Aversion Therapy: Technical, Ethical, and Safety Issues
| DOI | 10.1177/000486587901200207 |
| Author | Grant R Wardlaw |
| Published date | 01 June 1979 |
| Date | 01 June 1979 |
AUST
& NZ
JOURNAL
OF
CRIMINOLOGY
(June 1979) 12(43-54) 43
AVERSION THERAPY:
TECHNICAL,
ETHICAL,
AND
SAFETY ISSUES
Grant
R
Wardlaw
Summary
The
factors which should be considered
when
deciding
on the appropriateness of aversion therapy are
discussed in terms of
the
type
of stimulation to
be
used, the safety of electrical stimulation, and the
ethical problems
inherent
in using aversive
procedures.
It is
argued
that aversion
therapy
is
appropriate
in limited circumstances
provided
that
strict
control
is maintained
over
the decision making process.
Frequently
calls
are
made
for
the
use
of
aversion
therapy
in
the
treatment
of
offenders (particularly sex offenders)
who
are
considered
to
be
a
danger
to the
community.
Such
suggestions
are
regularly
countered
by
arguments
about
the
efficacy of
the
stimuli used in aversion
therapy
programmes,
about
the
safety
of
the
procedures,
and
about
the
ethics
of
such
modes
of
treatment
(Dirks 1974,
Leinwand, 1976).
The
present
paper
will
attempt
to
put
into
perspective
some
of
these concerns.
The
issues to
be
discussed
here
fall intoa
number
of
areas. First,
the
types of stimuli
which
may
be
included
in an aversion
therapy
programme
are
summarized
and
the
reasons for
preferring
faradic
stimuli
over
other
alternatives
are outlined.
Having
made
a
case
for
the
superiority of
faradic
stimulation,
we
tum
to the
safety
issues
which
arise in
their
application. Following this
we
discuss
the
ethical context
within
which
much
of
the
debate
over
aversion
therapy
takes
place
and
suggest a
form
of
regulation
over
decision making
and
programme
execution
which
answers
some
of
the criticisms
made
about
the
conduct
of
aversion therapy.
Properties
of
Useful
Aversive Stimuli
Since the
principal
purpose
of
aversive
procedures
is to
change
the
frequency
of
behaviour,
the
stimulus chosen to efficiently
produce
this
change
is
of
primary
importance. Azrin
and
Holz
(1966)
have
outlined
the
definite
properties
which
an
ideal punishing stimulus should
have,
and
we
consider
that
these criteria should
be
used to
evaluate
any
proposed
aversivestimulus.These
properties
are
as
follo\vs:-
(i)
The
physical
dimensionsof the stimulus should be specific
and
precise in such
a
way
as to
allow
accurate
measurement.
Use
of stimuli
which
consist
of
discrete
units allow
ready
replication
and
reliable measurement.
(ii)
The
actual
contact
the
stimulus
makes
with
the subject should
be
constant.
(iii)
The
subject
should
not
be
able
to avoid, escape, or
attenuate
the stimulation
unless this is a specific
option
built
into
the
procedure.
(iv)
There
should
be
no significant skeletal reactions to
the
stimulus. As Azrin
and
Holz
point
out:
"If
the punishing stimulus elicits
strong
and
enduring
skeletal
reactions,
then
the
elicitation
of
these reactions
per
se
may
well decrease the
response
frequency.
In such a case,
the
response
reductions will
occur
because
of
a
simple
incompatibility
of
the
elicited reactions with the punished response,
and
not
necessarily
because
of
the aversiveness
of
the
punishing stimulus" (1966: 384).
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