HEALTH aversion therapy for alcohol addiction (16 marks)

Question 1

A01 points for paragraph 1

Answer 1

1) Aversion therapy (AT) is based upon the principles of classical conditioning and aims to remove undesirable behaviours such as alcohol addiction. This is achieved by using an emetic drug called disulfiram which brings about an aversive (unpleasant) response.
2) AT is administered under supervision in a clinical setting and addicts may first have to undergo detoxification before treatment starts.

Question 2

A03 strength for paragraph 1 (and development point)

Answer 2

SUPPORTING EVIDENCE : FRAWLEY AND SMITH (1992)
Found that 81% of a sample of alcohol addicts remained abstinent for at least six months following AT and 71% were still abstinent 20 months. This shows the long-term effectiveness of AT in the treatment of alcohol addiction.

HOWEVER, since the success rate was less than 100% there are still a significant number of alcohol addicts who relapsed and did not find the therapy successful for them.

Question 3

A03 weakness for paragraph 1 (and development point)

Answer 3

REFUTING EVIDENCE : SMITH (1982)
Conducted a meta-analysis of 475 studies on the effectiveness of psychotherapy as an alternative treatment for alcohol addiction and found that it was effective in enhancing psychological well-being. It challenges the effectiveness of aversion therapy as the most suitable therapy for alcohol addicts.

HOWEVER, since data used in the meta-analysis was secondary data, there may be uncertainty about the validity of the original data collected meaning findings about the effectiveness of psychotherapy as a treatment for alcohol addiction are not clear.

Question 4

A01 points for paragraph 2

Answer 4

3) Disulfiram is administered to the addict before they are directed to sip a small amount of alcohol. The alcohol triggers a chemical reaction leading to the addict experiencing nausea, shortness of breath, vomiting and a throbbing headache (like a severe hangover); these effects may last for several hours.
4) Eventually alcohol will be associated with the aversive response of nausea and headaches and the addict will no longer find drinking alcohol an enjoyable experience.

Question 5

A03 strength for paragraph 2

Answer 5

ETHICAL
AT may be viewed as effective because it offers a variation in the form of covert sensitisation where the alcohol addict is not actually made to feel physically sick using disulfiram, instead they are asked simply to imagine being sick. This version of therapy removes unpleasant physical effects and is viewed as a more ethical form of therapy to remove alcohol addiction.

Question 6

A03 weakness for paragraph 2

Answer 6

SOCIAL CONTROL
AT is considered to have a high level of social control because the clinician has expert power over the addict. The addict may feel unduly pressured to accept the therapy because society would deem alcoholism as unacceptable therefore challenging the effectiveness of AT.

Question 7

A01 points for paragraph 3

Answer 7

5) There is no tolerance to disulfiram and the longer it is taken, the stronger its effects. Disulfiram is absorbed slowly and may last for up to two weeks after the initial intake. Disulfiram should not be administered if the addict has consumed alcohol in the previous 12 weeks.
6) The addict will receive regular therapy sessions which last for around an hour; this is carried out as part of a treatment program that often includes counselling.

Question 8

A03 strength for paragraph 3

Answer 8

ELECTIC APPROACH
AT is often given as part of an eclectic approach to treating alcohol addiction. Addicts may be given counselling such as CBT and social support alongside the drug treatment. Therapies are most effective when combined with other treatments meaning that compliance to the AT programme is likely to be higher.

Question 9

A03 weakness for paragraph 3

Answer 9

PALLIATIVE
The drug alone does not address personal and social issues which may have contributed to alcohol abuse making it palliative, not curative. The alcohol addict may not have learned coping skills to deal with such issues and is therefore susceptible to relapse over time challenging the effectiveness of the therapy.

Question 10

A03 strength for conclusion

Answer 10

TIME
Aversion therapy is a relatively quick treatment compared to alternative therapies such as psychotherapy which may take years. It would reduce the likelihood of alcoholics dropping out of the treatment program making it an effective treatment for alcohol addiction.

Question 11

A03 weakness for conclusion

Answer 11

SIDE EFFECTS
AT requires the patient to undergo detoxification first which is likely to result in unpleasant withdrawal symptoms such as nausea and headaches. Some critics of AT would argue that it is an unethical treatment, causing physical distress to the alcoholic which may lead to high attrition rates and challenging the effectiveness of AT as a treatment for alcohol addiction.