Reducing addiction- Behavioural interventions

Question 1

What are behavioural interventions?

Answer 1

Any treatment based on behaviourist principles of learning

Question 2

What is aversion therapy?

Answer 2

• Behavioural treatment based on classical conditioning
• Addiction develops through repeated association between substance/behaviour and pleasurable state of arousal
• Addiction reduced by exploiting same CC process, by associating substance with unpleasant state

Question 3

What is aversion therapy for alcohol addiction?

Answer 3

• Client given aversive drug (disulfiram), which interefres with normal boidly process of metabolising alcohol into harmless chemicals
• People who drink on the drug suffer severe nausea and vomiting
• Through association, alcohol and disulfiram become conditioned stimuli, producing a conditioned response

Question 4

What is aversion therapy for gambling addiction?

Answer 4

• Electric shock associated with addiction
• Addicted gambler thinks of gambling and non gambling related phrases and writes them down on cards
• Client reads out each card- when gambling related phrase is read, they receive a 2 second electric shock via device attached to wrist
• Intensity and duration pre-selected
• Pain (CR) becomes associated with gambling related behaviour (NS>CS), cravings subside and gambling stops

Question 5

Limitation-
I- Methodological issues

Aversion therapy

Answer 5

D- Hajek and Stead reviewed 25 aversion therapy studies for nicotine addiction. Concluded it was impossible to judge effectiveness as most studies had ‘glaring’ methodological problems. Failed to ‘blind’ procedures, so researchers aware of who received therapy/ placebo (influenced judgement)
E- Research tells us little about value of aversion therapy

Question 6

Limitation-
I- Poor long term effectiveness

Aversion therapy

Answer 6

D- Fuller et al gave one group of alcohol addicts disulfiram daily for 1 year, other group received placebo drug. Both had weekly counselling for 6 months. No significant difference in total abstinence
E- Suggests aversion therapy is no more effective than placebo

Question 7

Evaluation extra-
I- Ethical issues

Aversion therapy

Answer 7

Limitation-
D- Unethical- uses punishment to treat addiction. Involves deliberate pain infliction of pain, loss of dignity, so high drop-out rates. May cause physical/ psych harm. Shocks= painful and stressful. No long term benefits

Strength-
D- Addiction= dangerous to phsyical/ psych health. Temporary discomfort to avoid lifetime of addiction. Self-selected shocks= painful but non-life threatening. Unethical to NOT use
E- Some ethical limitations but more ethical to use than to not

Question 8

What is covert sensitisation?

Answer 8

• Form of aversion therapy based on classical conditioning
• Occurs ‘in vitro’ rather than ‘in vivo’- imagine unpleasant stimulus rather than actually experience it

Question 9

What are the stages of covert sensitisation in practice?

Answer 9

• Client to relax, therapist reads from script, enourage them to imagine aversive stimulus
• Client sees themselves smoking and imagines unpleasant consequences (e.g: nausea and vomiting)
• More vivid the scene, the better (detail about: sight, smell, sound, physical movement)

Question 10

What is a real-world example of covert sensitisation?

Answer 10

• McMullan- reports habitual user of slot machines with snake phobia. Imagines scenario involving picturing a slot machine paying out in writhing snakes

Question 11

Strength-
I- Research support

Covert sensitisation

Answer 11

D- McConaghy et al compared covert sensitisation vs electric shock aversion therapy for gambling addiction. After 1 year, 90% of covert sensitisation group vs 30% aversion therapy reduced gambling. Covert sensitisation= fewer/less intense cravings
E- Suggests treatment is highly promising

Question 12

Limitation-
I- Methodological criticisms

Covert sensitisation

Answer 12

D- Many studies do not include control groups. Studies omit non-behavioural therapies as comparison groups. Addiction has non-learning causes (i.e. cognitive factors). Non-behavioural therapies (CBT) address these
E- Means benefits may be exaggerated

Question 13

Evaluation extra-
I- Symptom substitution

Covert sensitisation

Answer 13

Limitation-
D- Not a cure, only suppresses addiction. Does not tackle underlying causes. Clients appear to recover but issues causing addiction remain, so addiction may return. Some symptoms disappear but others worsen (e.g: eat more)

Strength-
D- Point to change behaviour. If new symptoms appear, covert sensitisation can be used to treat these too. Symptom substitution= theoretical idea not a reality- based on methodologically flawed case studies
E- Effectively changes behaviour but does not cure addiction, so relapse it likely high