J. Behov. The-r. &Exp. Psychiof. Vol. IS, No. 4. pp. 337-340. 1984. Printed in Great Britain.

LXX-7916/84 $3.00+0.00 0 1984 Pergamon Press Ltd.

SATIATION IN THE TREATMENT OF INAPPROPRIATE FIRE SETTING

RICHARD WOLFF

Bethesda, Maryland

Summary-This paper concerns the treatment of a 7-yr-old boy, who exhibited multiple behavioral disorders, and was treated in a residential setting for inappropriate fire setting by a satiation procedure. Throughout treatment the number of adult interventions at home to “correct him about fire” were recorded. Treatment consisted of 100 30-min sessions in the residential setting during which he was free to light as many matches as he wished. Contrary to earlier studies, the number of matches lit per therapy session did not decrease. However, the number of “corrections about fire” at home completely ceased midway through treatment, and did not recur through the 24-month follow-up period.

Although an extensive literature on this topic has existed for a number of years, basic questions concerning its definition and treat- ment remain.

Traditional clinical definitions generally focus upon intrapsychic events and do not necessarily require that the behavior occur. Legal definitions (arson in adults and malicious burning in children) most often require that the behavior occur, that there be property destruc- tion, a victim, and intent on the part of the accused to destroy property by fire. The issue of intent is most often in question, for the individual usually either denies or justifies his actions (Laberge, 1974).

Functionally, the behavior is defined as a problem by a value judgment of “others”, who consider the fire setting to be inappropriate. A high and stable rate of fire setting in a fireplace, campfire or barbecue may go unnoticed and untreated if others consider it to be appropriate. However, a low and infrequent rate which occurs in the bedroom, hayloft, or family car will be viewed and defined quite differently indeed. The difference is the value judgment of others concerning the appropriateness-inappro-

priateness of the act. Thus, the term inuppro- priate fire setting best describes the condition without relying upon hypothetical variables.

The emphasis of the existing literature is clearly upon understanding the development and current manifestations of the condition (Greenberg, 1966; Nurcombe, 1964) with treat- ment by insight and personality reorganization comprising a smaller section of the literature (Freud, 1932; Fenichel, 1945). A confounding variable in any treatment of fire setting, which is especially important in the long-term treat- ments, is the age of the subject. Actuarial studies report that children, and those in the early teenage years, represent the group most likely to set fires, and the propensity decreases as a function of age. This factor remains as an uncontrolled variable in all of the existing reports of long-term treatment.

The behavioral literature, which is composed of a small number of case studies, defines the treatment procedures and demonstrates a positive treatment effect through extended follow-up periods. These reports have included treatment by aversion therapy (Royer, Flynn and Osadea, 1971), structured fantasies and

Requests for reprints should be addressed to Richard Wolff, Suite 207, Wildwood Medical Center, Bethesda, MD 20814, U.S.A. Jennifer Razes and Annette Grahm assisted in this project, which was conducted at the Regional Institute for Children and Adolescents, Baltimore, Maryland.

337

338 RICHARD WOLFF

DRO (Stawar, 1976), a treatment package of social skills training, overcorrection, and covert sensitization (McGrath, Marshall, and Prior, 1979), threat of punishment with a DRO component (Holland, 1969), and a form of stimulus satiation (Welsh, 1968). Treatment by satiation was developed by Dunlap (1938), and

revived by Yates (1958), and is reported as being successful in the current literature (Haynes, 1978; Levine and Sheff, 1981; St. James and Powell, 1979; and Wolff, 1977).

METHOD

Subject The subject was a ‘I-yr-old male in treatment at a

Sday-a-week residential center. Two years earlier a social agency had removed him from the home of his parents due to their neglect. The whereabouts of the parents were no longer known to the agency, and the etiology and duration of the inappropriate fire setting could not be determined. At age five he was placed in the home of dedicated and caring foster parents, where he exhibited multiple and severe behavioral disorders. When outpatient treatment did not prove to be successful, he was placed in a resident treatment program, where behavioral programs improved most of the presenting problems. However, the rate of inappropriate fire setting was unaltered. The foster parents, who had lost a home to fire many years earlier, were most eager to assist in this aspect of the treatment.

Procedure Without altering either their criteria of intervention or

the existing consequences, the foster parents were asked to record the number of times they “corrected him about fire”. Their reports indicated that the corrections were elicited by acts such as igniting paper items from the stove, stealing matches or cigarette lighters, and burning card- board boxes in the basement. The consequences for these acts, which continued to be employed despite their proven inefficiency, included scolding, time-out and an occasional spanking. The severity of the consequences was roughly equated with the judged degree of inappropriateness.

The present data collection was done when the subject returned to his foster home every weekend, and it con- tinued through baseline, treatment, and follow-up periods.

The satiation procedure consisted of 100 sessions during which the subject was free to light as many matches as he wished. Each session lasted for exactly 30 min. Two sessions a day, which were separated by a minimum of 2 hr, were conducted 5 days a week for 10 consecutive weeks. These sessions took place in a barren and well-ventilated 10 by 16 ft room containing only a chair and recording equip- ment for the therapist. Two therapists, who were both present during the first two sessions, alternated throughout the procedure. The barren room provided for no alternative behaviors, and throughout all sessions the therapists

remained with the subject, passively observing and recording his behavior without speaking to him or respond- ing to his attempts to initiate a conversation.

The subject sat in the middle of the floor and was given a book of 20 matches. His instructions were to remove one match from the book, close the match cover, light the match, blow it out and then place the burnt match into a metal cylinder containing 1 inch of water.

The form of the data is the number of matches lit per 30-min session.

RESULTS

The results of the 100 satiation sessions are presented in Fig. 1. Essentially, there is no difference in the number of matches lit in the initial (mean of sessions l-10=38,60), middle (mean of sessions 46-55 = 38,80), and final sessions (mean of sessions 91-100 = 45,00).

90

80

IO

0

T Range

n Mean

1 Range

I II 1 1 I 1 ; 11 12345678 9 IO

Ten-day blocks

Fig. 1. Matches set per 30-min session-IO-day blocks.

During the 100 sessions the subject lit a total of exactly 4,300 matches with the range of 10-83. No experimenter effect was noted, with the mean number of matches lit per session being 43.40 and 42.60 for the two therapists.

Although there was no difference in the behavior as measured in the therapy sessions, a marked improvement was noted in the “correc-

SATIATION IN THE TREATMENT OF INAPPROPRIATE FIRE SETTING 339

r’~~~!-._~_...L,....._..- IO 15 20 25

Weeks

Treatment Follow-up

Fig. 2. Total number of “corrections about fire” per weekend visit.

tions about fire” which occurred in the home. A six-week baseline yielded a mean rate of 5.00 corrections per weekend visit with the range being 2-8. By the middle of the satiation treat- ment, the behavior ceased and did not recur during the 1Zweek follow-up period. Following his discharge from the center, 1 week follow- up data was collected by the foster parents at 6, 12, 18 and 24 months. The fire-setting behavior did not recur, and the foster parents continually stated that the client’s attraction to fire was no longer a problem.

DISCUSSION

The continuation of the behavior through 100 satiation sessions was not predicted by the existing literature, e.g. Welsh (1968), which reports a rapid elimination of inappropriate fire setting by satiation. When, in this study, it became obvious that the original termination criterion of 10 consecutive sessions without lighting a match would not be achieved, an alternative termination point of 100 sessions was selected.

Several factors may account for this dif- ference. The barren room provided for no other behaviors. It is possible that if there were a choice between lighting matches or engaging in an alternative form of appropriate play, a much different session behavior result would have been obtained. Also, the fact that the child was involved in a treatment program where compliance to the verbal directions of adults was a source of material positive reinforcement may account for part of the difference.

Most case-study reports of treatment by satiation illustrate an initial increase of the baseline rate leading to a gradual decrease and termination (e.g. Ayllon, 1963). While that effect is not evident in the data (number of matches lit) of the 100 sessions, it is apparent from a sample of the notes recorded during the course of treatment.

Session 3. “Before the session began he asked a number of times if he could light matches today. ”

Session 11. “Very happy, laughing, singing ‘Light that match, light that match, burn, burn, burn.’ ”

Session 17. “Irritable about everything. Said, ‘Smells like hell in here.’ ”

Session 32. “No singing. Pretty solemn.” Session 45. “Singing obscenities about E.” Session 52. “Dragged to room.” Session 55. “Very high rate of swearing

today.” Session 62. “After lighting first match said,

‘Damn this match. I’m sick of matches.“’ Session 74 “Ran across playground when

saw E approaching. Carried 400 yards and up four flights of stairs while punching, kicking, and cursing E. At 22 min said, ‘I want you to stop these sessions.’ ”

Session 85. “Had tantrum all the way to room. Held onto all available doorknobs and stair railings to prevent getting to the room. Screamed ‘My mommy won’t let me stay in a school where they let me light matches. My mommy will kick your . . . (expletive deleted).’ ”

Session 97. “Dragged into session today saying he does not want to light matches.”

Although the frequency of match-lighting behavior in the therapy sessions remained un- altered, the inappropriate fire setting behavior in the natural environment, which was the reason for treatment, was eliminated.

REFERENCES

Ayllon T. (1963) Intensive treatment of psychotic behavior by stimulus satiation and food reinforcement. Behav. Res. Ther. 1,53-61.

340 RICHARD WOLFF

Dunlap K. (1938) A revision of the fundamental law of habit formation. Science 67,360-362.

Fenichel G. (1945) The Psychoanalytic Theory of Neurosis. W. W. Norton, New York.

Freud S. (1932) The Acquisition of Power over Fire. Col- IectedPapers. Vol. II. Hogarth Press, London.

Greenberg H. R. (1966) Pyromania in a woman. Psycho- analyt. Quart. 35,256-262.

Haynes S. R. (1978) Treatment of an obsessive-compulsive checker. Behav. Res. Ther. 16,136-137.

Holland C. J. (1969) Elimination by parents of fire setting in a seven-year-old boy. Behav. Res. Ther. 7, 135-137.

Laberge P. (1974) A case of fire fetishism. Inform. Psych. 50,1021-1024.

Levine F. M. and Sheff H. A. (1981) Contingent negative practice as a treatment of tics. The Behaviour Therapist 4,19-20.

McCirath P., Marshall P. G. and Prior K. (1979) A compre- hensive treatment program for a fire setting child. J. Behav. Ther. Exp. Psych. 10,69-72.

Nurcombe B. (1964) Children who set fires. Med. J. Australia, 1,579-584.

Royer F. L., Flynn W. F. and Osadea B. S. (1971) Case history: Aversion therapy for fire setting by a deteriorated schizophrenic. Behav. Ther. 2,229-232.

Stawar T. L. (1976) Fable mod: operantly structured fantasies as an adjunct in the modification of fire setting behavior. J. Behav. Ther. Exp. Psych. 7,285-287.

St. James-Roberts N. and Powell G. E. (1979) A case study comparing the effects of relaxation and massed practice upon tic frequency. Behav. Res. Ther. 17,401-403.

Welsh R. S. (1968) Stimulus satiation as a technique for the elimination of juvenile fire setting behavior. Paper presented at the Convention of the Eastern Psychological Association, Washington, D.C.

Wolff R. (1977) The systematic application of the satiation procedure to delusional verbiage. Psych. Rec. 31, 459-463.

Yates A. J. (1958) The application of learning theory to the treatment of tics. J. Abner. Sot. Psych. 56, 175-182.