Evaluating the use of Aversive Techniques in the Treatment of Challenging Behaviour inResponse to the Statement: 'Aversives should never be used in treating challenging behaviour'
The use of treatment procedures which intentionally inflict discomfort, distress, and often pain upon subjects has generated great debate surrounding the nature of the treatments, the efficacy of those methods, and the well-being of those subjected to them. Needless to say we may all agree as psychologiststhat an individual should have the right to treatment, moreover the right to a treatment that will alleviate negative symptoms as quickly and as painlessly as possible. However few of us explicitly denote the infliction of pain and discomfort to reach these goals. This discourse derives from modern society’saffiliation to human rights, protection of the weak, and the general softening of attitudes towards the sick that has developed over the last century. This liberal, ethical perspective is all well and good. But are we willing to use drastic measures in the treatment of seriously challenging behaviours? If all else f ails should we apply restrains and electric shock to a child, who left alone would proceed to mutilate himself? Or should we continue our less intrusive treatments regardless of their efficacy? Perhaps a short sharp shock is more ethical than the drawn out suffering of the patient.
This point of view is supported by Butterfield (1990) who argues that a treatment is ethical insofar as the treatment itself and the resulting condition cause less physical and psychological harm than if the patient received no treatment. Butterfield is far from alone in this fieldof thought as there are many who posit that not using punishment in situations where other treatments have been utilised unsuccessfully withholds a potentially effective treatment, and kee ps the patient in a dangerous or painful state (Cooper, Heron & Heward. 1987). In this way, avoidance of aversive techniques is the unethical choice, not the use thereof. By aversive technique we mean that upon presentation of a challenging behaviour, a stimulus is introduced thatupon its arrival depresses the behaviour, and upon its contingent removal positive behaviour are strengthened (Cooper, Heron & Heward. 1987, p411). In this way, behaviour can be managed by use of (or relief from) unpleasant or uncomfortable stimuli. However, for the purpose of this paper we may focus on the effect aversive have upon behaviour rather than slip into thetrap of dealing with the subjective interpretations of ‘unpleasant’ or ‘uncomfortable’ as theymay vary from person to person. Now we must decide whether the efficacy of an aversive procedure can determine whether or not it may be deemed ethical. In his paper, Butterfield (1990) concludes that serious s