Covert Sensitization Conditioning

Description of the Strategy

Covert sensitization is a conditioning-based psychotherapeutic and behavioral technique designed to change sexual deviations. Behavioral techniques, such as covert sensitization, olfactory aversion, and faradic or electrical aversion therapy have as their common clinical goal reducing sexual arousal to deviant stimuli through the introduction of aversive events. Covert sensitization is a form of conditioning therapy in which a behavior and its antecedent events are paired with some aversive stimulus in order to promote avoidance of the antecedent events and thereby to decrease the undesirable behaviors. The originator of the procedure, Joseph Cautela, and a colleague defined the conditioning procedure as follows:

Covert sensitization involves having a client imagine an undesirable or inappropriate sexual act, followed by imagining negative or aversive consequences. When employing covert sensitization, the negative or aversive stimulus that follows the inappropriate sexual act usually consists of an anxiety-inducing or nauseainducing image, which may be presented verbally by the therapist or imagined by the client. The aversive scene is individually created and is specific to each client's problem behavior. Covert sensitization has frequently been successfully employed by itself as a behavioral procedure in the treatment of sexual deviance, although oftentimes the procedure is introduced in context of other behavioral management strategies to change or manage sexual deviations. It is important to note that behavioral treatment of sexually offending behavior should be introduced only after a comprehensive functional analysis of the sexual deviance in question. Covert sensitization should be used as a procedure only if the following issues are addressed: (a) implementation of therapeutic behavior change regimens in sexual offending should be individualized to each client in all sexual and general curriculum areas; (b) behavioral responses are best if they are directly measured; (c) behavior patterns should be charted; (d) there needs to be an emphasis on the direct measurement of behavior; (e) functional and descriptive definitions of behavior are the best way to approach the implementation of behavior change regimens; (f) there should be an emphasis on building new and appropriate sexual behaviors as well as general behavioral skills; and (g) a requirement needs to be in place that there will be a behavior-analytic investigation of the impact of environmental influences on each client's behavior.

Covert sensitization is a behavioral approach to changing and managing sexual deviations that is usually employed as one of three tiers of quality behavioral [Page 236]programming, the other two tiers being behavioral skills training, such as social skills, assertiveness skills, communication skills, daily-living skills, and other areas of behavioral skills training, as well as behavioral programming in sexual education. The ultimate goal of a behavioral treatment program, of which covert sensitization is a part, is to achieve behavioral competency skills in all three areas simultaneously and fade advances in each area to the other areas. For example, client achievements in sexual education should be integrated with attainment of appropriate sexual behavior skills for the client in specialized behavioral programming. An example is sexual skills behavior training in which the client is learning appropriate ways to express his sexuality in an interpersonal situation. Furthermore, any major sexual deviancy issues are addressed through implementation of covert sensitization strategies.

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