The treatment of dangerous behavior

Individuals who display dangerous behavior towards others have historically been under-treated and under-researched. This paper discusses three published case studies wherein adult males were effectively treated for severe aggression towards others, the environment, and, in two cases, self-injury. All were diagnosed as having mental retardation and two also had a psychiatric diagnosis. All had experienced years of failed attempts to control their aggression through large pharmacological interventions and restricting their freedom of movement via restrictive environments. The use of comprehensive multifaceted behavioral programs involving punishment resulted in dramatic and long lasting reductions in aggression, the elimination or great reduction of drug use, and major lifestyle improvements. The conceptual, clinical, political, legal, philosophical, and ethical considerations that arose during the development and implementation of the programs are discussed as well as scientific issues related to achieving long term maintenance. An early published case study (Martin & Foxx, 1973) is discussed first because it illustrates how an informal functional analysis was used to design a very simple and effective non-punishment treatment program for a woman who displayed dangerous aggression.