Addiction : Behavioural Inventions For Addiction Flashcards
Why are aversion therapy and covert sensitisation effective?
- Aversion therapy (also called overt sensitisation) and covert sensitisation treat addiction using the principles of
classical conditioning. Specifically, both interventions utilise counterconditioning to replace the positive involuntary associations addicts have towards their addiction with negative involuntary associations. - At the start of the intervention, the object of the patient’s addiction (e.g., alcohol) is labelled the neutral stimulus.
During the intervention (the conditioning stage), this is paired with an unconditioned stimulus (e.g., an electric shock or horrible mental image). The intervention concludes when the previously neutral stimulus (alcohol) has become a conditioned stimulus producing a conditioned response (e.g., they feel pain or disgust when exposed to alcohol).
Outline how aversion therapy can be used to treat addiction (gambling, smoking, alcohol etc).
• At the start of the first session, the therapist will explain the treatment rationale and protocol. Patient
understanding and consent are important, given the unpleasant aspects of the treatment.
• The patient is also asked to keep a behavioural diary of their addiction. This can then be checked after every
session to evaluate whether the therapy is effective.
• During each session, the patient is exposed to their addiction and a pre-selected appropriate negative
stimulus. How this happens will vary for different addictions.
Example would be needed in the exam.
Outline how covert sensitisation can be used to treat addiction (gambling, alcohol, smoking etc).
• At the start of the first session, the therapist will explain the treatment rationale and protocol. Patient
understanding and consent are important, given the unpleasant aspects of the treatment.
• The patient is also asked to keep a behavioural diary of their gambling. This can then be checked after every
session to evaluate whether the therapy is effective.
• During the sessions, the therapist instructs the client to imagine themselves engaged in their addictive
behaviour and then imagine an extremely unpleasant consequence (e.g., involving nausea). The more vivid
and unpleasant the imagined situation, the more effective. The therapist will work with the client to ensure
a suitably unpleasant situation is found.
• At the end of a session, the patient will be instructed to imagine a situation in which they refuse the
addictive behaviour and experience feeling relieved.
How has research compared the effectiveness of behavioural interventions for addiction?
McConaghy (1983) found that at a one-year follow up 90% of patients receiving covert sensitisation had reduced
their gambling compared to only 30% of patients receiving aversion therapy.
Although these findings suggest that both interventions may be effective at helping addicts change their behaviour, it’s also clear that covert sensitisation is considerably more effective than aversion therapy at helping gambling addicts. However, one issue with this study is its participants were all gambling addicts. As a result, we can’t be confident that these findings on the effectiveness of behavioural interventions will generalize to other
populations of addicts (e.g., heroin addicts). Furthermore, the study’s lack of a control group is a significant issue.
Control groups are essential for internal validity, as they allow comparison with no intervention. Without this, it’s difficult to determine if the interventions truly caused the improvements in addiction.
What is a limitation with behavioural interventions as a treatment for addiction?
They offer a limited method of changing an addicts behaviour.
Behavioural intervention only really work by seeking to replace positive associations towards the addiction with
negative associations. One issue with this approach is that the task of changing associations is incredibly difficult, given that the addict has likely had many years to establish the positive associations, compared to a matter of weeks for the intervention
to establish the negative associations. Furthermore, behavioural interventions focus on the behaviour but do not
address the underlying cause of addiction, such as biological factors, cognitive biases, or social environment (i.e., the thing that is leading them to addictive behaviour in the first place). A more holistic approach that accounts for multiple levels of explanation might be more effective in achieving lasting improvement.
What ethical issues are there with the use of behavioural interventions for addiction?
Both aversion therapy and covert sensitisation will involve unpleasant experiences for the client. With covert
sensitisation this experience is imagined, but for aversion therapy the unpleasant stimulus is experienced directly. Since both interventions involve an unpleasant experience, this raises the ethical issue of protection from harm. However, this could of course be justified considering the potential for greater harm if the addiction is not dealt with, and the fact that behavioural interventions will always require the informed consent of the patient.Nonetheless, the experience of harm may lead patients to abandon the intervention before it becomes effective, meaning that it becomes harder to make the ethical argument that the benefits of either therapy (but especially aversion therapy) outweigh the costs. This may explain why aversion therapy is rarely used anymore.
