Chronic self-injury is a psychopathology which afflicts some persons with severe mental retardation. The self-injurious acts may be carried out to avoid completion of a task, or the behavior may be intrinsically reinforcing. Professional responses have included use of restraints, psychopharmacology, placement in more restrictive settings, and engaging the children in alternative activities. If all reasonable positive approaches have been tried and found to be unsuccessful, aversion techniques are called for, such as the SIBIS cloth helmet which delivers a shock to the arm following a self-injurious act. In many facilities, de facto elimination of the use of aversives has occurred due to the facilities' fear of lawsuits against them. A careful weighing of costs and benefits should be done on a case-by-case basis to ensure that the client's right to treatment and a better quality of life are not denied. A two-phase process is advanced to maximize the chance of treatment success and the social integration of the client: (1) a rigorous process should be established to guarantee that intensive nonaversive procedures are tried before a committee recommends use of aversive therapy; and (2) implementation of aversive procedures should be overseen by a national board of certified professionals. (JDD)