Originally emailed 1 March 2004
Cattle Prod Therapy: “Aversive Interventions”
Beverly James, an early critic of Attachment Therapy (AT), once derisively likened AT to using a cattle prod on children. She might have been surprised to learn that therapists once used actual cattle prods on children, and perhaps even more shocked to learn that children in residential centers are still enduring this very cruelty today.
Those using cattle prods, however, referred to its use as “skin shock,” implying only a tingling jolt is delivered to the child. And to obscure matters further, others call it “Faradic Stimulation,” an ill-deserved honor for scientist Michael Faraday. The prod is one of a set of “aversive interventions” that some therapists, educators, and their assistants employ to change undesirable behaviors in children diagnosed with a wide variety of mental and emotional problems.
Many aversive interventions overlap with practices found in Attachment Therapy and AT parenting methods, such as forced exercise, restraint, isolation, pulling hair, spraying various liquids on the face, auditory stimuli, withholding meals and providing inadequate nutrition. Indeed, some observers have characterized Holding Therapy as a combination of strong aversives and psychoanalysis.
Nancy Weiss of TASH, an international organization that “supports the inclusion and full participation of children and adults with disabilities” in society, has written a revealing paper on the use of aversives. Weiss says, “All aversive techniques have in common the application of physically or emotionally painful stimuli.”
Aversive interventions were phased out in many institutions after they were found to have poor effect on changing behavior in the long run, plus they could create more aggressive behaviors when patients rebelled against the “treatment.”
The present use of aversive interventions first came to the attention of AT NEWS when the Judge Rottenberg Education Center (JRC) was recently evaluated for licensure in Massachusetts. JRC’s website (note photos of electrical devices) justifies their longtime use of skin shock by citing a 1989 NIH Consensus Paper which states that skin shock may be a necessary emergency safety measure to prevent self-injurious behaviors or injuries to others. But that NIH document currently has the following warning: PLEASE NOTE: This statement is outdated and is no longer viewed by NIH as guidance for medical practice.
While skin shock is no longer recommended by NIH as an emergency safety measure, there is evidence that shocking has been and continued to be routinely used even for mere idiosyncratic behaviors, such as twitching or rocking. JRC itself claims to use skin shock 24/7 — even on children in the shower — for behaviors including:
- Inappropriate urination/defecation
- Preventive use in form of behavior rehearsal lessons
- Occasional use in negative reinforcement paradigm
- Occasional use to punish refusals in the form of intentional wrong answer
An alliance of organizations is currently forming — Alliance to Prevent Restraint, Aversive Interventions, and Seclusion (APRAIS) — to promote the elimination of aversives, seclusion and the non-emergency use of restraint. On the Steering Committee of APRAIS are representatives of:
- The Association for Persons with Severe Handicaps
- Judge David L. Bazelon Center for Mental Health Law,
- Family Alliance to Stop Abuse and Neglect
- Federation of Families for Children’s Mental Health
- National Association of Councils on Developmental Disabilities
- National Association of Protection and Advocacy Systems
- National Association of State Mental Health Program Directors
- National Down Syndrome Congress, and
- National Down Syndrome Society.
Caution: links may have aged since this AT News was first emailed.