reducing addiction - cognitive and behavioural Flashcards
define behavioural interventions
Any treatment based on behaviourist principles of learning such as classical and operant conditioning.
what is aversive therapies
behavioural treatment based on classical conditioning.
behaviour paired with unpleasant response eg electric shock
what is the principle of aversive therapy
addiction can develop through repeated associations
therefore
can be reduced by associating the addiction with an unpleasant state
how dose aversive therapy for alcoholism work
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
what has electric shock been used for
countercondition behavioural addictions such as gambling.
how dose electric shocks help gambling
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.
define covert sensitivity
A form of aversion therapy based on classical conditioning.
client imagines an unpleasant stimulus and associates this with a maladaptive behaviour
how dose covert sensitivity help nicotine addicts
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.
example of covert sensitivity
imagine being forced to smoke a cigarette covered in faeces
client imagines turning away from the cigarettes
one limitation of aversive therapies
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
one strength of covert sensitivity
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.
what are the two elements of Cognitive Behavioural Therapy
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
what is functional analysis and how dose it work
client and therapist together identifying the high-risk situations
therapist reflects on what the client is thinking
what is the therpaists role in CBT
to challenge a client’s cognitive biases.
what is reconstruction in CBT
addresses the client’s faulty beliefs about, for example, probability, randomness, and control.
then confronted and challenged by the therapist
what is skill training and how dose it work
Specific skills are taught - focuses on the wider aspects of a client’s life related to their addiction.
types of skill training
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
one limitation of CBT
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
one limitation of CBT
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.
