Behavioural Interventions

Question 1

Aversion therapy

Answer 1

• based on the idea of classical conditioning
• takes advantage of the principle of contiguity, which says that 2 stimuli will become associated if they occur together frequently
• counterconditioning takes place, replacing an association between an addictive substance and euphoria with an addictive substance and an unpleasant state

Question 2

aversion therapy for alcohol addiction

Answer 2

• a client is given an emetic, an aversive drugs which causes severe nausea followed by vomiting
• just before they vomit, the clients are given a drink of alcohol, typically a strong one due to its smell and taste
• this process is repeated a number of times, using higher doses of the aversive drug each time, as well as varying the alcohol
• another aversive drug is disulfiram, which interferes with the metabolism and the ability of the client to break down alcohol
• this means that if they drink alcohol, they will vomit
• both drugs counter-condition alcohol, forming an association between them and an unpleasant state
• they will start to fear these symptoms and know that they are caused by alcohol
• for some, this is enough for them to stop drinking
• however, there are a number of ethical issues with this approach, since clients are made to throw up a number of times

Question 3

Aversion therapy for gambling addiction

Answer 3

• electric shocks are used to treat gambling addiction and other behavioural addictions
• if the client has a pre-existing condition which would be worsened by vomiting a lot, electric shock therapy may be used instead
• the shocks are painful but dont cause permanent damage
• a gambler will be asked to think of phrases relating to their gambling behaviour and write them down
• the client also rights down non-gambling related phrases and has to read out all of the cards one by one
• when he reads a gambling phrase, they are given a shock

Question 4

Covert sensitisation

Answer 4

• covert sensitisation is used more often than aversion therapy nowadays due to the number of ethical issues associated with it
• a client has to simply imagine an unpleasant situation as opposed to actually experiencing it

Question 5

covert sensitisation for nicotine addiction

Answer 5

• firstly, the client is told to relax
• they then instructed to imagine that they are smoking then think of the most unpleasant consequences e.g. vomiting
• the more vivid the scene the better, with client being instructed to think of all of their senses
• McMurran (1994) had a participant addicted to slot machines and scared of snakes, so told to imagine a scenario where they were gambling but snakes were there instead of cash

Question 6

(-) EVAL - methodological problems with aversion therapy studies

Answer 6

• Hajek and Stead (2001) examined 25 studies where aversion therapy was used to treat nicotine addiction
• however, they concluded that it was impossible to judge the effectiveness of the therapy since all but one of the studies suffered from methodological issues
• in most of the studies double-blind procedures weren’t used, with the researchers knowing which participants received therapy of placebo
• sometimes this made a certain type of therapy seem more effective than it actually was
• most aversion therapy studies were also very dated, which illustrates their decline in use, and replacement with covert sensitisation

Question 7

(-) EVAL - treatment adherence issues

Answer 7

• one of the main issues with aversion therapy is its use of disturbing and traumatising experiences
• induced vomiting and electric shocks are not desired experiences
• for this reason, many participants drop out of treatment before its complete
• this makes it difficult to assess the effectiveness of aversion therapy
• there may be a pattern for people dropping out, typically being those less likely to respond to treatment
• this means that research and findings concerning aversion therapy may be over-optimistic
• this also highlights the advantage of covert sensitisation that it is less traumatic

Question 8

(+) EVAL - research support for covert sensitisation

Answer 8

• McConaghy et al. (1983) compared 2 types of behavioural intervention for treating gambling addiction: covert sensitisation and shock therapy
• they found that after 1 year those who had received covert sensitisation were significantly more likely yo have reduced gambling behaviours
• 90% covert sensitisation group had reduced gambling, compared to 30% shock group
• this is one of many studies which show that covert sensitisation is an effective treatment for addictions