The Ideology of Aversive Treatment as Applied to Clients and Colleagues

ABSTRACT

Despite calls for reconciliation, the debate over aversive versus nonaversive treatment continues. McNeil, Clemens-Mowrer, Gurwitch, and Funderburk (1994a) used a combination of brief timeout and brief physical restraint to teach severely behaviorally disordered preschoolers to remain in timeout. Their procedures were shown to be effective both clinically and statistically. However, one reviewer (Lutzker, 1994a, b) found the research “appalling,” and expressed the hope “never to see this land of research again” (1994a, p. 35).

Drawing on McNeil et al.'s research and Lutzker's evaluation, this paper addresses several aspects of the current controversy, including: potentially problematic aspects of an ideological approach; the nature of the reviewing process; other “aversive” research projects in the literature; the relative intrusiveness of psychoactive medications; alternatives to legal actions against school districts; side effects; the elusive nature of “positive” interventions; the aversive approaches to colleagues taken by some advocates of the nonaversive position; potentially therapeutic effects of restraint; individual differences; normalization, social validity, and reality; giving “dangerous” technologies to parents and other caregivers; and the rights of the victims of aggression.

Both “aversive” and “nonaversive” procedures can be effective or ineffective depending on the specific circumstances in which they are applied. As practitioners, we should continue to investigate these circumstances systematically, so that we can continue to develop empirically validated techniques that address these concerns.