Reducing addiction: Behavioural interventions

• Aversion therapy

  Aversion therapy is based on the principles of classical conditioning. It exploits the principle of contiguity which states that two stimuli will become associated if they frequently occur together. 

  Learning theory tells us that addictions can be conditioned because of their pleasurable effects, ergo they can in theory be reduced via the same conditioning process but with negative effects
• Aversion therapy for alcohol addiction - Variation 1

  The use of emetic drugs

  1. The alcoholic is given an aversive drug (an emetic) that causes them to experience severe nausea. 5-10 mins later they will then be sick.
  2. Just before they are sick, they have an alcoholic drink (often whiskey due to the very strong taste and smell)
  3. Over several repetitions and gradually higher doses, the patient comes to associate the taste of alcohol with the feeling of being sick

  This makes the idea of having a drink at all very off-putting and produces a nauseous feeling
• Aversion therapy for alcohol addiction - Variation 2

  Metabolism interference

  A second method is via drugs such as disulfiram (Antabuse). Antabuse interferes with the bodies ability to metabolise alcohol into harmless chemicals. 

  If an individual drinks whilst taking antabuse they will essentially experience an instant hangover (nausea, vomiting). 

  The fear and discomfort associated with these symptoms is therefore sometimes enough to prevent the client from drinking.
• Aversion therapy for gambling addiction

  Electric shocks have been used in some instances as a replacement for drugs in scenarios where frequent vomiting would be very dangerous (i.e people with high blood pressure).

  The addicted gambler thinks of phrases that relate to their gambling behaviour (as well as some neutral words) and then reads the cards out. Whenever they read a gambling-related word they are given a 2 second, painful shock
• Covert sensitisation

  Because of all of these considerations, aversion therapy is fairly outdated now having been very popular in the 60s & 70s. 

  Since it has been superseded by other treatments such as covert sensitisation - a type of aversion therapy that happens in vitro

  This means that rather than actually experiencing the unpleasant stimulus the individual is instructed to imagine how it would feel in a therapeutic setting.
• What is the first step in covert sensitization for nicotine addiction?

  The client is encouraged to relax
• Why does the therapist and client discuss unpleasant consequences?

  To identify extreme aversive stimuli
• What should the therapist focus on when discussing aversive situations?

  Extreme and vivid details
• What does the client do after imagining the aversive situation?

  Conjures an image of smoking a cigarette
• Covert sensitisation - AO3

  Research support

  McConaghy et al (1983) directly compared conventional electric shock aversion therapy with covert sensitisation in treating gambling addiction. 

  After one year, covert sensitisation resulted in a significantly greater reduction in gambling activity than aversion therapy (90% compared to 30%). 

  They also reported experiencing fewer and less intense gambling cravings than those treated with aversion therapy
• What is the purpose of imagining aversive stimuli after smoking?

  To create a negative association with smoking
• What does the client do at the end of the session?

  Imagines turning their back on cigarettes
• How does the client feel after imagining turning away from cigarettes?

  They feel relief
• What is the therapeutic technique used for nicotine addiction discussed in the material?

  Covert sensitization
• What role does the therapist play in covert sensitization?

  Guides the client through the process
• What is the significance of the vividness of imagined scenarios in covert sensitization?

  It enhances the effectiveness of the technique
• Covert sensitisation - AO3

  Comparative points

  • CS much less ethically sensitive than AT - no actual physical risk to clients
  • Lack of physical symptoms means less chance than clients will drop out of treatment compared to AT as CS is less traumatic