reducing addiction - cognitive and behavioural

Question 1

define behavioural interventions

Answer 1

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

Question 2

what is aversive therapies

Answer 2

behavioural treatment based on classical conditioning.
behaviour paired with unpleasant response eg electric shock

Question 3

what is the principle of aversive therapy

Answer 3

addiction can develop through repeated associations
therefore
can be reduced by associating the addiction with an unpleasant state

Question 4

how dose aversive therapy for alcoholism work

Answer 4

disulfirim causes severe nausia after drinking. through association disulfiram and alcohol become conditioning stimul producing a conditioned response of vomiting.

client now expects this whenever they drink

Question 5

what has electric shock been used for

Answer 5

countercondition behavioural addictions such as gambling.

Question 6

how dose electric shocks help gambling

Answer 6

gambler selects phrases that relate to their gambling behaviour and phrase that docent

read out phrase

gambling related phrase = shock

pain (UCR) becomes associated with gambling-related behaviours (was NS, now CS), the client’s craving subside and they stop gambling.

Question 7

define covert sensitivity

Answer 7

A form of aversion therapy based on classical conditioning.

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

Question 8

how dose covert sensitivity help nicotine addicts

Answer 8

first encouraged to relax,
then imagine themselves smoking a cigarette,
followed by the most unpleasant consequences such as vomiting.

The association formed reduces smoking habit.

Question 9

example of covert sensitivity

Answer 9

imagine being forced to smoke a cigarette covered in faeces

client imagines turning away from the cigarettes

Question 10

one limitation of aversive therapies

Answer 10

poor long-term effectiveness.

fuller at al - randomly assigned alcohol addicts to receive either disulfiram or a placebo, plus weekly counselling for six months for all participants.

found no significant difference in total abstinence from drinking between the groups after one year

Question 11

one strength of covert sensitivity

Answer 11

research support

McConaghy et al.- compared gambling addicts who received covert sensitisation with addicts who had electric shock aversion therapy.

90% of covert sensitisation participants gambled less (and had fewer cravings) after one year compared with 30% of aversion participants.

Question 12

what are the two elements of Cognitive Behavioural Therapy

Answer 12

The cognitive element: identifying cognitive biases that underlie the addiction and replace them with more adaptive way of thinking

The behavioural element: skill training helps a client develop coping behaviours to avoid the high-risk situations

Question 13

what is functional analysis and how dose it work

Answer 13

client and therapist together identifying the high-risk situations

therapist reflects on what the client is thinking

Question 14

what is the therpaists role in CBT

Answer 14

to challenge a client’s cognitive biases.

Question 15

what is reconstruction in CBT

Answer 15

addresses the client’s faulty beliefs about, for example, probability, randomness, and control.

then confronted and challenged by the therapist

Question 16

what is skill training and how dose it work

Answer 16

Specific skills are taught - focuses on the wider aspects of a client’s life related to their addiction.

Question 17

types of skill training

Answer 17

Assertiveness training - help a client confront interpersonal conflicts that trigger drinking.

Anger management training

Social skills training - helps the client to refuse alcohol with minimum fuss in order to avoid embarrassment

Question 18

one limitation of CBT

Answer 18

short term limited.

Cowlishaw et al., 2012 - meta-analysis of 11 studies
CBT had medium to very large effects in reducing gambling for up to three months after treatment.

after 9 to 12 months there were no differences between CBT and controls

Question 19

one limitation of CBT

Answer 19

clients drop out of CBT.

Cuijpers et al. (2008) - CBT drop-out rate can be up to five times greater than for other therapies

clients often seek CBT because of a crisis caused by their addiction, but they drop out when the crisis is less important or resolved.