Behavioural Interventions for Addiction (AQA A Level Psychology): Revision Note

Aversion therapy to treat addiction

• Aversion therapy is based on classical conditioning, exploiting the principle of contiguity; that two stimuli will become associated if they frequently occur together

• According to learning theory, an addiction can develop through repeated associations between a drug and the pleasurable state of arousal caused by it

  • Therefore, addiction can be reduced by exploiting the same conditioning process but associating the drug with an unpleasant state, known as counterconditioning

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

Alcohol addiction

• To try and cure alcohol addiction, individuals are given an aversive drug which causes vomiting and makes them feel nauseous 

• Five or ten minutes later, before this point is reached, the client is given an alcoholic drink, usually whisky because it has a particularly strong alcoholic taste and smell, and vomiting begins almost immediately after this

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

Nicotine addiction

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

Gambling addiction

• Aversion therapy for gambling often uses electric shock therapy

• The gambler thinks of phrases that relate to their gambling behaviour and writes them down on cards, and some non-gambling behaviours are also included such as 'Went straight home'

• The participant reads out each card, and when they get to a gambling-related phrase they are given a two-second electric shock

• The intensity of the shock is pre-selected by the participant themselves, following instructions that it should be painful but not distressing

Covert sensitisation to treat addiction

• Covert sensitisation works similarly to aversion therapy by also using classical conditioning, but it is less physically demanding and harmful

• Covert sensitisation is a form of aversion therapy that occurs in vitro, meaning that rather than actually experiencing the unpleasant stimulus of an electric shock or vomiting, the individual is instructed to imagine how it would feel

  • 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 rat or snake near/in their drink if they have a specific phobia to aid the aversive imagery)

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

  • The addicted person is then asked to imagine themselves smoking, drinking, or gambling whilst thinking about the unpleasant images

• The aim is to make the scene as vivid as possible to create a strong association, as it is believed that the more negative 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

Research which investigates behavioural intervention therapies

• McConaghy et al. (1983) directly compared conventional electric shock aversion therapy with covert sensitisation in treating gambling addiction, and at a one-year follow-up those who had received covert sensitisation were significantly more likely to have reduced their gambling activities (90% compared with just 30% undergoing aversion)

  • They also reported experiencing fewer and less intense gambling cravings than the aversion-treated participants

Evaluation of behavioural intervention therapies

Strengths

• Covert sensitisation avoids the ethical problems of aversion therapy, as it does not use shock or induced vomiting and poses fewer medical risks, while also allowing individuals to retain their dignity and be less challenging to their self-esteem

  • The popularity of aversion therapy was severely dented by research questioning its efficacy and by concerns over the ethics of its use, as inflicting extreme nausea, pain and loss of dignity came to be seen as ethically questionable

• McConaghy et al.'s findings are one of many studies suggesting that covert sensitisation is a highly promising behavioural intervention for a range of addictions, including alcohol, nicotine and gambling

Limitations

• Hajek & Stead (2001) reviewed 25 studies of aversion therapies used to treat nicotine addiction and concluded that it was impossible to judge the effectiveness of these therapies, because all but one suffered from glaring methodological problems

  • Perhaps the most damaging was a failure to blind the procedures, so the researchers evaluating the outcomes knew which participants received therapy and which received a placebo, and such inbuilt biases usually make therapy appear more effective than it actually is

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

Issues & Debates

• Behavioural therapies take a reductionist view of addiction by focusing only on learned associations (stimulus-response links)

  • This ignores biological, cognitive and social factors, which may also contribute to addictive behaviour, limiting the overall effectiveness

• 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