School That Shocks Gets Slapped

Categories: Follow-Up
Fourteen workers at the Judge Rotenberg Center, a residential special education school in Massachusetts that uses skin shocks as a form of "aversive therapy" to treat behavioral problems, have agreed to pay a total $43,000 in fines for calling themselves "psychologists" without being licensed in the Bay State. Most of the students at the school, featured in a recent Voice cover story, are New Yorkers whose $214,000 annual tuition is paid by state agencies.


Dr. Matthew Israel in his office in Canton, Mass. (David Yellen)

The Center's director and founder, Dr. Matthew Israel (who is licensed by Massachusetts), says that it was an honest error. "I believe that we and our professional staff were singled out because of a bias against aversive therapy, and not because of our mistake," he adds.

The fines, which Rotenberg must pay on behalf of the practitioners, range from $2,000 to $5,000 per person. One of the clinicians fined, Dr. Robert von Heyn, was identified in the Center's 2004 federal tax returns as "director of psychology," even though he is not licensed in any state. While von Heyn holds a doctorate, people with master's degrees have also been dubbed "psychologist" at the Center. Von Heyn's designation was changed to "clinician" this spring.

A spokesperson for the school calls the matter "a technical error." But the agreement ends criminal charges filed against the practitioners; their conduct violated a 1996 Massachusetts law. And it comes just as the New York State Board of Regents is about to decide whether to extend a set of rules—passed on an emergency basis this summer—that bans some of what the Rotenberg Center does. The Regents' action followed a lawsuit by a parent who claims Rotenberg hurt her son, a report by New York inspectors that alleged deficiencies in the school's use of skin shocks, and recent activity in Albany that cast an unfriendly eye at out-of-state placements in general and skin shock in particular (a ban of skin shock failed to become law might could be re-introduced next session).

The Rotenberg Center was founded in 1971 to treat children with severe behavior disorders. The students are retarded, or have autism, or mental illnesses, and might engage in conduct that threatens their lives or their health or endangers others, like banging their head against a wall or cutting themselves. Rotenberg says it uses skin shocks on students for whom other therapies alone don't work. There are around 150 New Yorkers at the Center; 100 or so are from New York City. About half the students at JRC, and half the New Yorkers as well, get skin shocks. Some parents believe the treatments have saved their children's lives, and have gone to federal court to block New York State from altering Rotenberg's treatments.

Most psychologists agree that there are extreme cases were such "aversive therapies" are the only course of treatment left for children who could kill or blind themselves. The question is whether Rotenberg applies the therapy properly. Israel says the people it called "psychologist" wrote the treatment plans for the use of aversive therapy.

The Center is quick to note (as my article failed to mention, due to an error) that it requires not only parental permission but also approval by a state probate court before using skin shock on a student. However, Massachusetts regulators say that five of the 14 clinicians who've been fined "acknowledged that they had held themselves out as Psychologists in Massachusetts Probate Court while testifying regarding the treatment of children at JRC."

Israel provided this statement on the fines:

    Ever since its founding in 1971, the Judge Rotenberg Center, Inc. (JRC) has employed clinical staff with training and graduate degrees (masters and doctorates) in psychology. These professionals provide diagnostic evaluations and develop and implement behavioral treatment plans. JRC assigned the job title "psychologist" to all of these persons even though not all of them had chosen to become licensed as psychologists by the Massachusetts Board of Registration.

    In 1996, the Massachusetts Legislature amended existing law to limit the use of the title "psychologist" to only those holding a Massachusetts license. Prior to 1996 the law required that those who held themselves out to the public as psychologists (to offer, for example, outpatient psychotherapy) be licensed, but permitted non-licensed psychologists who were working within a school to use the title "psychologist". After 1996, non-licensed individuals who worked within a school could no longer call themselves "psychologists;" however, the amendment did not restrict them from continuing to do exactly the same diagnostic, counseling and treatment work they had always done within schools such as JRC. Unaware of the 1996 amendment, JRC continued to use the title "psychologist" for staff holding graduate degrees in psychology who were providing diagnostic, counseling and treatment services.

    When, in May 2006, JRC first learned of this amendment, we immediately changed the title of those professional staff who were not holding a Massachusetts license to that of "clinician." And in response to an administrative review by the Board of Registration of Psychologists, a number of our present and some former professionals not holding a license from that Board recently entered into consent agreements assuring they will not use the title of "psychologist" unless they are licensed. Further, on behalf of these clinicians who held the title of "psychologist" after 1996 when, lacking a Board license, they were no longer allowed do so, JRC paid an administrative assessment to the Commonwealth to settle and close the Board's inquiry.

    The intent of the 1996 amendment was no doubt to protect consumers from purchasing services from individuals who might hold themselves out to the public at large as "psychologists" without having been sufficiently trained in the field. But because the law did not change the substance of the work of the professional staff working within a specialty schools like ours, I believe that we and our professional staff were singled out because of a bias against aversive therapy, and not because of our mistake. Dozens of professionals employed at other schools made exactly the same honest mistake and to this day have not faced penalty. Furthermore, at no time during the ten-year period that the new law has been in effect has the Board of Registration of Psychologists ever notified schools such as ours of the change in the law or notified the licensed psychologists of the change. And this was despite constant interactions between these schools and the Commonwealth, and despite dozens of references these schools made to members of their staff as "psychologists." Indeed, it was only upon the suggestion of JRC's counsel that the Commonwealth ultimately did send a directive, earlier this year (2006) to schools, urging staff to correct their titles to be in compliance with the 1996 amendment.

    Aversive therapy makes many people uncomfortable—at is understandable. But the parents of children who cannot be successfully treated elsewhere know that it works, and it saves lives. Parents do not place their children at JRC because of the titles of our highly trained professionals; they place their children with us to address life threatening behaviors that in many instances cannot be addressed elsewhere.



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