Covert sensitization has been the most widely used behavioral treatment procedure to decrease deviant sexual arousal in sex offender therapy. However, it is unknown whether reductions of deviant sexual arousal in the laboratory generalize to the natural environment. This study conducted a generalization analysis of covert sensitization treatment effects to the natural environment using a portable-penile plethysmograph for a sex offender. Results indicated that deviant sexual arousal was reduced in the laboratory, but not in the natural environment. An examination of the reasons for the lack of generalization are discussed. Covert sensitization has a long history of use in treating such socially undesirable behaviors as alcoholism (Elkins, 1980), drug use (Maletzky, 1974) and sexual deviancies (Barlow, Leitenberg, & Agras, 1969; Maletzky 1980; Moergen, Merkel, Brown 1990; Maletzky, 1993). All of these harmful behaviors could be considered maladaptive approach disorders (Cautela, 1967). Covert sensitization involves the pairing in imagination scenes of unwanted behavior with scenes aversive to the individual. The hope is that the pairing of the undesirable stimulus with the aversive stimulus creates an avoidance response to the undesirable stimulus (Cautela, 1967). Maletzky (1973) reported that for some individuals the aversive scenes in the imagination did not sufficiently suppress overt sexual behavior. Therefore, he introduced a nauseating odor with the aversive scenes. Maletzky (1973) used the term assisted covert sensitization for this procedure. The advantage of covert sensitization as a procedure for decreasing undesirable behaviors is that it can be used without the objectionable behaviors occurring. For instance, the events of past alcohol use can be imagined during therapy sessions without actual alcohol consumption. Another advantage of covert sensitization is that it can be applied to a greater range of stimulus situations (Cautela & Wisocki, 1971). In other words the alcoholic can generate both past drinking scenes and other drinking fantasies that have not actually occurred. Dougher (1993) reported that covert sensitization was one of the most widely used behavioral procedures in sex offender treatment programs. It has been implemented in two ways with sex offenders. Both procedures rely on pairing an unpleasant stimulus with the socially unacceptable, imagined behavior. The goal of covert sensitization is to reduce the desire to engage in the offending behaviors. There have been many speculations as to the mechanism by which change may occur. First, it is seen as a private, verbal operant punishment procedure that reduces corresponding overt behavior (Cautela, 1967). The assumption is that overt and covert behaviors are equivalent and obey the same laws. In addition, these overt and covert events interact and exert reciprocal control on each other (Dougher, Crossen, & Garland, 1986). A second speculation is that the procedure can condition physiological responses that are incompatible with the undesirable behavior. Maletzky (1993) reports that nausea is neurologically incompatible with sexual arousal. Thus, by conditioning a nausea response to the target stimuli (e.g., child stimuli) the offender will no longer become sexually aroused when confronted by children. Finally, a third speculation is that the conditioning procedures reduce the effectiveness of the sexual stimuli as reinforcers (Dougher, Crossen, Ferraro, & Garland, 1987). Dougher et al. (1987) suggests that covert sensitization is actually a classical conditioning procedure, not an operant procedure. They suggest that classical conditioning can alter operant behaviors by reducing the effectiveness of the targeted stimuli as reinforcers. Michael (1983) terms this process a repertoire-altering hybrid operation. Irregardless of mechanism, the goal of covert sensitization is to reduce sexual arousal to deviant stimuli and corresponding behavior (e. …
Read full abstract