Aversion therapies can take many forms, for example: placing unpleasant-tasting substances on the fingernails to discourage nail-chewing; pairing the use of an emetic with the experience of alcohol; or pairing behavior with electric shocks of various intensities.
The major use of aversion therapy is currently for the treatment of addiction to alcohol and other drugs. This form of treatment has been in continuous operation since 1932. The treatment is discussed in the Principles of Addiction Medicine, Chapter 8, published by the American Society of Addiction Medicine in 2003. Their website is www.asam.org.
Aversion therapy works on changing positive emotional associations with the sight smell and taste of alcohol or other drug. Follow up studies done at 6 and 12 months on populations matched on 17 baseline variables shows that aversion therapy resulted in significantly better abstinence rates. There was no increase in leaving the hospital against medical advice in patients seeking aversion therapy compared to patients in non-aversion programs.
The results of Antabuse combined with behavioral marital therapy for treating alcoholism has growing research support
The use of aversive procedures by applied behavior analysis, behavior modification, and behavior therapy is always under scrutiny. These issues are discussed in regards to the ethics of such practices (see Professional practice of behavior analysis) However, it is important for regulatory bodies to discuss the use of aversives and punishment techniques. For example, in Massachusetts in the U.S. Judge Rotenberg Educational Center has led to several bills (e.g., H109)to be developed limiting the use of aversives to licensed psychologists and/or board certified behavior analysts. Other states have begun to push for licensing of behavior analysts to ensure regulatory control over such processes. While in some cases the means is jusified by the end effect, behavior analysts need to remember that their overaching goal is to do no harm
Since 1994, the American Psychological Association has declared that aversion therapy is a dangerous practice that does not work. Since 2006, the use of aversion therapy to treat homosexuality has been in violation of the codes of conduct and professional guidelines of the American Psychological Association and American Psychiatric Association. The use of aversion therapy to treat homosexuality is illegal in some countries. The standard in psychotherapy in America and Europe is currently Gay Affirmative Psychotherapy. Guidelines for Gay Affirmative Psychotherapy can be found by APA.
Psychologist Martin E.P. Seligman reported that using aversion therapy to try to change homosexual men's sexual orientation to heterosexual was controversial. In some instances, notably a series of 1966 experiments, the process was initially judged to have worked surprisingly well, with up to 50% of men subjected to such therapy not acting on their homosexual urges. These results produced what Seligman described as "a great burst of enthusiasm about changing homosexuality [that] swept over the therapeutic community" after the results were reported in 1966. However, Seligman notes that the findings were later shown to be flawed: most of the men treated with aversion therapy who stopped homosexual behaviour were actually bisexual; among men with an exclusive or near-exclusive homosexual orientation, aversion therapy was far less successful.
A notorious case of aversion therapy occurred in the 1970s and 1980s, when suspected homosexuals of both sexes in the South African Defense Force underwent aversion therapy and chemical castration. Aversion therapy sometimes involved applying electric current, via electrodes, to men while they were shown pictures of naked men. The current would be turned off when photographs of naked women were shown. See the article in "external links" below for more information.
Injections of apomorphine were also reportedly used as part of aversion therapy for homosexuality, resulting in violent illness. At least one person has reportedly died from this treatment.
There is currently little published data available on conversion rates. However, four studies have reported success rates during conversion therapy of 0.4%, 0.0%, 0.5% and 0.04%. That is, conversion therapy has a failure rate in excess of 99.5% in each study. Furthermore, anecdotal data indicates a high percentage of extremely depressed and suicidal clients emerging from conversion therapy.
In 1992, the Arizona Civil Liberties Union challenged the Phoenix Memorial Hospital for its use of these methods on children as young as 10. They were defended by the Association for the Treatment of Sexual Abusers. Since then, policies have usually discouraged the use of forced aversion therapy on children under 14.