GLOVER (1985) COVERT SENSITISATION FOR KLEPTOMANIA TREATMENT

Question 1

a

What is covert sensitisation?

Answer 1

A CBT technique based on the principles classical conditioning to pair an unpleasant stimulus with an undesirable/ compulsive behaviour to reduce the liklihood that the behaviour is repeated. It occurs in vitro (uses imagination instead of actual aversive stimuli)

To reduce the liklihood that the behaviour is repeated.

Covert= in the mind/ imagined
Sensitisation= Making someone more sensitive/reactive to something

Question 2

How does it work?

Answer 2

1. Visualisation & scripting:The therapist reads a carefully prepared script whilst the patient visualises mentally engaing in the compulsive behaviour (imagery is made as vivid/ realistic as possible)
2. Aversive stimuli: While the person is imagining the act (of stealing) the therapist then introduces a highly unpleasant consequence, such as vomiting, being caught and humiliated, or feeling overwhelming guilt and shame.
3. Pairing/ repetition: This aversive imagery is repeatedly paired with the compulsive behaviour through repeated visualisation, to condition the brain to associate the behaviour with negative emotional or physical responses.
   ~~ leads to a reduction in the behaviour over time, as the mental association shifts from reward to aversive outcome.

Question 3

Name 1 strength of covert sensitisation?

Answer 3

Ethical and safe
1. Avoids real-life exposure to the stimuli (triggering)
2. Avoids need for real-life aversive therapy (uses positive punishment- like showing disgusting images to cause discomfort (smoker) or alcholic may be given antabuse to cause nausea if alcohol is consumed)
* Psychologically protects individuals from harm leading less distress/resistance to particpation

Question 4

Name 1 weakness of sensitisation?

Answer 4

• Reductive (only focuses on the learned aspects of addictive behaviours and not other psychological factors such as trauma, low self-esteem, comorbidity)
• Problematic as addictions are highly complex/ not adressing core issue may expose patient to risk of relapse/developing another addiction or destructive behaviour

Question 5

What was the aim of Glover (1985) study?

Answer 5

• To assess whether covert sensitization could reduce or eliminate kleptomaniac tendencies

Question 6

What method did Glover (1985) use?

Answer 6

• (Longitudinal) case study

Question 7

What methods were used in the treatment?

Answer 7

• Covert sensitisation
• Muscle relaxation- technqiue used in stress reduction/anxiety managment. Can be induced by medication/ visualisation/ repetition of calming phrases.

Question 8

Describe the sample of Glover (1985)?

Answer 8

• 56 y/o woman.
• Had a 14 year history of shop-lifting.
• Kleptomanic

Question 9

Describe the case details of Glove (1985)

Answer 9

• Onset: The symptoms began after her husband was convicted of embezzlement. She struggled with forgiving him, and became isolated from her close friends. She reluctantly took on a low-status job and became depressed.
• Compulsive thoughts: She developed compulsive thoughts of shoplifting every morning, which she found impossible to resist and repulsive.
• No external reward: Her shoplifting was without any external reward, as she once stole baby shoes, w/out having a baby.
• She then sought treatment.

Question 10

Can you describe the treatment (Glover 1985)?

Answer 10

1. Duration: underwent 4 sessions every 2 weeks.
2. Imagery: She visualised vomiting as she lifted the item to steal, which attracted the attention and disgust of the people around her (practices these visualisations outside of sessions as HW).
3. Last session: During the last session she imagined the sickness going away AS she REPLACED the item (negative reinforcement)

The imagery of nausea/ vomiting (unpleasant sensation) was paired repeatedly with the behaviour to make the behaviour less desirable.

Question 11

What was the result of Glover (1985)

Answer 11

• During 19th monthly session- she reported the desire for stealing reduced (without any instance of relapse)
• Reported improvments in her self-esteem and social life.

Question 12

Name 1 strength and 1 weakness of Glover (1985)

Answer 12

• Strength: Avoids real-life exposure to the stimuli/ avoids need for real-life aversive therapy
• Weakness: A single case study on a 56-year-old woman means the findings may not apply to other individuals (men/younger patients/those with different causes)

Question 13

What type of punishment does aversive therapy use?

Answer 13

• Positive punishment- adding an unpleasant stimulus to reduce liklihood of behavioural repetition.

Associates undersirable behaviour with negative outcome

Question 14

What drug may an alcholic be given during aversive therapy?

Answer 14

• Antabuse (causes nausea and vomiting)

Question 15

How does the classical conditioning mechanism work in covert sensitistaion?

Answer 15

Before the conditioning: Gambling (neutral stimulus) → Excitement or pleasure (unconditioned response).

During the conditioning: Gambling (neutral stimulus) + Negative mental image (unconditioned stimulus) → Fear, shame, discomfort (unconditioned response).

After the conditioning: Gambling (conditioned stimulus) → Fear, shame, discomfort (conditioned response).