THERAPIES

• WHAT IS COVERT SENSITISATION?


  AN AVERSION THERAPY TECHNIQUE THAT FOLLOWS THE SAME PRINCIPLES BUT DOESNT PHYSICALLY PRESENT THE UNWANTED CONSEQUENCE TO THE CLIENT.
• WHAT DOES THE THERAPIST INSTEAD RELY ON?


  THE CLIENT’S ABILITY TO USE THEIR IMAGINATION RATHER THAN EXPERIENCING THE NEGATIVE CONSEQUENCE.
• WHAT IS AN EXAMPLE OF COVERT SENSITISATION? 


  ALCHOLICS ARE REQUIRED TO UPSETTING, REPULSIVE OR FRIGHTENING SCENES SCENES WHILE THEY ARE DRINKING.
• WHAT IS ANOTHER FACT ABOUT COVERT SENSITISATION?

  IT IS MUCH LESS COMMONLY USED THAN OTHER FORMS OF AVERSION THERAPY.
• WHAT MAY THE THERAPIST MAY ALSO DO?

  VERBALLY ENCOURAGE THE CLIENT TO IMAGINE SCENARIOS THAT MAY PROGRESSIVELY GET WORSE. (IMAGINING FEELING SICK AFTER DRINKING ALCOHOL TO VOMITING OVER SOMEONE BECAUSE OF DRINKING TOO MUCH)
• WHY IS ”NEW DEVELOPMENTS” A PRINCIPLE OF AVERSION THERAPY?

  NEW DEVELOPMENTS IN THE TREATMENT OF ALCOHOLISM HAVE REFINED THE USE OF TRADITIONAL AVERSION THERAPY. THIS IS BECAUSE RESEARCHERS HAVE DEVELOPED/ DISCOVERED DRUGS THAT THAT MAKE USERS SICK IF MIXED WITH ALCOHOL BUT ALSO REWARD AND ABSTINENCE BY INDUCING FEELINGS OF TRANQUILITY AND WELLBEING (BADAWY 1999).
• HOW DO THESE DRUGS WORK?

  THESE COMPOUNDS THAT ARE KNOWN AS TRYPTOPHAN METABOLITES PREVENT ALCOHOL FROM BEING PROPERLY CONVERTED IN THE BODY- CAUSING IT INTO A CHEMICAL THAT CAUSES UNPLEASANT EFFECTS SUCH AS NAUSEA, VOMITING AND HOT FLUSHE.
• WHAT IS THE IMPORTANCE OF ABSTINENCE?

  IT INCREASES LEVELS OF SEROTONIN THAT HELP RELIEVE WITHDRAWAL SYMPTOMS AND INDUCES FEELINGS OF TRANQUILITY AND WELL BEING- WHICH IS A FORM OF POSITIVE REINFORCEMENT.
• THEREFORE, WHAT DOES THIS SHOW?

  UNLIKE CONVENTIONAL AVERSION COMPOUNDS, THESE ALSO OFFER AN INCENTIVE FOR STAYING WITH THE TREATMENT.
• WHAT DOES THE PRINCIPLE OF “HOW IT WORKS” IN AVERSION THERAPY INCLUDE?

  IT INCLUDES THE PRINCIPLES OF CLASSICAL AND OPERANT CONDITIONING.
• WHAT DOES THIS MEAN? (1)

  INDIVIDUALS ARE REPEATEDLY PRESENTED WITH AN AVERSIVE STIMULUS (SOMETHING UNPLEASANT- ELECTRIC SHOCK OR DRUG THAT INDUCES NAUSEA)
• WHAT DOES THIS MEAN? (2)

  AT THE SAME TIME THEY ARE ENGAGING WITH THE UNDESIRABLE BEHAVIOUR BEING TREATED (E.G SMOKING OR ALCOHOLISM)
• WHAT DOES ANTABUSE DO?

  CAUSES INDIVIDUALS TO VOMIT WHEN PAIRED WITH ALCOHOL.
• HOW DOES THIS FIT IN WITH CONDITIONING?

  1. THE AVERSIVE STIMULUS (ANTABUSE) CAUSES THE UNCONDITIONED RESPONSE (VOMITING)
• HOW DOES THIS FIT IN WITH CONDITIONING? (2)

  WHEN ANTABUSE IS REPEATEDLY PAIRED WITH THE UNDESIRED BEHAVIOUR WHICH IS ALSO THE NEURAL STIMULUS (DRINKING ALCOHOL), THE SAME CONSEQUENCES OCCUR (DRINKING ALCOHOL)
• HOW DOES THIS FIT IN WITH CONDITIONING? (3)

  DRINKING THEN BECOMES THE CONDITIONED STIMULUS AND PRODUCES THE CONDITIONED RESPONSE OF VOMITING.

  AS A RESULT THE CLIENT WILL LOSE THEIR DESIRE TO ENGAGE IN THE ADDICTIVE BEHAVIOUR
• WHAT IS THE EVIDENCE THAT CAN PROVE THAT AVERSION THERAPY IS AN EFFECTIVE TREATMENT FOR ALCOHOL ADDICTION?

  SMITH ET AL 1997
• SMITH ET AL 1997

  STUDIED 249 PATIENTS ADDICTED TO ALCOHOL.

  PATIENTS WERE TREATED WITH EITHER SHOCK TREATMENT OR NAUSEA INDUCING DRUGS

  FOUND THAT THEY HAD A HIGHER ABSTINENCE RATES AFTER ONE YEAR THAN THOSE WHO‘D TAKEN IT ONCE.
• SMITH 1988

  ALSO REPORTED SUCESS WITH A GROUP OF 300 SMOKERS, 52% OF THOSE WHO WERE TREATED WITH SHOCKS MAINTAINED ABSTINENCE AFTER INE YEAR.
• WHAT IS THE CONFLICTING EVIDENCE?

  MILLER, 1978

  COMPARED THE EFFECTIVENESS OF 3 TYPES OF TREATMENT:

  AVERSION THERAPY, COUNSELLING THERAPY PLUS AVERSION, COUNSELLING ALONE

  ONE YEAR LATER, FOUND RECOVERY WAS THE SAME FOR ALL GROUPS, SHOWING THAT AVERSION THERAPY SHOWED NO BENEFIT
• WHAT IS SUBSTANCE SUBSTITUTION?

  WHERE THERAPISTS FAIL TO TREAT THE POSSIBLE UNDERLYING CAUSES.
• WHY DOES SUBSTANCE SUBSTITUTION OCCUR?

  THIS IS BECAUSE THE BEHAVIOURIST APPROACH BELIEVES THAT MALADAPTIVE BEHAVIOUR IS THE DISORDER AND THEREFORE NO UNDERLYING CAUSES CAN BE TREATED. THIS MEANS THAT THE ORIGINAL SYMTOMS MY BE REMOVED (LIKE ALCOHOLISM) BUT MAY APPEAR IN ANOTHER FORM (LIKE GAMBLING).
• WHY DOES SUBSTANCE SUBSTITUTION HAPPEN?

  THERE IS AN UNDERLYING CAUSE THAT HAS NOT BEEN IDENTIFIED (E.G. SOME PEOPLE TURN TO ADDICTION TO AVOID TRAUMA).
• WHAT IS AN ISSUE THAT ARISES WHEN IT COMES TO AVERSION THERAPY?

  SHORT TERM EFFECTS- IT‘S QUESTIONABLE IF THE POSITIVE EFFECTS OF AVERSION THERAPY LAST LONG.
• WHY CAN THE EFFECTS OF AVERSION THERAPY BE SEEN AS SHORT TERM?

  MANY PATIENTS ARE TREATED IN THE CONFINEMENTS OF THEIR THERAPIST’S OFFICE WHERE IT MAY APPEAR THAT THEY HAVE RECOVERED. HOWEVER, THIS MAY NOT TRANSLATE TO THE OUTSIDE WORLD WHEN THE PUNISHING ASPECTS OF ELECTRIC SHOCKS OR ENHANCING DRUGS MIGHT DISSAPEAR.
• HOW CAN THIS BE BACKED UP?

  RESEARCH ON CLASSICAL CONDITIONING BY PAVLOV SHOWED THAT A CONDITIONED RESPONSE IS EXTINGUISHED WHEN THE CONDITIONED STIMULUS IS NO LONGER PAIRED WITH THE UNCONDITIONED STIMULUS.
• WHAT PROBLEM DOES AVERSION THERAPY SUFFER WITH?

  DROP OUT RATES
• EVIDENCE OF DROPOUT RATES?

  BANCROFT (1992) REPORTED THAT UP TO 50% OF PATIENTS EITHER REFUSE TREATMENT OR DROP OUT OF AT PROGRAMMES.
• HOW DOES THE EVIDENCE OF DROP OUT RATES DAMAGE THE EFFECTIVENESS OF AVERSION THERAPY?

  IT MAKES IT DIFFICULT TO EVALUATE AT IF ONLY WILLING PTPS ENGAGE IN THE THERAPY IN THE FIRST PLACE. THIS MAKES IT DIFFICULT TO GENERALISE FINDINGS AS THEY WERE NOT REPRESENTATIVE.
• WHY IS AVERSION THERAPY SEEN AS UNETHICAL?

  DUE TO ITS PSYCHOLOGICAL AND PHYSICAL HARM DONE TO THE PATIENT, MAKING IT VERY HARMFUL.
• HOW CAN AVERSION THERAPY CAUSE HARM?

  TECHNIQUES THAT ARE DONE AS A FORM OF PUNISHMENT (ELECTRIC SHOCKS) HAVE BEEN CRITICISED FOR EXERCISING TOO MUCH CONTROL OVER THE PATIENT AND BRAINWASHING THEM INTO TREATMENT.