Contingent Electric Skin Shock: An Empirical or Ideological Issue?
Blenkush et al. claim the field should test, not ban, contingent electric skin shock for the most dangerous behaviors.
01Research in Context
What this study did
Blenkush et al. (2023) wrote a position paper. They say the field bans contingent electric skin shock (CESS) for ideological reasons, not data.
The authors want researchers to test CESS with strict single-case designs. They say only data should decide if shock stays or goes.
What they found
The paper does not report new data. It argues that past studies showed CESS can stop life-threatening self-injury when everything else failed.
The authors claim the field now rejects those findings without running better trials.
How this fits with other research
Three 2023 papers directly clash with this view. Fisher et al. (2023), Lerman (2023), and Zarcone et al. (2023) each say CESS is unethical and unnecessary. They see no duty to study it again.
The split is sharp: Blenkush wants more data; the others want a total stop. All four papers cite the same old studies yet read them opposite ways.
Older work foreshadows the fight. Gerhardt et al. (1991) said aversives could stay if strict safeguards exist. Wishart (1993) warned that real consent is almost impossible for people with intellectual disabilities. Those consent worries now fuel the anti-CESS side.
Why it matters
If you write behavior plans for severe self-injury, you live inside this debate. The paper pushes you to ask: ‘What data would I need before even thinking about shock?’ It also reminds you to document every less-intrusive step and to seek truly informed consent, not just a signature.
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02At a glance
03Original abstract
Intractable self-injury, aggressive, and other destructive behaviors are real human conditions. Contingent electric skin shock (CESS) is a technology, based on behavior-analytic principles, used to ameliorate such behaviors. However, CESS has always been extraordinarily controversial. The Association for Behavior Analysis (ABAI), commissioned an independent Task Force to examine the issue. After a comprehensive review, the Task Force suggested the treatment should be available for use in select cases through a largely accurate report. Yet, ABAI adopted a position indicating CESS is never appropriate. On the issue of CESS, we are extremely concerned behavior analysis departed from the fundamental epistemology of positivism and is misleading nascent behavior analysts and consumers of behavioral technology. Destructive behaviors are extremely difficult to treat. In our commentary, we outline clarifications regarding aspects of the Task Force Report, proliferation of falsehoods by leaders in our field, and limitations to the standard of care in behavior analysis. We recommend using science to answer important questions instead of propagating false information at the expense of current and future clients with treatment refractory behaviors.
Perspectives on Behavior Science, 2023 · doi:10.1007/s40614-023-00380-3