School of Shock : Rotenberg Center Director Matthew Israel Responds

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School of Shock School of Shock By Jennifer Gonnerman Food deprivation. Isolation. Electric shocks. Inside the taxpayer-funded program that treats American kids like enemy combatants. Sidebars • Nagging? Zap. Swearing? Zap: New York's Investigations of the Rotenberg Center • Why Can't Massachusetts Shut Matthew Israel Down? • The Cult That Spawned the Tough-Love Teen Industry • Experts on Self-Injurious Kids Challenge Dr. Israel's Methods • What Works for Troubled Teens? Photo Essay on the Rotenberg Center Primary Sources TOOLS E-mail article Print article BACKTALK E-mail the editor RELATED ARTICLES Camp Fear

(See Mother Jones' response)

Additional Comments from Matthew Israel

1. The title page sets the tone of the article by referring to JRC as a "School of Shock." The overwhelming reliance at JRC is on positive rewards and educational programs and ninety nine percent or more of a student's time is spent in educational and rewarding experiences. Less than half of the school-age students at JRC have parent- and court-approved supplementary skin shock as a possible treatment option in their treatment programs. Those that do receive an average of one harmless (no significant side effects) two-second application to the surface of the skin, usually of the arm or leg, per week. As time goes on, many are able to graduate completely from needing this therapy.
2. The title page contains the phrase "Food Deprivation." Food deprivation is never used as a punishment at JRC. In the case of a small number of students food is used, with full parental and court approval, in the form of "mini-meals" that are earned as rewards in the the training of new skills. When this is done, elaborate steps are taken to either provide make-up meals at the end of the day or to otherwise insure proper nutrition and avoid any weight loss.
3. The title page contains the word "Isolation." Isolation is never used as a punishment at JRC.
4. The title page says "Treats American kids like enemy combatants." This statement, like the cover material and drawing, reflects an attempt to sensationalize JRC's treatment and evidences a refusal to recognize the use of supplementary aversives as a scientifically proven and accepted form of behavioral treatment.
5. The cover page shows a child in an Abu Ghraib torture-type position on a box with wires leading from the hands. Skin-shock is never used at JRC in the manner depicted in that drawing and is never used for the purpose implied (torture). Skin-shock is used at JRC as one small part of a behavior modification treatment program, based overwhelmingly on positive rewards and educational procedures, to help save and extend lives, to take students off of psychotropic drugs, and to help youngsters turn their lives around. Students whose problematic behaviors were so great that they were expelled or refused admission to every other available school, and who were headed for a prematurely short or miserable life of drugs, restraint and warehousing in a psychiatric hospital, in an institution, in a jail or on the streets are, through effective education and treatment at JRC based on scientifically-validated behavior modification procedures, given hope and optimism for their future where previously they had none. To compare this with Abu Ghraib-type torture is like equating a surgeon's use of a knife in life-saving surgery to a felon's use of a knife in a murderous stabbing.
6. JRC has a unique set of rewarding features that is found in no other program. These rewards start with beautifully decorated school buildings that make coming to school a visually interesting and rewarding experience (many of our students have refused to attend school in the past). It continues with: an arcade-type Rewards Lounge; a "retail store" where students can purchase attractive personal items with the money they earn each week by displaying appropriate behaviors and learning; a lounge/reward corner in many classrooms; a reward afternoon once per week; Reward Boxes in many classrooms that contain desired items that students can earn each day; a personal computer and self-instructional software for every student; frequent field trips used as rewards; healthy and nutritional foods and no junk foods and soda machines; health-club type exercise facilities; community residences with wide-screen televisions, stereos and electronic games; and an open visiting policy in which parents or visitors can visit at any time of the day or night. To imply that a program that does all this for its students and parents is similar to the Abu Ghraib prison, as the cover and text of this article does, is to perpetuate a journalistic fraud on the readers.
7. The article devotes the initial two pages to two former students whose parents changed their minds and decided to remove their son from JRC. JRC parents are always free to change their minds and withdraw their consent to JRC to employ aversives with their child. In both of the cases Ms. Gonnerman describes, the students made major progress while they attended JRC (a fact not reported by Ms. Gonnerman), and were removed prematurely before their treatment had been completed. The overwhelming majority of JRC parents have been extremely positive about JRC and thankful for the changes they have seen in their children. The fact that the first two pages focus on two former parents or students who have no verifiable evidence that the JRC program caused them any harm is further evidence of the bias that pervades the article.
8. "To change their behavior, he developed a large repertoire of punishments..." Here, as in the article as a whole, there is a failure to give adequate space to JRC's innovative and wide-ranging use of rewards and educational procedures, which is the background against which aversives are introduced, if needed in some cases, as an occasional (once per week, on average) supplement in the programs of a minority of our school-age students. No mention is made of the fact that all of these aversive procedures were parent- and court-approved.
9. Ms. Gonnerman discusses California student Danny Aswad's death as though it had something to do with JRC or me. It did not. JRC had ceased its operations in California a year or two prior to this student's death which was from natural causes.
10. "Three quarters of the articles were published more than 20 years ago…" Ms. Gonnerman fails to explain that the reason for the decrease in the number of recent professional articles dealing with skin-shock is that the procedure has become increasingly controversial during the last few decades. During the past 10 years, however, five papers involving the clinical use of skin shock, or reviewing research in which skin shock has been used, have appeared in the professional literature
11. Ms. Gonnerman presents negative comments about JRC or me from three psychologists, Drs. Axelrod, Iwata and Touchette. One of these (Dr. Touchette) has never visited JRC and the others (Drs. Iwata and Axelrod) have not visited JRC during the last 12 and 18 years respectively. Ms. Gonnerman never asked me to provide her with the names of psychologists who support the use of aversives and who have taken the time to visit the current JRC program and observe our current treatment at first-hand.
12. In a sidebar that appears on the Mother Jones web site, but not in the printed article, Dr. Iwata criticizes us for not using his approach to functional analysis/assessment. We are aware of Dr. Iwata's approach and have tried it at JRC. The main problem is that the students who come to JRC have, by and large, already had the benefit of extensive functional analysis/assessment and despite this still have major behavior problems that were not solved with this approach alone. In that respect the situation is similar to the use of psychotropic drugs—the students who come to JRC have already been treated with psychotropic drugs and the drugs have been found insufficient. Despite this, JRC does do a comprehensive functional assessment of each student and takes the results into account in designing a program for the student and in designing the general treatment procedures employed in JRC's program. In a comprehensive review of the literature on Positive Behavior Support, an approach that is opposed to the use of aversives, Carr et al found that the studies that use positive-only treatment procedures, even when functional analysis is included, were effective in only 60 percent of the cases. JRC's population is largely taken from the remaining 40 percent.
13. Ms. Gonnerman incorrectly states that the only time that JRC students can socialize freely is in the Big Reward Store. This is not true. There are many other places where students can socialize with each other such as on the playground, on field trips, at their residences, etc. They are not allowed to socialize with each other in the classroom, however, which is the rule in most schools.
14. A former teacher, Jessica Croteau, complains of the fact that a lot of the education at JRC takes place through self-instructional software and personal computers. This is a very valuable application of behavioral psychology to education and is probably unique to JRC, where each student is given his/her own computer. Most of our teachers, parents and students value this self-instructional aspect of the program very much, which is provided in addition to classroom discussion. Their point of view was not presented. Why did Ms. Gonnerman not interview some former teachers who are positive about our program?
15. Former student Rob Santana made great progress while at JRC which was a huge improvement when compared to his plight prior to his admission to JRC. It is unfortunate that Rob's parent chose to remove him from JRC prematurely and it is unfortunate that he has been arrested and jailed since his discharge from JRC.
16. Ms. Gonnerman complains that she did not have the opportunity to speak privately with JRC's students. She never asked for such opportunities.
17. Ms. Gonnerman objects to the fact that direct care staff members are not given the authority and flexibility to decide when to apply skin shocks and when not to. But to allow that to happen would mean that the treatment would not be applied consistently as it must be in order to be effective. More importantly, to allow that would be similar to allowing nurses in a hospital to decide whether and how much medication should be administered, instead of keeping such decisions under the control of the supervising physician. Direct care staff at JRC are encouraged and required to convey suggestions and concerns about treatment to the student's treatment team at JRC, but the final decision as to what behaviors need to be treated with an aversive, and when this treatment should be administered, is properly placed under the control of the supervising clinician.
18. Ms. Gonnerman objects to the fact that JRC discourages staff members from socializing with each other while on duty. It is vital, however, that the staff members give their undivided attention to the students. If a staff member socializes with other staff members when he or she should be attending to the students, this can create an unsafe situation.
19. Ms. Gonnerman interviewed eight former staff members who were critical of how the GED was used. These alleged witnesses have no credibility because they refused to be identified. Furthermore, how did she happen to choose these former staff members and why did she not interview some of the many former staff members who are not critical? She did not ask JRC to recommend any former or current employees for possible interviews.
20. Ms. Gonnerman makes much of the June 2006 New York State Department of Education Report that contained numerous criticisms of JRC. She fails to mention the fact that subsequent to that report three Massachusetts agencies have investigated JRC and found no support for the major findings of that report.
21. The squib about Ms. Gonnerman characterized her article as resulting from a "yearlong investigation." In fact her "investigation" was both brief and one-sided. She spent only two days visiting JRC in September of 2006 and did not witness even a single application of skin-shock to a student (despite giving the incorrect impression in her article that such applications are frequent occurrences). She went to great lengths to interview hostile former parents, teachers and staff (eight disgruntled former staff members—one for eight hours—out of thousands of possible former JRC staff members). She failed to interview any former parents, teachers and staff members with favorable opinions about JRC. Ms. Gonnerman devoted 10 column inches to describing students who died from natural causes entirely unrelated to their treatment (one 26 years ago and not even a JRC student, one 22 years ago, and one 17 years ago), but no column inches at all to students whose lives have been saved by JRC's treatment procedures and no column inches to the case of a former JRC student (a case that I brought to her attention) who died from inadequately treated self-abuse when he was abruptly transferred from JRC to a program that used positive-only procedures.
    
    She failed to inform the reader that all large treatment facilities for the severely disabled experience deaths, especially facilities like JRC that have been in operation for over 35 years and that treat the most fragile and dangerous population. JRC actually has experienced very few deaths, all of which were investigated by the proper state authorities, and none of which were found to be caused by JRC's treatment program. She devoted 36 column inches to three disgruntled former parents and only 4 inches to parents who are among the hundreds who are extremely favorable to JRC. We heard no reports of her speaking to any supportive JRC parents other than the few that she interviewed for an hour or two during her visit to JRC.
    
    Ms. Gonnerman's article was originally written for the New York Times Sunday Magazine. The Times rejected it, a fact that she learned in early April of this year. She then apparently tried to find some other magazine which would buy the article. Consequently, much of the so-called "year-long investigation" was probably spent in trying to find a magazine willing to publish such a biased story.
22. Ms. Gonnerman's objective (which the Mother Jones editors joined in on) was apparently to incite opposition to JRC and agitate for laws to prohibit aversives. At least one mother was not persuaded as evidenced from this email that was sent to the JRC website recently.

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