Nature, if not God, has created man in such a way that he can be controlled punitively.

The need for punishment seems to have the support of history, and alternative practices
threaten the cherished valued of freedom and dignity.

DESCRIPTION OF THE STRATEGY

In colloquial terms, punishment has moral overtones: an unpleasant thing done to people who
deserve to be punished due to violations of laws or social norms. From a behavioral
perspective, punishment has a neutral and operational definition that is not necessarily linked
to the hedonic value of the stimuli involved or the intent of the punishment. Punishment is
defined as an operation or environmental change that, when made contingent on behavior,
reduces the probability or likelihood of that behavior in the future. In other words, certain
results or consequences of behavior, whether caused by or coincidental with the behavior,
serve to decrease the probability of that behavior in the future. This process is called
punishment in behavioral terminology. There is no judgment as to whether the punishment
was deserved or the outcome was beneficial, but rather punishment is a process whereby the
rate of behavior is reduced. The term punishment can describe both the procedure involving
the delivery of a punisher and the effect that results from the operation (i.e., decrease in
responding).
Punishment can occur either by the introduction of a stimulus contingent upon a behavior or
by the termination of an ongoing stimulus situation. The term positive punishment describes
the process of adding or presenting a punishing stimulus after a behavior or response has been
performed. Generally, these stimuli are considered to be aversive or unpleasant. The
presentation of an aversive stimulus is the most familiar form of punishment, and it
corresponds most closely with the layperson's concept of punishment. All animal species need
punishment in the behavioral sense, as it serves to teach the organism which behaviors lead to
pain, discomfort, or danger and to avoid those dangers in the future. Touching a hot stove,
even if accidental, results in a more careful approach to the stove in the future. Without this
learning mechanism, organisms would be doomed to repeat behaviors that may result in
discomfort, injury, or even death.
Punishment can also occur when an ongoing stimulus situation is terminated contingent upon
a response or behavior. This process is called negative punishment. The ongoing stimulus
situation is usually assumed to be positive, pleasant, or enjoyable so that its termination is
unpleasant. For example, a teenage boy enjoying his date accidentally calls her by another
girl's name. The date becomes upset and, perhaps, asks to be taken home, thereby turning the
pleasant interaction between boy and date into an unpleasant one. The boy is less likely to call
his date by another name in the future as a result of her reaction (a consequence of his
behavior), and therefore the process of punishment has taken place. Behaviorally defined, if a
contingent reduction in reinforcement density leads to a decrease in the rate of a behavior, the
behavior can be said to have been punished. Negative punishment forms the basis for
common punishment techniques, such as time-out or grounding, that will be discussed later.

Positive Punishment
Therapeutically, positive punishment is generally used to decrease the occurrence of
behaviors that may be dangerous to the individual or to others and should be combined with a
reinforcement-based program designed to teach other more appropriate behaviors. These
interventions usually involve the planned introduction of an aversive or unpleasant stimulus

upon the occurrence of a predefined behavior. The most effective punishers are those that can
be delivered immediately. As in the process of reinforcement, immediate delivery of the
punishing stimulus is important, and delays in the presentation can dramatically reduce the
effectiveness of the punisher or render it ineffective altogether. In addition, a punisher is more
effective if it is resistant to having its intensity reduced or if the punisher can be avoided
altogether by the behavior of the person being punished. For example, one technique for
reducing unwanted behavior has been to squirt sour lemon juice into the mouth of a person
contingent upon an undesired behavior. Clamping the mouth shut or physically resisting the
lemon juice application can serve to reduce the amount of lemon juice in the mouth or avoid it
altogether, thereby reducing its effectiveness as a punisher. An effective punishing stimulus
should have unpleasant effects that are short lived. Lingering unpleasant effects may be
associated with behavior that is actually desired, thereby inadvertently reducing it, or the
effectiveness of subsequent applications for the target behavior may be reduced because the
person is still experiencing the last application. As in the example of contingent lemon juice,
once in the mouth, the unpleasant sensation may linger, making further applications less
aversive, as they do not serve to increase the unpleasantness beyond what is already
experienced.
Examples of punishing consequences that have been reported in therapeutic interventions
using positive punishment range from mild verbal reprimands to contingent electric shock,
and include aversive or unpleasant agents such as the lemon juice mentioned above, water
mist sprayed to the face, aromatic ammonia (smelling salts) applied under the nose, pinching,
and visual screening. The application of contingent electric shock is often perceived as the
strongest and least acceptable punishing stimulus. However, there is substantial evidence
supporting its rapid and dramatic effectiveness for treating severe self-injurious behavior and
aggression. The assumption is that contingent electric shock may the most effective punisher
based on its intensity. Given the above-stated requirements for an effective punisher, it may be
that electric shock is effective based more on the properties of shock itself rather than the
intensity. First, it can be delivered immediately and without personal contact if a
remotecontrolled device designed for use with humans is utilized. In addition, the person
cannot escape from or reduce the intensity of the shock based on their behavior. If the
duration of the shock is brief and if kept to as low an intensity as possible, the sensation
disappears with the termination of the shock. The Selfinjurious Behavior Inhibiting System or
SIBIS is an example of a device that was designed for use with humans. It has a number of
electrical safeguards and uses standard 9-volt batteries to power its components. A mild
electric shock can be delivered to the subject instantly, the shock lasts only 0.2 second, and is
at an intensity that causes only a startle reaction with mild discomfort. Immediacy of delivery,
short duration with nonlingering effects, and the inability of the person to reduce or avoid the
shock make electric shock an effective punisher at lower intensities than often assumed and
accounts for its superiority over other forms of punishers that do not have these qualities.
The above discussion of positive punishment referred to techniques in which a specific
stimulus is contingently introduced in order to decrease the frequency of a behavior. Another
approach is called overcorrection and involves requiring the person engaging in undesirable
behavior to perform another set of behaviors contingent upon the undesirable behavior.
Overcorrection is often not thought of as punishment, as it seems to be more of a teaching
procedure, but because it reduces the future probability of the undesired behavior, it is by
definition punishment. There are two types of overcorrection: restitution consists of requiring
the individual to correct the environmental effects of the inappropriate behavior (e.g.,
apologizing, cleaning a room), and positive practice involves repeated practice of an

alternative and appropriate behavior (e.g., writing an incorrect spelling word correctly 100
times). Restitution and positive practice can be combined or used separately.

Negative Punishment
As discussed earlier, the adjective negative refers to how the punishment comes about and
does not have an evaluative meaning. The reduction in the rate of behavior is produced by a
contingent reduction or termination of an ongoing positively reinforcing situation rather than
by the contingent introduction of an aversive stimulus, as is the case with positive
punishment.
The most common application of negative punishment is commonly called time-out, but the
full name of the procedure is time out from positive reinforcement. Contingent upon a
specified target behavior or behaviors, all sources of possible reinforcement are removed. This
is commonly accomplished by sending a child to his or her room or to sit on a chair, based on
inappropriate behavior. The assumption is that the child's room or being made to sit on a chair
in an uninteresting part of the house will functionally reduce the child's access to reinforcing
stimuli (e.g., toys, TV, social interaction) and therefore serves as a time-out from positive
reinforcement. This is referred to as exclusionary time-out. If the source of reinforcement is
primarily social, it may not be necessary to physically exclude the individual from others if
others in the environment can withhold social interaction contingent upon inappropriate
behavior. This is called inclusionary time-out. In both procedures, the effectiveness of the
procedure depends on two factors. First, the ongoing situation (time-in) must be reinforcing to
the individual, and second, there must be a dramatic reduction in reinforcement density
imposed. An already bored child will not learn much by being removed to another boring
situation contingent upon behavior. Similarly, a child who is sent to his or her room where
there are toys, games, and so on may not learn to reduce the rate of the targeted inappropriate
behavior.
Response cost is another negative punishment procedure and involves the loss of positive
reinforcers such as tokens, points, or rewards as a consequence of the occurrence of a
behavior. The procedure entails a penalty or a fine of some sort. Response cost is often used
as a component of a positive reinforcement program (e.g., token economy), in which
conditioned reinforcers are delivered for some desired behaviors and removed following
inappropriate ones.

RESEARCH BASIS
There is strong research evidence for the effectiveness of punishment procedures in the
therapeutic reduction of undesirable behaviors. The research has used primarily single-case
designs rather than large N-group comparisons and has investigated punishment alone and in
combination with reinforcement procedures.
For the reduction of severe and physically dangerous behaviors, research suggests that
contingent electric shock is capable of producing rapid and dramatic reductions in targeted
behaviors. Despite widely held beliefs, there is little research evidence for negative side
effects from contingent electric shock treatment; indeed, the empirical evidence documents
more positive than negative side effects.

It has been shown that the immediate delivery of a punishing stimulus coupled with the
inability of the person receiving the punishment to reduce it or avoid it produces the greatest
therapeutic results. In addition, treatments that combine punishment with positive
reinforcement to teach appropriate alternative behaviors are the most effective. Continuous
punishment (punishing every occurrence of the target behavior) is most effective for initial
suppression of the behavior, and there is disagreement about whether intermittent punishment
can be used to reduce the recovery of the behavior if the punisher cannot be administered on
each occasion of the behavior. There is no substantial evidence suggesting that punishment
leads to aggression by the person being punished. This phenomenon, called elicited
aggression, has been demonstrated in animal research but only under very specific conditions
that are not usually in effect when punishment is used with humans.

RELEVANT TARGET POPULATIONS AND

EXCEPTIONS
Most commonly, the therapeutic use of punishment has been investigated with typically
developing children and in the population of individuals with mental retardation or
developmental disabilities. Because these populations are vulnerable to abuse, misuse and
overuse of punishment was not uncommon, and a strong antiaversive, antipunishment
advocacy movement arose beginning in the late 1980s. As a result of this movement, there has
been a significant decrease in the inappropriate use of punishment and a dramatic reduction in
research on punishment techniques. However, there are many appropriate uses of punishment,
and its systematic inclusion into overall treatment programs can produce significant
therapeutic results. Care must be taken to ensure the rights of individuals subjected to
punishment, and this is accomplished by utilizing strong oversight committees, advocacy
groups, or legally appointed guardians.

COMPLICATIONS
Opponents of punishment argue that punishment dehumanizes individuals and results in side
effects worse than the original behavior. However, as stated above, there is little empirical
evidence for negative side effects of elicited aggression when using punishment. Terms such
as dehumanization are subjective, and there is much room for disagreement on the relative
benefits of treatment versus the potential for misuse or abuse. In addition, because punishment
can produce very dramatic and rapid effects, some argue that its success itself can lead to an
overreliance on it to the exclusion of positive reinforcement procedures or environmental
changes that may also be therapeutic. Careful and intense monitoring of punishment programs
is needed by trained professionals to guard against these complications.

CASE ILLUSTRATION
Jim was a 14-year-old male with a diagnosis of autism, severe mental retardation, and
Tourette's syndrome with a history of aggressive behaviors. Over a period of 3 months, Jim
had drastically reduced his food intake, resulting in a 35-pound weight loss in the absence of
any medical explanations. This prompted a referral to a behavioral feeding program.
Upon referral, and following a thorough behavioral history that failed to identify precise
factors that triggered Jim's food refusal and subsequent weight loss, it was decided to admit

Jim to a medical hospital for a behavioral feeding program to promote weight gain and
increase the variety of his diet. The behavioral plan involved the following components:
manipulation of hunger to increase acceptance of nonpreferred items, positive and negative
reinforcement of eating, and extinction (by ignoring) of inappropriate (spitting, throwing, and
expelling food) and aggressive (biting, kicking, hitting) behaviors.
Functional assessment throughout the first 5 days of treatment indicated that inappropriate
and aggressive behaviors were most likely maintained by escape from eating or nursing
interventions (blood draws, bathing). These behaviors were extremely difficult to extinguish
and were compromising his relationship with the medical staff. Jim's aggressive and
inappropriate behaviors were blocking the effectiveness of the feeding treatment intervention,
thereby impacting his overall heath and nutrition. For these reasons, it was deemed necessary
to address his aggressive behaviors that could not be ignored (severe physical aggression and
spitting in caregiver's face) by using contingent electric shock as administered by the SIBIS to
decrease interfering behaviors. SIBIS was introduced on Day 6 and used contingently to treat
aggressive behaviors throughout the remaining feeding interventions at mealtime only.
As seen on Figure 1, the introduction of the punishment component to the ongoing positively
based feeding intervention produced large decreases in severe and long-standing aggressive
behaviors and significant improvements in Jim's eating behaviors. This resulted in adequate
weight gain and nutritional status. In addition, he began to exhibit a number of positive
behaviors such as increased sociability and communication with staff, which in return resulted
in positive reinforcement from staff who had avoided him for fear of his aggressive kicking
and spitting. Positive side effects clearly outnumbered negative side effects. He was
discharged after 10 days of treatment eating an adequate and nutritionally balanced diet and
with his aggressive behaviors essentially eliminated. The use of punishment in this case
speeded treatment, resulted in the return of natural reinforcers in his environment, and made it
possible to eliminate his nutritional deficits.
Burrhus Frederic Skinner (1971 p. 75)
Thomas R. Linscheid and Sarah-Jeanne Salvy
Further Reading

Entry Citation:
"Punishment." Encyclopedia of Behavior Modification and Cognitive Behavior Therapy.
2007. SAGE Publications. 15 Apr. 2008. <http://sageereference.com/cbt/Article_n2098.html>.