Reducing addiction: Behaviour Interventions

Question 1

What are behavioural interventions?

Answer 1

Any treatment based on behaviourist principles of learning such as classical conditioning and operant conditioning

Question 2

Aversion therapy and alcohol addiction

Answer 2

Aversion therapy involves using unconditioned stimuli to create an unpleasant sensory experience, such as fear, disgust, pain, or nausea.

These stimuli are paired with neutral stimuli, which don’t typically evoke dislike, related to the problematic behaviour being eliminated. The neutral stimuli are used to create an unpleasant sensory experience

E.g. Patients are given an aversive drug which causes vomiting-emetic drug. They start experiencing nausea. At this point, they are given a drink smelling strongly of alcohol, and they start vomiting almost immediately.

Question 3

Aversion therapy for gambling addiction

Answer 3

During treatment, the patient may write gambling-related statements. Then the patient is asked to read from cards that either include statements related to gambling (neutral stimuli) or statements unrelated to gambling.

Anytime they read a gambling-related card, they are given a mild electric shock or are exposed to an unpleasant, loud noise (unconditioned stimuli). The patient’s natural response to the unpleasant stimuli involves feelings of fear, pain or irritation; this is the unconditioned response.

The patient’s conditioned response to gambling-related statements can lead to a dislike towards gambling behaviour, potentially helping them quit their addiction.

Question 3

Barker and Mill case study

Answer 3

Barker and Miller’s 1966 case study showed that a man with gambling addiction underwent ten days of 30-minute sessions, including painful electric shocks, and did not relapse two months later.

Question 4

What is one strength of aversion therapy to reduce nicotine and gambling addiction?

Answer 4

Evidence based theory

Question 5

EVALUATION: Evidence based theory

Answer 5

Aversion therapy is an evidence-based theory that has been proven effective in treating addictions.

A study by Elkins et al. (2017) supported the effectiveness of aversion therapy for alcoholism, where 13 patients with alcohol use disorder received five sessions of chemical aversion therapy in addition to standard treatment, including individual and group counselling and psychoeducation.

However, the effectiveness of aversion therapy for treating addictions in humans remains limited, unpopular treatment choice, likely due to its unpleasant and potentially ethical nature

Question 6

Two weaknesses of the aversion therapy to reduce nicotine and gambling addiction?

Answer 6

Reductionist
Poor long term effects

Question 7

EVALUATION: Reductionism

Answer 7

The fact that this kind of treatment may be viewed as reductionistic is a significant criticism. Aversion therapy minimises the significance of a person’s social setting or internal thought processes in favour of concentrating solely on behaviour.

Aversion therapy may be able to stop the behaviour, but it doesn’t deal with the underlying issues that lead to it. As a result, while the initial undesirable habit may be addressed, it’s possible that it might develop as a different kind of addiction or as a different problematic side effect.

Question 8

EVALUATION: Poor long term effects

Answer 8

Addicts of alcohol were randomised by Fuller et al. to receive either disulfiram or a placebo in addition to weekly counselling.

After a year, there was not a significant difference in the groups’ overall rates of abstinence from alcohol; disulfiram offered no further advantages over counselling.

This implies that, over time, aversion therapy for alcohol addiction is no more successful than a placebo.

Question 9

Another behavioural intervention is covert sensitisation, what does this mean?

Answer 9

A form of aversion therapy based on classical conditioning but occurs in vitro rather than in vivo (i.e actual experience). So rather than actually experiencing the unpleasant stimulus of an electric shock or vomiting, the client imagines how it would feel

A client imagines an unpleasant stimulus and associates this with a maladaptive behaviour.

Question 10

Nicotine associated with imagined vomiting

Answer 10

Clients with nicotine addiction is asked first to relax and then to imagine themselves smoking a cigarette, followed by the most unpleasant consequence such as vomiting (including graphic details details of smells, sights e.t.c)

The association formed (classical conditioning) should reduce smoking behaviour

Question 11

Imagining faeces or snakes

Answer 11

Client images being forced to smoke cigarette covered faeces or imagines slot machines paying out with writing snakes instead of coins

Towards the end of the session client imagines turning away from cigarettes/slot machines and experiencing the resulting feelings of relief

Question 12

What is one strength of using covert sensitisation to reduce addiction

Answer 12

Supporting research

Question 13

EVALUATION: Supporting research

Answer 13

In their study, McConaghy et al. contrasted addicts receiving electric shock aversion therapy with those with gambling addictions receiving covert sensitization. After a year, 90% of covert sensitization individuals gambled less (and experienced fewer cravings) compared with30% of aversion participants

This implies that a very promising behavioural solution for gambling addiction and perhaps other addictions too

Question 14

One limitation of using covert sensitisation to reduce addiction

Answer 14

Lack of suitable comparison groups

Question 15

EVALUATION: Lack of suitable comparison groups

Answer 15

Studies e.g McConaghy often make comparison with another behavioural therapy
Addiction has many non learning causes i.e cognitive factors. Non behavioural therapies such as CBT address these. Meaning benefits of covert sensitisation may be exaggerated because it is not compared with more effective therapies

Question 16

Overall evaluations (limitations)

Answer 16

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 might be more effective in achieving lasting improvement.

Relapse is a problem for both therapies. Away from the controlled environment where the associations between behaviour/drug and unpleasant stimuli are formed, it is common for addictions to return.

Behavioural therapies are mostly used in combination with other therapies [(CBT) or biological (drugs)]. It is, therefore, difficult to evaluate their effectiveness.

Question 17

Symptom substitution

Answer 17

Covert sensitisation only supresses addiction, clients may appear to recover, but issues do remain

Some symptoms might disappear but others may appear

Behavioural interventions change behaviour. If new symptoms appear CS can treat those as well

Still helpful to remove main symptoms of addiction even if other less serious one appear