Date of Conferral







Lisa Scharff


Aversion therapy has reemerged as a treatment for self-injurious behavior (SIB) but remains unpopular, as it is perceived to be unethical. The purpose of this mixed-methods sequential explanatory study was to investigate the effectiveness of positive therapy and aversion therapy in the treatment of twins with SIB as well as to understand the lived experiences of their caretakers regarding treatment ethics. The frameworks used included classical and operant conditioning as well as utilitarian ethics theory. Quantitative research questions focused on changes in SIB, aggressive and prosocial behaviors with treatment, while the qualitative research question focused on the perceptions of caretakers regarding treatment. The quantitative component used a case study design and archived data from 2 U.S.-based treatment centers. The qualitative component included essay-type questionnaires for family members and caretakers regarding perceptions of the different therapies. The quantitative data that was obtained measured different behaviors that were not comparable. The twin in aversion therapy demonstrated aggressive behaviors that decreased with treatment, while the twin in positive therapy demonstrated positive behaviors that showed little to no change. Caretaker and family reports were consistent with the quantitative data, and family members considered aversion therapy ethical because they perceived it to be effective in treating SIBs. They also perceived it as ethically preferable to the use of large amounts of medication. Findings suggest that aversion therapy may be effective and ethical. Implications for positive social include potential continued research on aversion therapy to enhance treatment outcomes for individuals with SIB, and possible changes in public perceptions of aversion therapies.