Addiction: Behavioural Interventions for Reducing addiction

Question 1

What is aversion therapy?

Answer 1

• A behavioural intervention for addiction based on classical conditioning.
• Allows for association of the addictive behaviour/substance and an unpleasant state.

Question 2

How does aversion therapy work for alcohol addiction?

Answer 2

• Client is given aversive drug like disulfram.
• Disulfram increases hypersensitivity to alcohol, so a person will experience severe hangover effects if they consume it.
• The aim of this treatment is for the client to learn a new association. The aversive and alcohol together make a conditioned stimuli, and the severe hangover effects are the conditioned response.
• The client will expect the CR when they drink, which is enough to prevent them from drinking.

Question 3

How does aversion therapy work for alcohol addiction?

Answer 3

• Client is given aversive drug like disulfram.
• Disulfram increases hypersensitivity to alcohol, so a person will experience severe hangover effects if they consume it.
• The aim of this treatment is for the client to learn a new association. The aversive and alcohol together make a conditioned stimuli, and the severe hangover effects are the conditioned response.
• The client will expect the CR when they drink, which is enough to prevent them from drinking.

Question 4

How does aversion therapy work for gambling addiction?

Answer 4

• Painful (but safe) electric shock will become associated with gambling behaviour
• The gambler will write down phrases in cards that link to their gambling behaviour, alongside some non-gambling related cards.
• When they read out a gambling related phrase they are shocked- the intensity and duration of the shock are selected by the client.
• The client will associate the pain (UCR) with gambling related behaviour (now CS), so the clients cravings reduce and they stop gambling.

Question 5

Briefly explain what covert sensitisation is:

Answer 5

A form of aversion therapy based on classical conditioning where a client imagines and unpleasant stimulus and associates with a substance/behaviour.

Question 6

How does covert sensitisation work in practice to treat an addiction?

Answer 6

• Client is encouraged to relax while the therapist reads from a script instructing the client to imagine an aversive situation.
• The client sees them doing a behaviour/taking a substance, followed by them imagining the most unpleasant consequences, such as nausea and vomiting. The more details, the better (why the therapist reads from a script, so all the senses can be associated).
• Towards the end of a session, the client imagines a situation where they stop doing a behaviour/taking a substance and they feel relief.

Question 7

What are the 3 evaluation points for aversion therapy?

Answer 7

1) Methodological issues (L)
2) Poor long-term effectiveness (L)
3) Ethical issues (L)

Question 8

Explain poor long-term effectivness (L) as an evaluation points for aversion therapy:

Answer 8

• Aversion therapy lacks long-term benefits
• Fuller gave alchohol addicts disulfram everyday for a year, and another addict group a placebo. Both groups had weekly counselling for 6 months.
• There was no significant difference in total abstinence from drinking between these groups after one year.
• Suggests that aversion therapy for alcohol addiction is no more effective than a placebo- which may be because the counselling had a bigger impact.

Question 9

Explain ethical issues (L) as an evaluation points for aversion therapy:

Answer 9

• Aversion therapy is unethical as it uses punishment to treat addiction.
• Aversion therapy may cause physiological or psychological harm, which is why drop-out rates are so high.
• However it may be more ethical than using drugs to treat addiction- as drugs risk danger to life while aversion therapy doesn’t.

Question 10

Explain methodological issues (L) as an evaluation points for aversion therapy:

Answer 10

• Hajek and Stead reviewed 25 studies of averison therapy for NRT.
• They concluded that it was impossible to judge the effectiveness of aversion therapy because most of the studies had ‘glaring’ methodological issues- with no blind or double blind trials, so the researchers knew which patients were receiving the therapy or the placebo.
• This may have influenced the researchers judgements of the therapy’s success. Therefore this research tells us little about the value of aversion therapy.

Question 11

What are the 3 evaluation points for covert sensitisation?

Answer 11

1) Research support (S)
2) Methodological issues (L)
3) Symptom substitution (L)

Question 12

Explain research support (S) as an evaluation point for covert sensitisation:

Answer 12

• McConaghy compared covert sensitisation an electric shock aversion therapy for gambling addiction.
• Found that after 1 year those with covert sensitisation were significantly more likely to have reduced gambling (90% of CS, compared to 60% AV).
• CS patients also reported that they experienced fewer cravings
• Suggests that covert sensitisation is a highly promising behavioural intervention.

Question 13

Explain methodological issues (L) as an evaluation point for covert sensitisation:

Answer 13

• Many studies of covert sensitisation do not include a suitable comparison group.
• For example, the studies do not use non-behavioural therapies as a comparison group. Instead they compare covert sensitisation to aversion therapy.
• Addiction has many non-learning causes (such as cognitive factors). Non-behavioural therapies address these whereas covert sensitisation nor aversion therapy do.
• This means that the benefits of covert sensitisation may be exaggerated.

Question 14

Explain symptom substitution (L) as an evaluation points for covert sensitisation:

Answer 14

• Covert substitution (like aversion therapy) only suppresses addition, it is not a cure.
• People undergoing covert sensitisation may appear to recover is to change the behaviour, but the issues that caused the addiction remain and then new symptoms appear.
• However the whole point of behavioural interventions is to change the behaviour - the behaviour is the addiction
• If symptoms arise to replace the ones that have disappeared, how useful is covert sensitisation.