Twenty-Four Hour Social Isolation

Abstract

A program was developed for reducing the aggressive behavior (i.e., attacks on others, self-injury, and property destruction) of an institutionalized, psychotic like, retarded adult male. All previous treatments, including drugs, prolonged custodial restraint, and various behavioral procedures, had been ineffective. The program consisted of excluding the resident from all social interactions for a 24-hour period, although he remained in the living area. Social and intellectual criteria for determining the resident's suitability for the program, an increased density of reinforcement, multiple timeout intervals, and a relaxation training procedure were all included in the program. The program reduced the percentage of days each month in which aggression occurred, from a baseline of about 90C% to 4% in the last month of the program. Comparisons of the resident's medical records before and during the program revealed that there were major reductions in: number of times sutures were required following self-injury (from twelve to four per year); daily Thorazine dosage (from 2000 to 800 mg.); and number of PRN Thorazine injections received (from an average of nine per month to one every other month). This stringent program appears to be an effective and enduring method of treating certain types of chronically aggressive individuals, provided that specific guidelines are followed.