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Wednesday, 11 April 2012

Aversion Therapy at the Judge Rotenberg Centre

An upsetting video was played to a jury in a Massachusetts courtroom yesterday. According to Fox Boston the video 'shows former resident Andre McCollins screaming, writhing in pain, and begging for help'. He was a student in 2002 at the Judge Rotenberg Center, a special needs school for children with behavioural problems. The eighteen year old was screaming because of the electric shocks he was suffering - 31 of them during that day - the first applied because he would not remove his coat.

'For 39 years JRC has provided very effective education and treatment to both emotionally disturbed students with conduct, behavior, emotional, and/or psychiatric problems and developmentally delayed students with autistic-like behaviors'

The JRC Web Site describes the school's behaviourist approach - behaviour modification using a token economy, psycho-education and behavioural contracts. It seems very clinical but it's accepted practice in the treatment of behavioural problems. Behaviourists have effectively demonstrated that if you reward a behaviour you will see more of it. So by praising and rewarding positive behaviour the therapist brings about desired changes in the child.

The Web Site goes on to describe what happens to those children who do not respond to positive reinforcement. It seems they are given 'optional intensive treatment' also described on the Web Site as 'aversive treatments'. We are talking here of electric shocks, but note how this use of medical language provides a cloak of legitimacy and distances the reader from the deed.

This is aversion therapy - electric shocks are 'administered' whenever the individual shows signs of defiance. The Judge Rotenberg Center says this 'treatment' is only considered when other approaches have failed and only after the Center has obtained permission from the child's parents and a court. Andre McCollins's mother says she never consented to this for her son.

I was shocked to see the video, but I was also surprised that formal and systematic aversion therapy was still being used in this way. I had assumed it belonged to the last century, when it was used unsuccessfully in prisons to 'treat' gay men. Electric shocks were applied whenever an individual experienced 'inappropriate' sexual arousal. After a few days most individuals were too terrified to respond sexually to either men or women and were pronounced 'cured'. After a few months, however, these 'treatment gains' were lost as a phenomena the behaviourists call 'extinction' crept in. Even B.F. Skinner, the most radical of the behaviourists disapproved of aversion techniques. Can this really be evidence based practice?

Quite clearly this video shows someone's human rights being abused. It wouldn't be permitted in a prison, so why is it permitted in a special school for autistic children? Why does society think it is OK to treat children in this manner? The Judge Rotenberg Center point to testimonials from former students with happy lives and happy children thanks to the systematic punishment administered by Rotenberg staff. That must be the only justification for this treatment - the end justifies the means.

I was wondering about the position of the staff. I have worked in residential care myself and I've seen the videos of Milgram and the Stanford Prison Experiment. So I guess I'm not surprised when individuals depersonalise and do awful things if there are not adequate structures in place to monitor standards. Did Rotenberg staff lose touch with the morality of the outside world? Look at Abu Graib for an example of what can happen when effective control systems are not in place and power is misused. In this case the treatment meted out to this young man was officially sanctioned - 'we were following his treatment plan' was the phrase repeated in court.

What happens when we apply a theory that reduces human behaviour to stimulus and response? When human values are replaced with a set of medico-scientific values? At the Judge Rotenberg Centre it resulted in an attempt at behaviour modification through the systematic application of pain and stress ... and that's torture.

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