294). 1990-Present The discussion to use or not use aversive intervention became an increasingly emotional debate in late twentieth century. Several organizations which support individuals with disabilities issued policy statements against use of aversive interventions. The Council for Exceptional Children, The American Association on Mental Retardation, and Association for Persons with Severe Handicaps stated their support of less-intrusive methods of intervention, asserting their effectiveness without negative side effects (Lohrmann-O'Rourke & Zirkel, 1998). …