ICD glover (1985) psych treatment CBT covert sensitisation

Question 1

covert sensitisation

Answer 1

assumes all behaviours are learned except basic reflexes so can be unlearned

covert sensitisation uses classical conditioning to create unpleasant associations w the behaviour the person wants to stop

visualise disturbing images > unconditioned stimulus
create unpleasant feelings > unconditioned response
paired w thoughts of target behaviour so thoughts of that behaviour will trigger neg feelings
override urge to enact it

Question 2

case history

Answer 2

56 year old
married woman
stealing daily 14 years
year before husband found guilty of embezzlement
received fine and new low paid job
prev friendships melted away
taken extra work to support them
stole from supermarkets on lunch break
resented husbands behaviour and unable to forgive
had been prescribed antidepressants over the years

Question 3

symptoms

Answer 3

waking every morning w compulsive thoughts about stealing

attempts to resist the thought, which she found repugnant/awful

giving in to urge to steal, taking items she didnt need like baby shoes

urges = overwhelming
wishes she was chained to a wall to stop stealing

Question 4

methodology

Answer 4

the woman attended 4 covert sensitisation sessions, once every 2 weeks

prev tried to cure herself imagining being arrested and prosecuted

w therapist used vom imagery

imagine stealing then vom and what other ppl wld see

then when she put the stuff back vom stops

cont visualisations several times a day as hw

1st two sessions muscle relaxing meds to immerse herself

last 2 sessions self hypnosis > increased the vividness of her visualisations

therapist told her never shop without list
leave bag she used to steal shit in

after initial 2 months she had a follow up once every 3 months to reassess progress

Question 5

results

Answer 5

months since therapy began and progress

4 sessions 2 months > urges reduced, stole 2 times 5 low value things from 4 shops

3 month followup > hw many times daily, more confident shopping alone

9 month > stole soap bar, didnt relieve tension like b4

19 month > no relapses, outgoing, not shunning social contact, stealing not overwhelming
made her unwell but relieved when walked away

Question 6

conclusions

Answer 6

impossible to know which aspects of therapy most effective in overcoming klepto

urge to steal was reduced by ability to clearly imagine the unpleasant scenes

Question 7

glover eval weakness

Answer 7

case study, only one middle aged woman

not be representative of the wider population of people w klepto

devloped w husbands stealing also so BG INFO

if others cant fully immerse also then wont work

BUT evidence to say can be effective bc kohn and antonuccio 2002 treated a 39 yearoldman stealing since he was 6

can be effective regardless of age of onset and gender

Question 8

glover idiographic vs nomothetic

Answer 8

STRENGTH
idiographic approach

solely qualitative data
detailed case history
can see extent of effectiveness and transfer to other ps
vomiting better than arrest for eg

glovr goal was not generalisable conclusions but personalisation to client

Question 9

covert sensitisation STRENGTH

Answer 9

supported by research evidence

glover 1985
kohn and antonuccio 2002

therapy favourable to side effects of the meds

neg effects can cause relapse bc no take meds

Question 10

covert sensitisation weakness

Answer 10

relies on being able to imagine stuff in detail

those w aphantasia cannot > neurodiverse

wicken et al 2021 aphantasia flat physiological response when listening scary story
so ICD + aphantasia means covsen therapy less effective