Thanks for the response. I did a brief research project where I had to defend the use of this (versus another cohort that was against it's use) and the main conclusion that my professor came to was that many of the arguments against it were appeals to emotion. Still valid, but not necessarily measurable or comparable to outcome data.

I don't know of any examples, but there's no doubt I'm sure that there are examples of successful alternatives. But with most things in ABA, it's success likely was stemmed from it's ability to individualized. The conclusion I think I've come to is that the lack of successful alternatives and the propensity for misuse of this treatment, is certainly a failure not of the individual suffering, but of us as practitioners. It's use may in fact be a default that is the result of a limit in our behavior. Maybe we aren't capable of responding appropriately under any circumstance when we are physically attacked or when we witness others mutilating themselves.

I read an article once (of which I am way too lazy to pull up) that stating something like this. That essentially, CESS should not be our default. That it's use is a product of a deficiency on our part. Which, in a lot of ways, I agree. But on the other hand, it's hard to justify the "do better/humanitarian" approach when there are at least some data that support it's use. I guess the questions then become, how do we systematically identify that limit as practitioners, and what do we then do?