behavioural interventions for addiction

aversion therapy to treat addiction overview

• Aversion therapy works on the principle of classical conditioning

• Classical conditioning is used to break the individual’s pleasurable association with the addictive substance and replace it with a negative association

aversion therapy - alcohol addiction

• Individuals are given an aversive drug drug which causes vomiting and makes them feel nauseous

• The addicted person is then offered a drink smelling strongly of alcohol, which usually results in them vomiting almost immediately

• The aversive treatment is repeated until the individual no longer wants to drink alcohol

aversion therapy - nicotine addiction

• The aversion therapy often involves the smoker inhaling cigarette smoke rapidly and so deeply that it makes them feel nauseous

aversion therapy - gambling addiction

• Aversion therapy for gambling often uses electric shock therapy

• The individual creates cards with key phrases they associate with their gambling and cards for everyday statements that have nothing to do with gambling

• As they read through the statements, they self-administer an electric shock for each gambling related statement

• The individual sets the intensity of the shock themselves, aiming to make the shock discouraging but not too painful

covert sensitisation to treat addiction overview

• Covert sensitisation also uses classical conditioning but is less physically demanding and harmful

• Instead of experiencing real electric shocks or vomiting, the individual imagines how it would feel to experience these (in vitro conditioning)

• The aim is to make the scene as vivid as possible to create a strong association, as it’s believed that the more negative in the imagined situation, the greater the chance of success in conquering the addiction

• This association results in the addictive behaviour becoming the conditioned stimulus and the negative feelings becoming the conditioned response

stages of covert sensitisation to treat addiction

• The individual is asked to relax and then to imagine feeling nauseous and to imagine themselves vomiting (they may also be asked to picture a phobic object if they have a specific phobia to aid the aversive imagery)

• The imagined vomiting or unpleasant scene is the unconditioned response

• The individual is encouraged to use a lot of detail in building up these images

• The addicted person is then asked to imagine themselves completing the addictive behaviour whilst thinking about the unpleasant images

research which investigates behavioural intervention therapies

• Danaher (1977)

  • Tested aversion therapy with smokers, using deep inhalation of the cigarette smoke to induce nausea, but found that this treatment was only effective for some individuals

  • This undermines the classical conditioning premise behind aversion therapy, which would assume universal efficacy

strengths of behavioural intervention therapies

• Covert sensitisation avoid the ethical problems of making someone ill or causing them distress that accompany aversion therapy

• Behavioural intervention therapies can be adapted to suit individual circumstances for all substance and behavioural addictions, and so they are helpful in many situations

weaknesses of behavioural intervention therapies

• Aversion therapy and covert sensitisation treat the individual in isolation from their social context, thus making relapse more likely in social conditions

• Behavioural intervention therapies treat the behaviour rather than the underlying problem, which means that the problem may still be present - other addictive behaviours may replace the one that has ceased (Griffiths 1995)

links of behavioural intervention therapies to issues & debates

• Behavioural therapies take an environmentally reductionist view of addiction by focusing only on learned associations

• These interventions assume that addiction is determined by past learning and can be reconditioned, implying limited personal control

  • However, covert sensitisation, which relies on mental imagery, may better support an individual’s active role and free will in overcoming addiction