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“Why are you shocking him? He’s tied down. He can’t hurt anyone.”
September 4, 2012 10:11 AM   Subscribe


 
He must have skimmed the works of Skinner. For lasting behavioral modification, punishment is incredible ineffective.
posted by TwelveTwo at 10:22 AM on September 4, 2012 [6 favorites]




Funny timing, we actually just found a VHS with a promotional video about the Judge Rotenberg Center on it in an old filing cabinet where I work. A lot of the students at a school like the Judge Rotenberg Center are placed there because the public schools can't (or at least, won't) given them an appropriate education. The jurisdiction where I worked used to send kinds to JRC, but doesn't anymore. Interestingly, some parents, convinced that the treatment at JRC was the only way for their kids to get an education sued (and lost) because New York State stopped sending kids to schools that use averse interventions.
posted by Bulgaroktonos at 10:29 AM on September 4, 2012


Absolutely horrifying. Those poor children.

.
posted by the young rope-rider at 10:30 AM on September 4, 2012 [7 favorites]


...the shocks are now banned for new students but existing students are not grandfathered in. The center resolves to fight this ban.
posted by availablelight at 10:30 AM on September 4, 2012


I want to make it clear that I don't feel that much compassion for the students at the center - I feel it's much more important to make society safe than worry about whether a dysfunctional person is treated well. So please don't take my criticism of the Center as coming from a mindless knee-jerk response to seeing somebody getting shocked.

However, simply from a purely pragmatic perspective, I simply can't picture this scenario ending well. Whenever one human has this much power over another human, it inevitably leads to abuse. Already there was one incident where students where wrongfully given shocks when another student pretended to be staff. What happens when you get a staff member with sadistic inclinations? Or an unscrupulous staff member who is sexually attracted to one of the patients? So far the Judge Rotenberg center has been fortunate in that their staff members generally seem to want to help their patients (regardless of whether you agree with their methods), but all it takes is for one bad apple to slip through the mental-health screening and some incredibly horrid stuff could take place.

So while I give full credit to Matthew Israel for his good intentions (and I truly do believe he had good intentions in mind), I have to question if he really thought through all the ramifications of travelling this path.
posted by wolfdreams01 at 10:32 AM on September 4, 2012


He must have skimmed the works of Skinner. For lasting behavioral modification, punishment is incredible ineffective.

He did graduate work under Skinner.
posted by availablelight at 10:34 AM on September 4, 2012 [2 favorites]


You can read more about Israel in this Mother Jones article:

With permission from Andrea's mother, Israel decided to try out Skinner's ideas on the three-year-old. When Andrea was well behaved, Israel took her out for walks. But when she misbehaved, he punished her by snapping his finger against her cheek. His mentor Skinner preached that positive reinforcement was vastly preferable to punishment, but Israel says his methods transformed the girl. "Instead of being an annoyance, she became a charming addition to the house." Israel's success with Andrea convinced him to start a school.
posted by vacapinta at 10:37 AM on September 4, 2012 [1 favorite]


I wonder what the author of this article expects as an alternative. My understanding is that the center only accepts patients that are (A) rejected by all other institutions for being too violent, and (B) there is nothing but complete parental consent, including (C) the parents have to really want their child to be admitted.

I realize that those three issues don't make anything happening here OK. However, it seems to me that the result of such legislation would be that these "last chance" patients would end up having zero options. It would make more sense to me to create legislation that gives these patients more options in the public school system, including in-class and in-home treatment, parental support, etc.
posted by rebent at 10:47 AM on September 4, 2012 [1 favorite]


Having now read the longer article I realize my comment was superfluous. Whoops.

Anyway, I get the weird sensation that there was something sexual about all this torture.

Punishment, according to Skinner's empirical evidence, only generates or suppresses a behavior so long as there is a punisher. No matter how long the training period, the intended behavior is never internalized. One immediate consequence is that the success of any such 'treatment' would be successful only so long as the 'treatment' continues. How profitable!

There is absolutely no grounds to dismiss the most critical finding of Skinner's research. The fact that he had studied Skinner's work thoroughly at all is proof of his guilt!

Oh, right, I opened this comment with references to sexuality. Well, if he wasn't in it for the money, as I hinted above, then the role he got to play was as the man that matters. He a dickhead being a corporeal godhead. I'm sure that rise to station, gave rise. His dick, he dreams, the whole world orbits, they just need to know it. Zap. What I am saying illustratively is he tried to be a total tool, to erect himself as an absolute fuck, for all fucks to be thus measured by. What he is, if not a con-artist, is a pedagogiphilliac.
posted by TwelveTwo at 10:49 AM on September 4, 2012 [8 favorites]


TwelveTwo: "Anyway, I get the weird sensation that there was something sexual about all this torture (...)"

This is some serious whole-cloth-spinning.
posted by boo_radley at 10:54 AM on September 4, 2012 [5 favorites]


If not money is his motivation for such out and out distortion of Behaviorism, then it is enjoyment.
posted by TwelveTwo at 10:55 AM on September 4, 2012


something sexual about all this torture

Well if they can't outright ban the torture maybe the government could call him a terrorist and use the PATRIOT act to lean on the banking industry to make it impossible for him to process payments. That's proven to put a stop to torture-promoting businesses.

Then again maybe they only go to the trouble if you take pictures of the torture and publish them on the internet?
posted by localroger at 11:00 AM on September 4, 2012 [1 favorite]


Oh god. That Mother Jones article is just terrifying and heartbreaking. It's appalling that such backward medical practices are allowed to exist in 2012.
posted by schmod at 11:02 AM on September 4, 2012 [3 favorites]


TwelveTwo: "Punishment, according to Skinner's empirical evidence, only generates or suppresses a behavior so long as there is a punisher. No matter how long the training period, the intended behavior is never internalized. One immediate consequence is that the success of any such 'treatment' would be successful only so long as the 'treatment' continues. How profitable!"

well, my understanding of it is that once the patients are trained to cease the unhealthy behaviors of self-injury and violence, they are then able to come into contact with natural rewards for more typical behaviors that outweigh the natural rewards for unhealthy behavior. The thing is, because of the problem behavior, they have never had the opportunity to become accustomed to the natural rewards for healthy behavior. Once the treatment is concluded, the natural rewards for healthy behavior should be controlling that behavior, eliminating the need for the contrived punishment.
posted by rebent at 11:08 AM on September 4, 2012 [4 favorites]


Come to think of it, I don't want to argue about the ethics of this place. I learned about it in my intro to behaviorism class in grad school. It was used as an example of "Look at an edge-case of how behavioral principles of punishment and reward can work."

It seemed edge-cased. It seemed extreme. The patients they accepted were extreme. There was no where else for them to go.

Was it backed by empirical evidence? Yes (but don't expect me to dig it up - I graduated!). Was it effective at much higher rates than alternative treatments? Yes. Does that make it right? I donno. The whole place seemed a little bit uncanny valley to me. For instance, check out the images of the place in this newsletter.

So, yeah, I could see this place get shut down. But my original point stands: then what?
posted by rebent at 11:20 AM on September 4, 2012 [2 favorites]


I wonder what the author of this article expects as an alternative. My understanding is that the center only accepts patients that are (A) rejected by all other institutions for being too violent, and (B) there is nothing but complete parental consent, including (C) the parents have to really want their child to be admitted.

I think the problem is that in those sorts of situations it's easy for a program or institution that's supposed to be rehabilitative to just slip into being a prison. Electro-shock punishments for enforcing compliance to rules is great from the perspective of someone wanting to control a prison population but probably not so great in terms of actually teaching kids skills to be functioning adults. Especially considering that the article mentions how greatly the scope of the center has increased over the years (it used to be only for children with severe developmental disorders but now covers much more common issues like ADHD), at a certain point you have to wonder if it's just the system sweeping kids under the rug so that nobody else has to deal with them, rather than actually having the childrens' best interests in mind.
posted by burnmp3s at 11:29 AM on September 4, 2012 [4 favorites]


I want to make it clear that I don't feel that much compassion for the students at the center - I feel it's much more important to make society safe than worry about whether a dysfunctional person is treated well.

God, if there were just some way to treat the mentally ill and developmentally disabled in a safe, controlled environment that didn't rely on torture...

But nah that shit sounds expensive! Let's just taze 'em until they're too traumatized to move!
posted by Benjy at 11:29 AM on September 4, 2012 [16 favorites]


America is a nation in decline, with many medical, educational, legal, academic and other authorities who run the gamut from sociopath to self-deceiver, allowing their authority to be used, if not creatively deployed, to legitimize the increasingly barbaric, dehumanizing mechanisms of population control needed to deal with social decay metastasizing everywhere around us
posted by crayz at 11:34 AM on September 4, 2012 [15 favorites]


For instance, check out the images of the place in this newsletter.

Oh jesus fuck. Kill it with fire
posted by crayz at 11:35 AM on September 4, 2012 [10 favorites]


Good god. When I started reading this FPP I assumed it would describe how the center was shuttered in 1934 and the incident helped the emergence of the medical ethics field. Why, in a world where we're regularly hearing about another "troubled teen boot camp" abusing residents, sometimes to death, is this not something we all know about?
posted by zachlipton at 11:37 AM on September 4, 2012 [5 favorites]


There is absolutely no excuse or justification for a place like this to exist. Yes, there are people who have violent and self-injurious behaviors and communication difficulties that make "typical" treatment difficult. The solution is not to put them in a torture chamber. There is a lot of good work being done on treating challenging behaviors without the use of aversives, restraint, or seclusion. See Think: Kids for a model that is both humane and more effective.
posted by Daily Alice at 11:41 AM on September 4, 2012 [4 favorites]


So please don't take my criticism of the Center as coming from a mindless knee-jerk response to seeing somebody getting shocked.

Please take my criticism of the Center as coming from a mindless knee-jerk response to seeing somebody getting shocked.

Don't fucking torture people. I think it's a pretty basic thing that any reasonable person should agree upon. I don't care what they did, don't fucking torture people. How hard is that to understand?
posted by aspo at 11:44 AM on September 4, 2012 [32 favorites]


But nah that shit sounds expensive! Let's just taze 'em until they're too traumatized to move!


Treatment at the JRC costs $220,000/year per student. There are 900 employees for under 250 students.
posted by mr_roboto at 11:46 AM on September 4, 2012 [3 favorites]


I want to make it clear that I don't feel that much compassion for the students at the center - I feel it's much more important to make society safe than worry about whether a dysfunctional person is treated well.

Good God, what a horrible thing to say. What, your compassion is such a limited resource that it doesn't extend to "dysfunctional" (i.e. mentally and physically disabled) people trapped in a prison that attempts to control their behavior with torture?
posted by Daily Alice at 11:47 AM on September 4, 2012 [20 favorites]




I'm actually not all skeptical of the idea that shock torture can produce desired changes in behavior. I'd bet that simply burning the victims with cigarettes, or waterboarding, or a cat of nine tails might be able to produce changes in behavior. Why would it be any better to use "medical" equipment? If your method is "torture the prisoner into submission" why pretty it up? Oh. The money.

I am personally proud to kneejerk object to torture.
posted by tyllwin at 11:51 AM on September 4, 2012 [7 favorites]


...the shocks are now banned for new students but existing students are not grandfathered in. The center resolves to fight this ban.

So if the shocks are so effective, how does this make any sense? Presumably the new students display the most problematic behaviors and need the most correction, while the existing students have been getting shocked for a while and are better behaved? I suppose I can see how you would argue that it's going to be disruptive to the students to change from the system they are used to, but so what?
posted by zachlipton at 11:52 AM on September 4, 2012 [1 favorite]




Good heavens! I think my sister worked there for a while while in graduate school in the mid-90s while getting a Master's in special education with EBD students. (Maybe a practicum or something?) I don't recall her ever mentioning this!

Now she works in a bank.
posted by wenestvedt at 11:56 AM on September 4, 2012


In other news, students can still be legally hit with a wooden paddle by their teachers and administrators in a couple dozen states in the US, so maybe we haven't come as far as we think.
posted by zachlipton at 12:02 PM on September 4, 2012


Interestingly, some parents, convinced that the treatment at JRC was the only way for their kids to get an education sued (and lost) because New York State stopped sending kids to schools that use averse interventions...

There have been recent suits against this place. I saw one video where they literally tackled a kid and shocked him 23 times. Someday these people will be stopped. Remember it wasn't that long ago that even the Kennedy's ( and others at the time) once believed that frontal lobotomy was a cure for promiscuous behavior amongst the mentally retarded.
posted by Gungho at 12:03 PM on September 4, 2012 [1 favorite]


well, my understanding of it is that once the patients are trained to cease the unhealthy behaviors of self-injury and violence, they are then able to come into contact with natural rewards for more typical behaviors that outweigh the natural rewards for unhealthy behavior.

The problem with this is that Skinner proved that positive reinforcement (in this case, rewarding whenever the problem behavior stops or lessens, even for an instant) is much more effective than negative reinforcement (punishing until the problem behavior stops). Unless these people were acting out 24/7 in precisely the same degree every time, there's no reason why sticking to positive reinforcement wouldn't work just as well, if not better.

Besides, "once the patients are trained to cease the unhealthy behaviors of self-injury and violence, they are then able to come into contact with natural rewards for more typical behaviors" doesn't describe what happened. New York State found that "the children are controlled by the threat of punishment. When that threat is removed, they revert to their original behaviors". This is precisely what Skinner would have predicted -- the patients are not being "naturally rewarded" for anything save a momentary lack of punishment, so the moment that lack becomes permanent their entire motivation for displaying typical behaviors disappears.

Also, the fact that a motherfucking prank call about "seeing three boys misbehaving earlier in the evening" led to a patient being shocked 77 times is beyond ridiculous. That speaks to a serious lack of control over what was happening at the facility, which further suggests that the punishments were not applied with rigor to begin with (as things like "misapplication" of shocks also suggest). Conditioning doesn't happen if the punishment/reward doesn't immediately follow the associated behavior... which means that the staff sometimes shocked patients for no reason at all, just because they were afraid they'd get in trouble with their "monitors".

Israel didn't condition the patients to behave. He simply conditioned everyone (including staff) to punish each other constantly, and then conflated the resulting state of fear and apprehension with good behavior. Skinner would be appalled.
posted by vorfeed at 12:04 PM on September 4, 2012 [17 favorites]


mr_roboto: "Treatment at the JRC costs $220,000/year per student. There are 900 employees for under 250 students."

That works out to just $61,000 per employee, which doesn't seem realistic. Where else are they getting money from?
posted by schmod at 12:04 PM on September 4, 2012 [1 favorite]


@crayz
Kill it with fire
no no they're just teaching them with it
posted by This, of course, alludes to you at 12:26 PM on September 4, 2012 [1 favorite]


In a society of many millions of people, there will be some who present a persistent and severe threat to themselves or to others, and calling that person who poses such a persistent violent threat merely "dysfunctional" understates the risk that their family, practitioners, and even the general public face.

But somehow, like in the thread about the violent man on the airplane who both physically and sexually assaulted other passengers, these people are not getting enough hugs?

I personally don't interact with people who present a persistent threat of violence upon themselves or others, and aside from simply sedating them into oblivion or locking them all up in a supermax where they have no human interaction at all, all I can think of for those who attempt to help these dangerous people is there but for the grace of god, go I.

When positive reinforcement and rewards fail, what then? All indications are that the group in the article admit only the very worst among the very worst.

Perhaps the infliction of pain to bring about compliance is less inhumane than massive sedation or total supermax-style isolation. Or are there new methods of reward that work for the very worst of violent threats?
posted by chimaera at 12:36 PM on September 4, 2012 [1 favorite]


Leaving violent autistic people to interact with society without an almost ironclad guarantee of their good behavior would certainly fall under that "socially irresponsible" umbrella.

Treating violent autistic people with compassion instead of electric shocks doesn't mean just "leaving" them. There is plenty of research to show that treatment methods that don't use aversives are not only more humane but more effective, even for the "severe and profound" population.

Yeah, my beliefs in this case are colored by emotion. I have one of these kids. He's almost 10. He's not currently violent, but when he was younger I was covered in bruises and bite marks a lot of the time. The improvement in his behavior is a combination of medications, behavioral therapy, and increasing maturity with the passage of time. At his public school he divides his time between a self-contained autism class, a mainstream fourth-grade class, and a gifted-level math and reading class. I'm sure there are some people who would have sent him off to be "trained" with electric shocks, but I'm not one.
posted by Daily Alice at 12:43 PM on September 4, 2012 [10 favorites]


Israel is a technology pioneer in the technology of applying electric shocks for behavioral modification

I feel like everything after "is a" could be profitably replaced with "an amoral, torturing prick".
posted by jaduncan at 12:43 PM on September 4, 2012


wolfdreams01, are you aware that people who lack of compassion and empathy are much more prone to committing violent crimes? That being the case, your apparent lack of same for these patients is worrisome. Making decisions based at least partially on emotion isn't just a good idea, it's what allows us to live together in societies.

I'm aware of that, Gilrain, but it feels like you're conflating general compassion with targeted compassion. There is a wide spectrum between "compassion for all creatures great and small" and "sociopathic criminal behavior." Saying that compassion is an inherently virtuous thing and it's impossible to have too much compassion is extremist and (in my opinion at least) just foolish.

For example, the people who made the decision to kill Osama Bin Laden didn't allow themselves to feel compassion for him. Instead, they made the reasonable decision to feel compassion for his victims instead. Does failing to have empathy for Osama make them sociopathic monsters? I appreciate that it's an extreme example, but it help illustrate my point that mindless compassion - without thinking of the long-term ramifications of that compassion - is just irresponsible and damaging to the world at large. Does that not seem like a reasonable principle to hold?

Anyway, I'd prefer to focus this topic back on the Judge Rotenberg Center rather than individual ethical codes, so if you have any further comments, please memail me and we can discuss privately.
posted by wolfdreams01 at 12:48 PM on September 4, 2012 [3 favorites]


In a society of many millions of people, there will be some who present a persistent and severe threat to themselves or to others, and calling that person who poses such a persistent violent threat merely "dysfunctional" understates the risk that their family, practitioners, and even the general public face.

But somehow, like in the thread about the violent man on the airplane who both physically and sexually assaulted other passengers, these people are not getting enough hugs?


I just... I just don't even know where to go with this. The people imprisoned at the JRC are not terrorists or gangsters or warlords. They are human beings with social, communication, and behavioral disabilities. "Treating" them with aversives does not help them, and it doesn't do the rest of us any good either.

I personally don't interact with people who present a persistent threat of violence upon themselves or others, and aside from simply sedating them into oblivion or locking them all up in a supermax where they have no human interaction at all, all I can think of for those who attempt to help these dangerous people is there but for the grace of god, go I.


Well, I do interact with "those people" - my son and his school-mates. If you want to talk about the grace of God, maybe think about how we are treating "the least of these".
posted by Daily Alice at 12:53 PM on September 4, 2012 [8 favorites]


Also, I'm not clear where people are getting that these kids are a danger...one child featured in the article is now in a residential facility and spends weekends in the community with his mother. Hardly a danger to society...!
posted by the young rope-rider at 12:54 PM on September 4, 2012 [1 favorite]


All indications are that the group in the article admit only the very worst among the very worst.

No. The NY Mag article indicates that over the past ten years, the center has made a point of expanding, and in so doing, has accepted a far wider swath of students than you're suggesting: "Israel sent recruiters to New York State and elsewhere to try to drum up referrals, and he began ­taking in many more of what he called 'higher-functioning' kids: students who are not autistic or mentally retarded but have diagnoses like attention-deficit disorder or bipolar disorder. Between 2000 and 2005, the facility’s annual revenues grew from $18 million to more than $50 million. "

But somehow...these people are not getting enough hugs?
Torture has proved to be clinically ineffective. Do you think that repeatedly hurting a dangerous, angry individual with a cognitive defecit is going to make them any less angry or dangerous, over time? Will it make them less likely, when there is no threat of reprisal, to lash out? While were at it, do you really think of "the absence of torture" as "getting hugs"?
posted by evidenceofabsence at 12:54 PM on September 4, 2012 [7 favorites]


Well, I do interact with "those people" - my son and his school-mates. If you want to talk about the grace of God, maybe think about how we are treating "the least of these".

Have you been beaten unconscious by your son or his school-mates? Stabbed? Attacked so viciously you had to be hospitalized?

If not, you're not dealing with the level of persistent and severely violent people I'm talking about. You're dealing with children who have responded and improved with conventional treatments.
posted by chimaera at 12:57 PM on September 4, 2012 [1 favorite]


God, if there were just some way to treat the mentally ill and developmentally disabled in a safe, controlled environment that didn't rely on torture...

Confining, restraining, and chemically sedating someone for the entirety of their life may be safe and controlled, but it's hardly more humane.
posted by Behemoth at 12:58 PM on September 4, 2012 [2 favorites]


No. The NY Mag article indicates that over the past ten years, the center has made a point of expanding, and in so doing, has accepted a far wider swath of students than you're suggesting:

In this case, I withdraw my previous indication of conditional support for the JRC. Application of pain for compliance or punishment of violent behavior, IF there is a consensus among practitioners that it is less inhumane than sedation or isolation, should be considered as only a very last resort -- where sedation or isolation are the only feasible alternatives.
posted by chimaera at 1:04 PM on September 4, 2012


I'd just like to point out that the alternative I'm proposing is not to leave people untreated, but to treat them more humanely. There are sound and evidence-based treatments that do not include restraints, seclusion, or aversives. From the link I posted earlier to Think: Kids:

The model used by Think:Kids has been implemented in inpatient child and adolescent psychiatry units, residential treatment facilities, group homes, juvenile justice centers, day treatment programs, therapeutic day schools, and general education schools and classrooms.
posted by Daily Alice at 1:09 PM on September 4, 2012


When positive reinforcement and rewards fail, what then? All indications are that the group in the article admit only the very worst among the very worst.

"Positive reinforcement and rewards" didn't "fail", they were never the foundation of Israel's strategy to begin with. Which is funny, because he basically created an environment in which small positive reinforcements really can change otherwise intractable behavior -- a panopticon in which any instance of the desired behavior could be instantly rewarded -- and then he punished instead of rewarding. Note that both of his attempts at communal living failed in similar ways, even though neither involved anyone who was violent or who could not be reached with positive reinforcement and rewards. Turns out that neurotypical people don't respond well to living under the fear of spying and reprisal, either.

I feel pretty comfortable suggesting that the impetus for constant punishment here was Israel himself, not the fact that positive reinforcement failed these patients.
posted by vorfeed at 1:18 PM on September 4, 2012 [7 favorites]


Also, the idea that this is about "not getting enough hugs" is bizarre. You do not teach pigeons to play table tennis with hugs, you don't teach dogs to sit with hugs, and you don't teach nine million people to sit and play World of Warcraft for hours a day using hugs. Positive reinforcement is not about being sufficiently loved, although I'm sure that helps... it's just about following desired behaviors with an immediate reward, whatever that reward may be.
posted by vorfeed at 1:41 PM on September 4, 2012 [7 favorites]


but I thought "human behavior [was] animal behavior"
posted by This, of course, alludes to you at 1:49 PM on September 4, 2012


The "treatment" is torturous pseudoscience: they cannot produce a single controlled trial in favor it, let alone the multiple controlled trials you'd need to pass the FDA selling a drug with similar dangers.

Here's what I wrote about it for TIME just after the trial, explaining why even if they did publish multiple controlled trials in peer reviewed journals favoring it, I still would think it's too dangerous to use.

The fact that they expanded this nonsense beyond people with severe self-mutilating behavior is itself evidence that it is profit and power-driven, not help driven. And, as I noted when I wrote about it for the New York Times, for $220,000 a year, you could have 24/7 help at home to manage even the most severe behavior with positive reinforcement. Research shows over and over that treating people with mental and behavioral issues outside institutions is healthier for them, cheaper for everyone else and safer too.
posted by Maias at 1:52 PM on September 4, 2012 [23 favorites]


"Positive reinforcement and rewards" didn't "fail", they were never the foundation of Israel's strategy to begin with.

Judging by their flier, your appraisal and others here, seems to be a bit off. Not saying this place sounds grand or anything, just that it isn't a den of torture. Or maybe it is and all that is a mockup.
posted by Rocket Surgeon at 1:55 PM on September 4, 2012


Judging by their flier, your appraisal and others here, seems to be a bit off. Not saying this place sounds grand or anything, just that it isn't a den of torture. Or maybe it is and all that is a mockup.

Who's going to pay $220,000 per kid for a place that LOOKS like a den of torture?
posted by 23skidoo at 2:05 PM on September 4, 2012


arrgh, I see that first link didn't work. Here's link to TIME piece on evidence and Rotenberg.
posted by Maias at 2:06 PM on September 4, 2012


"Positive reinforcement and rewards" didn't "fail", they were never the foundation of Israel's strategy to begin with.

The Boston Magazine article notes:

Moreover, a 2004 book edited by academics at Ohio State, Penn State Harrisburg, and the Sage Colleges Center for Applied Behavior Analysis shows that positive-behavior support practitioners generally don’t attempt to treat the most difficult cases. Presented with such children, they find another school for them.

JRC gets these kids. That’s really what no one talks about. On average, its students have been to five other treatment centers.

posted by Behemoth at 2:10 PM on September 4, 2012


"Current positive-behavior practitioners are not equipped to deal with the most difficult cases" != "Positive Punishment is the best way to deal with the most difficult cases."
posted by muddgirl at 2:19 PM on September 4, 2012 [1 favorite]



Moreover, a 2004 book edited by academics at Ohio State, Penn State Harrisburg, and the Sage Colleges Center for Applied Behavior Analysis shows that positive-behavior support practitioners generally don’t attempt to treat the most difficult cases. Presented with such children, they find another school for them.

JRC gets these kids. That’s really what no one talks about. On average, its students have been to five other treatment centers.


Yes, and prisons get lots of such people too. That doesn't mean we recommend them as treatment, nor do we allow the use of untested medications or harsh behavioral therapy as official policy.
posted by Maias at 2:26 PM on September 4, 2012 [4 favorites]


Application of pain for compliance or punishment of violent behavior, IF there is a consensus among practitioners that it is less inhumane than sedation or isolation, should be considered as only a very last resort -- where sedation or isolation are the only feasible alternatives.

My big issue is that it is clear that the shocks were, in multiple cases that we know of here, applied for a wide range of less serious infractions and were given repetitively to residents who were obviously in distress. I can maybe see a valid argument for treatment like this in the case of someone who is so violently out of control that every other approach has completely failed. Maybe some kind of painful stimulus is the only way besides continuous strong sedation to treat a rare patient who constantly bangs his head forcefully into concrete walls despite all other efforts. Not really in favor of it, but I can see a justification whereby it's not completely unreasonable in highly limited, clinically administered, circumstances.

These people, on the other hand, were shocking a young man 30 times after he was tied down to a restraint board for "tensing up." Other articles describe residents being shocked for "nagging” or “failing to maintain a neat appearance.” In another case, a former resident performed his own Milgram experiment on unsuspecting residents by conning a staff member over the telephone to wake up two students and administer dozens of shocks to them for infractions that he claimed had occurred earlier. These situations are so different from the completely violent last resort circumstances we're talking about here that it's hard not to call this torture.

Maybe, just maybe, the ends justify the means under highly extraordinary circumstances (and here there's no real scientific evidence to demonstrate that the ends were ever really achieved or that shocks work better than anything else). But once the ends go from "keep patient from cracking his own skull open because all he does is smash it on the wall" to "make patients maintain a neat appearance and stop nagging," there's simply no justification for it. And when the ends become "stop tensing up when tied to a restraint board and scary men are standing over you with the shock button" or "some guy on the phone told me to wake you up and shock you a few dozen times," it's torture.

I sympathize with the "we've tried everything and are desperate" mentality of the parents and even some of the clinicians, but it's clear that these folks are using the shocks for so many situations that are neither violent nor self-injurious.
posted by zachlipton at 2:27 PM on September 4, 2012 [13 favorites]


but I thought "human behavior [was] animal behavior"

Yes, it is. And as I pointed out in the thread you are referencing, negative reinforcement is less effective than positive reinforcement for both humans and animals.

Judging by their flier, your appraisal and others here, seems to be a bit off. Not saying this place sounds grand or anything, just that it isn't a den of torture.

I'm not saying it was a "den of torture", although it does seem to have been such for at least a few patients. I'm saying that the program is based on the constant threat of negative reinforcement, which it is. The system does use positive rewards (such as the ball pit), but getting to the positive rewards first requires not-doing whatever it is that causes the shock.

Moreover, a 2004 book edited by academics at Ohio State, Penn State Harrisburg, and the Sage Colleges Center for Applied Behavior Analysis shows that positive-behavior support practitioners generally don’t attempt to treat the most difficult cases. Presented with such children, they find another school for them.

First of all, this is true of all kinds of schools, not just "positive-behavior support practitioners". Second, this does not imply that negative reinforcement is the only other option; Israel could just as easily have run a positive-reinforcement school directed at the most difficult cases.

The fact that this isn't routinely done says more about our cultural assumptions about reward and punishment than it does about which is more effective.
posted by vorfeed at 2:27 PM on September 4, 2012


zachlipton: "In another case, a former resident performed his own Milgram experiment"

Oh, glad I wasn't the only one who noticed the parallels to the Milgram Experiment here...

Also, "Milgram Experiment with live voltage, and defenseless children instead of actors" should be a phrase that terrifies anyone. If a "last-resort" treatment requires violently electrocuting a person over 5,000 times a day, we may need to revisit the euthanasia debate, because I'm pretty sure most reasonable people would choose death in that scenario.
posted by schmod at 2:38 PM on September 4, 2012 [1 favorite]


As a compliment to the punishment, Rotenberg houses a reward room, where students can buy prizes with points earned for good behavior.

"Hey, Punishment! Your buddy Rewards here. You're doing a great job-- keep it up, chum!"

That's a compliment to the punishment.
posted by supercres at 2:40 PM on September 4, 2012 [1 favorite]


With permission from Andrea's mother, Israel decided to try out Skinner's ideas on the three-year-old. When Andrea was well behaved, Israel took her out for walks. But when she misbehaved, he punished her by snapping his finger against her cheek. His mentor Skinner preached that positive reinforcement was vastly preferable to punishment, but Israel says his methods transformed the girl. "Instead of being an annoyance, she became a charming addition to the house." Israel's success with Andrea convinced him to start a school.

So he had a sample size of one? That's his basis for starting a school using these techniques?
posted by asnider at 2:53 PM on September 4, 2012 [1 favorite]


I'm saying that the program is based on the constant threat of negative reinforcement, which it is.

A couple of things. Your previous comments seem to indicate that they did not have any reward system at all and even disputing someone who has a graduate degree in behaviorism over that, but whatevs. Second it doesn't look like all the children are under a constant threat of punishment so it kind of makes me wonder where they're drawing the line and perhaps if this is a misguiding idea for some of the discussion here. Last, positive punishment - an introduction of a stimulus to decrease behavior, negative punishment - removal of a stimulus to decrease behavior.
posted by Rocket Surgeon at 3:06 PM on September 4, 2012


America is a nation in decline, with many medical, educational, legal, academic and other authorities who run the gamut from sociopath to self-deceiver, allowing their authority to be used, if not creatively deployed, to legitimize the increasingly barbaric, dehumanizing mechanisms of population control needed to deal with social decay metastasizing everywhere around us"

What a bizarrely myopic word salad. This kind of bullshit is nothing compared to what we've 'decayed' from.

Y'all know that the American Eugenics Movement was still imprisoning hundreds of thousands of children, mostly within normal ranges of intelligence, for 'feeble-mindedness' up until the 1970s [Summary]. Children were picked for coming from single or 'promiscuous' mothers, poor backgrounds, appearance, appallingly applied and primitive standardized testing, or not receiving an education, and they were sterilized, used for manual labor, not meaningfully educated, and experimented on.
"We thought for a long time that we belonged there, that we were not part of the species. We thought we were some kind of, you know, people that wasn't supposed to be born," says Boyce.

And that was precisely the idea.

The Fernald School, and others like it, was part of a popular American movement in the early 20th century called the Eugenics movement. The idea was to separate people considered to be genetically inferior from the rest of society, to prevent them from reproducing. Eugenics is usually associated with Nazi Germany, but in fact, it started in America. Not only that, it continued here long after Hitler's Germany was in ruins. At the height of the movement - in the '20s and '30s - exhibits were set up at fairs to teach people about eugenics. It was good for America, and good for the human race. That was the message."
One particularly infamous 'school' was also the site of human research involving exposure to radioisotopes performed by researchers from Harvard and MIT, and sponsored by the Quaker Oats company, between 1946 and 1953 for which informed consent was never provided. From the linked report,

"In 1946, one study exposed seventeen subjects to radioactive iron. The second study, which involved a series of seventeen related subexperiments, exposed fifty-seven subjects to radioactive calcium between 1950 and 1953. It is clear that the doses involved were low and that it is extremely unlikely that any of the children who were used as subjects were harmed as a consequence. These studies remain morally troubling, however, for several reasons. First, although parents or guardians were asked for their permission to have their children involved in the research, the available evidence suggests that the information provided was, at best, incomplete. Second, there is the question of the fairness of selecting institutionalized children at all, children whose life circumstances were by any standard already heavily burdened."
If you are going to pine for the past, you might as well face it
posted by Blasdelb at 3:07 PM on September 4, 2012 [8 favorites]


Tangential to the main topic, but this line from the Boston Magazine article is a bizarre non sequitur of racism:
...a kid whose scalp resembles that of a frontier settler worked over by a furious native

posted by desjardins at 3:16 PM on September 4, 2012


These scalp natives they are furious?
posted by TwelveTwo at 3:18 PM on September 4, 2012


Discussions of ethics often center around utilitarian "do the ends justify the means?" questions. Looking at this program from several ethical standpoints might be interesting... My take is that it can't be justified in any way.

Utilitarian: There is no peer reviewed evidence that this program is successful. In fact, peer review is specifically avoided.
Rules-based ethics: Violates the, "First, Do No Harm," rule. Violates the rule that torture is never acceptable.
Care-based ethics: Practitioners must be conditioned and controlled by the institution in order to suppress their empathy/sympathy responses.
Virtue-based ethics: Again, practitioners are required to suppress several widely accepted virtues in order to administrate this program, such as their senses of justice, temperance/restraint, compassion, and non-violence.

Israel uses his theories of conditioning on his own employees and writ large in his handling of public relations and the media (naming the center after the public official that ruled in his favor is a particularly cute piece of manipulative positive reinforcement). His star pupils are still warehoused in his facility and still receive the "treatment." He has no qualms about using violent coercion against a 36 year old patient, or a 9 year old patient. They have no qualms about coercing the graduate, no longer connected to the facility in any way, shape or form, that he hand picked for an interview, during the interview.

Dude is a zealot who thinks all problems can be solved through positive and negative behavior modification. The good news is that he's a failure with regards to healthy people. The bad news is that he, like all other predatory manipulators, kept trying farther and farther down the chain of vulnerable people until he found a cohort so vulnerable and so invisible that he could get away with harming them.
posted by Skwirl at 3:21 PM on September 4, 2012 [4 favorites]


I really didn't dare get into this at work, because this is not only some sick shit it hits very close to home.
Instead, the footage showed him tied face down to a four-point restraint board, each limb held in place by a locked cuff, his head encased in a helmet. She learned he had been held in this position for six hours, hollering and pleading whenever he got another shock.
...
Robert von Heyn, then the director of psychology, explained that Andre had been shocked for “tensing up” his body, which was considered an unhealthy behavior.
This is not just torture; it is straight-up sadism, and I can say that with some authority. Somebody was getting jollies off of this, and the idea that they were doing that to someone who isn't a masochist and doing real harm to them makes me physically ill.

I mean a hood? Really? Make the kid a girl and take her clothes and this is a straight-up Insex scene. (It's not really a Kink.com scene because Kink's guidelines wouldn't let you go this far.)

This punishment has nothing whatsoever to do with behaviorism. Surely a true-believing behaviorist would, after the first few shocks did not correct the "tensing" behavior, get a fucking clue that the "treatment" is not working. To keep shocking someone every ten minutes or so for six hours is the classic snarky definition of insanity ... unless the goal isn't to correct the kid's behavior.

You give individuals this much power over others and you'll get assholes taking it too far; that's the Stanford Prison Experiment coming home to roost. That the institution defended this activity when they were called on it is extremely disturbing. If jollies are not being had by some extremely irresponsible asshole who makes me uncharacteristically ashamed of my paraphilia, I will eat my whip collection.
posted by localroger at 3:28 PM on September 4, 2012 [3 favorites]


Robert von Heyn, then the director of psychology, explained that Andre had been shocked for “tensing up” his body, which was considered an unhealthy behavior.

This man could not sound more like a Nazi in a bad war movie.
posted by jaduncan at 3:34 PM on September 4, 2012


I'm assuming there are contrasting examples of institutions of last resort, which handle severely violent or self-harming individuals, but rely on evidence-based treatment rather than torture. Could anyone name a few? Maias, did you come across any in your research?

It would be nice to have some examples of what can go right, especially in response to the straw arguments about hypothetical violent individuals who, by definition, can only be cured through corporal punishment.
posted by evidenceofabsence at 3:40 PM on September 4, 2012


A couple of things. Your previous comments seem to indicate that they did not have any reward system at all

I never meant to imply this. What I said was that the system would be as or more effective if they had stuck to positive reinforcement, and I stand by that. The existence of rewards like ice-cream parlors and arcades does nothing to address the problem of patients being shocked 31 times because they won't stop tensing up. Concentrating on reinforcing desired behaviors would have prevented this.

Second it doesn't look like all the children are under a constant threat of punishment so it kind of makes me wonder where they're drawing the line and perhaps if this is a misguiding idea for some of the discussion here.

The article suggests that this is a matter of parental permission. It also says "the repertoire of punishments includes painful electric shocks", so I'm not sure it's fair to assume that patients without shock backpacks aren't under the threat of other forms of punishment.

Last, positive punishment - an introduction of a stimulus to decrease behavior, negative punishment - removal of a stimulus to decrease behavior.

Yes, you're right, I should have drawn this distinction. This is punishment, not reinforcement, as the aim is to get the patient to stop doing things.
posted by vorfeed at 4:05 PM on September 4, 2012


Hey guys, read the linked article before posting too much on this. From the description, it sounded like it might not be a terrible idea. I mean behaviorism isn't a completely discredited school of psychology, Skinner was a big name, and some of the bad things said about his research are urban legends.

But it only took the first page of the first article to change my attitude from 'This is nuanced and difficult, we need to learn more before judging' to 'rescue the kids, arrest the staff, and burn the building to the ground'.
posted by Mitrovarr at 4:08 PM on September 4, 2012 [6 favorites]


This page has several PDF links to studies of inpatient psychiatric units treating children who have violent outbursts with a method called Collaborative Problem Solving, which does not focus on punishments or rewards, but teaches children the appropriate cognitive skills to avoid violent behavior.
posted by Daily Alice at 4:26 PM on September 4, 2012 [3 favorites]


I was never shocked.

But I had the contracts and the punishment/reward behaviour cycle in grade 9. Not sure how effective it was. What I found really interesting, though, is the continued use of the anti-pyschotic Risperdone, which I was on for years. Never quite sure the implications of the popularity of that med (and it is v. popular). might be worth investigating.
posted by PinkMoose at 4:33 PM on September 4, 2012


I fantasize about teaching my kids Brazilian Jiu Jitsu from a very young age and giving them strict instructions to choke unconscious any adult who ever attempts to do them physical harm for any reason.

Of course, I'd have to have kids, first, to bring this fantasy to fruition, and my kids would likely be placed in a foster home for such rebelliousness, but THAT'S WHY THEY CALL IT "FANTASY", PEOPLE.

I have other fantasies, too.
posted by LordSludge at 4:42 PM on September 4, 2012


does nothing to address the problem of patients being shocked 31 times because they won't stop tensing up.

Well, actually, yes it does if you're talking about behaviorism and variable reinforcement. What it doesn't address is why the patient was tied up as if being quartered. The only assumption I can make is that they stepped him up a ladder of more aversive punishments in disobeyance of what they were asking until all they were left with was what they ended up doing.
Again, I'm not saying I agree with what happened, but if you understand the basic precepts of behaviorism and how they can be applied then you can make the distinction of what they were doing and why.

Yes, you're right, I should have drawn this distinction. This is punishment, not reinforcement,

The distinction was that shocks are not negative punishment, but actually positive punishment.
posted by Rocket Surgeon at 5:07 PM on September 4, 2012


This guy sounds like the sort of behaviorist monster who would drill a probe into the skull so as to light up their pleasure centers when the patient behaved appropriately, or installed boxes that mechanically administered cocaine into their blood stream.

If only he were that monster, then above being merely a monster was also a monster that was accomplishing something. But this monster, beneath being a monster is also a monster which is accomplishing nothing but monstrous deeds.

Inhuman and incompetent, that is the charge against him. If only he were one or the other, but both is an outrage.
posted by TwelveTwo at 5:17 PM on September 4, 2012 [1 favorite]


You know who else was a monster?

Shrek
posted by Rocket Surgeon at 5:27 PM on September 4, 2012


But he saved a Princess or some shit. Totes competent!
posted by TwelveTwo at 5:31 PM on September 4, 2012


The treatment works by hooking the students up to electrodes worn on different parts of the body, which communicate with a small device carried around in a backpack or fanny pack. When the student engages in forbidden behavior, a staff member administers a shock. Some students wear the electrodes as much as 24-hours a day, seven days a week. And sometimes for years.

Years. So tack on some PTSD to whatever other mental health issues these children are suffering from. Fuck this guy, fuck this school.
posted by Purposeful Grimace at 5:34 PM on September 4, 2012 [2 favorites]


I feel it's much more important to make society safe than worry about whether a dysfunctional person is treated well.

because dysfunctional people, when treated badly, are SO much SAFER to be around

it takes a lot of love and a lot of patience to deal with someone who has serious issues dealing with society - i say that as a father of an autistic daughter who used to have problems with violence and acting out

does your kind of mental health philosophy have a name? - can i call it the omelas school?
posted by pyramid termite at 5:55 PM on September 4, 2012 [1 favorite]


all they were left with

"All they were left with"? No other choice? That's really "the only assumption" you can make?

The guy strapped to the board for seven hours, who was electrocuted 31 times, can be expected to control whether or not he "tenses up," but the guys who strapped him to that board and are electrocuting him (which they began doing not because of a violent outburst, but because the guy didn't take his jacket off when ordered to) are the ones who don't have agency?
posted by evidenceofabsence at 6:01 PM on September 4, 2012 [4 favorites]


Oh no. It's Peter Høeg's fucking terrifying book Borderliners in real life.
posted by yoHighness at 6:05 PM on September 4, 2012 [1 favorite]


"All they were left with"? No other choice? That's really "the only assumption" you can make?

No, I can make the assumption that you are not interested in having a good faith conversation by nitpicking fragments out of a whole paragraph. Shit, that has to be some of the biggest garbage I've seen in awhile. If you want to decontextualize what I said, at least pull a whole sentence.
posted by Rocket Surgeon at 6:39 PM on September 4, 2012


I feel it's much more important to make society safe than worry about whether a dysfunctional person is treated well.

You know, it's not that hard to make the argument that this is a pretty dysfunctional attitude and that anyone who feels that way is easily as much a hazard to society as someone who is merely developmentally disabled.

I think you can figure out what comes next.
posted by Kid Charlemagne at 7:11 PM on September 4, 2012


I would love to know more details on how the "high functioning" ADHD and bipolar kids ended up in JRC. I mean, I've known plenty of people with ADHD or bipolar, and I can't imagine any of them even being close to needing such a place. What other alternatives were exhausted? Even if they don't get the shock treatment, I wonder what kind of psychological trauma they suffer by having to watch other kids get shocked.
posted by desjardins at 7:51 PM on September 4, 2012 [1 favorite]


“Superficially … the program is very impressive,” [...] But, they concluded, “the children are controlled by the threat of punishment. When that threat is removed, they revert to their original behaviors.” Ultimately, the officials found the program’s effect on its students to be “the singular most depressing experience that team members have had in numerous visitations to human-service programs.”
RTFA. I mean really. Some folks here need to do so before retreading the thin ground of their freshman psych survey class. This obviously has nothing to with behaviorism, it has a whole lot to do with plain old sadism and ego.
posted by smidgen at 9:24 PM on September 4, 2012 [3 favorites]


I want to make it clear that I don't feel that much compassion for the students at the center - I feel it's much more important to make society safe than worry about whether a dysfunctional person is treated well.

Well, at least now I know how it feels to start your day thoroughly creeped out.
posted by ominous_paws at 2:07 AM on September 5, 2012 [3 favorites]


This is clearly not the right way to do it. But it does try to serve a very real need. We need a place for people with problems to go, before we lock them up in jail or a mental hospital.
posted by psycho-alchemy at 3:22 AM on September 5, 2012


I wonder if they take in adults who act like children?
posted by Rocket Surgeon at 6:33 AM on September 5, 2012


I wonder if they take in adults who act like children?

The first paragraph of the first article calls the center "A school of last resort for troubled children and adults". You're not the only one here who has taken intro psych, and I'm not sure where the snark and condescension is coming from or why you think it's appropriate here.
posted by the young rope-rider at 7:00 AM on September 5, 2012 [1 favorite]


and I'm not sure where the snark and condencension coming from or why you think it's appropriate here

And I'm not sure where the personal attacks are coming from or why you obviously think they're appropriate here. My MeMail is open and working if you or anyone else wants to act like an adult, otherwise I see no reason in participating in this conversation anymore.
posted by Rocket Surgeon at 7:44 AM on September 5, 2012


This is clearly not the right way to do it. But it does try to serve a very real need. We need a place for people with problems to go, before we lock them up in jail or a mental hospital.

What? A mental hospital is exactly where people with severe behavioral problems need to be, if by mental hospital you mean an *evidence based* medical facility where people are treated with dignity and respect. Obviously, exhaust outpatient options before using inpatient, but the idea that psychiatric hospitals are evils to be avoided is *exactly* why bogus places like this continue to flourish.

There are innumerable problems with mainstream psychiatry, but one thing it does get right is that punishment — or use of restraint and isolation as punishment— is simply not acceptable. Psychiatry has developed policies and practices to minimize harm related to those issues, but the rest of the world (schools, these kinds of "programs") insists on replying the worst of the barbaric history of ill-treatment of the mentally ill and behaviorally problematic in institutions.
posted by Maias at 11:49 AM on September 6, 2012 [1 favorite]


> I feel it's much more important to make society safe than worry about whether a dysfunctional person is treated well

Those people are part of society and deserve to be safe.
posted by The corpse in the library at 9:57 AM on September 8, 2012 [2 favorites]


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