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Behavioural interventions

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Behavioural interventions

Aversion therapy is a type of therapy based on the principles of behaviourism. As a recap, behaviourism states that all behaviour arises due to stimulus and response conditioning. There are two kinds of conditioning; classical conditioning and operant conditioning.

Classical conditioning: when a neutral stimulus is paired with an unconditioned stimulus. Eventually, the neutral stimulus will become a conditioned stimulus that produces a conditioned response.

Operant conditioning: this is when we are reinforced positively or negatively for our behaviour. Positive reinforcement is adding something to reinforce the behaviour, such as giving a treat. Negative reinforcement is taking something away to also reinforce behaviour, such as letting a child go out without a guardian (taking away the guardian) when they show they are responsible (the behaviour that is being reinforced). Behaviour can also be decreased through punishment and stopped through extinction (when a behaviour is no longer reinforced).

Aversion therapy is based on classical conditioning. In this therapy, an undesired behaviour is paired with an aversive stimulus to produce an intense dislike (aversion) to the behaviour. Let us look at the different types of aversion therapy as well as the effectiveness of this therapy. After this, we will look at the strengths and weaknesses of this therapy.

No Alcohol Aversion Therapy StudySmarterNo alcohol symbol in aversion therapy, flaticon.com/Vectors Market

Types of aversion therapy

Aversion therapy is usually used to treat additions to drugs or alcohol. It can also be used to help stop smoking, gambling, aggression, and even bad habits such as nail-biting.

Aversive stimuli include mild electric shocks, drugs that produce unpleasant sensations like nausea, and unpleasant tastes and smells.

For example, those who bite their nails can apply a nail polish that produces a horrible, bitter taste in their mouth whenever they bite their nails, which should eventually reduce nail-biting urges.

Let us look at how aversion therapy is used in the examples of alcohol and gambling addictions.

Alcohol addiction

Patients with alcohol addiction are usually given a drug, for instance, Antabuse (unconditioned stimulus) that when taken has unpleasant effects, causing nausea or vomiting (unconditioned response).

Patients are asked to take the drug and then drink alcohol (neutral stimulus). The effects of the drug become associated with alcohol. The alcohol was a neutral stimulus, which becomes a conditioned stimulus with the unpleasant effects of the conditioned response, resulting in patients not wanting to drink alcohol anymore.

Aversion therapy [+] alcohol addiction [+] StudySmarterAversion therapy for alcohol addiction, Erika Hae, StudySmarter Originals

Gambling addiction

Patients with a gambling addiction are commonly treated with mild electric shocks. For the gambling behaviour, the therapist could ask the patient to write down behaviours associated with gambling on cards. Neutral behaviours are written on other cards.

The patient reads the cards and each time they encounter a gambling-related card they give themselves an electric shock.

Aversion therapy [+] gambling addiction [+] StudySmarterAversion therapy for gambling addiction, Erika Hae, StudySmarter Originals

Effectiveness of aversion therapy

Research has shown that aversion therapy is effective in the treatment of alcohol addiction.

However, while aversion therapy is effective in the short term, its long-term effectiveness is still somewhat unclear. Aversion may be successful while undergoing the therapy but once the patient is out in the world without the help of the aversive stimulus, it is harder to avoid the undesired behaviour.

Elkins et al. (2017) conducted a study in which patients with alcohol use disorder received five sessions of chemical aversion therapy. The patients still avoided alcohol 30 and 90 days after treatment, 69% of patients were still sober one year after treatment. In addition, fMRI scans in the patients showed reductions in craving-related brain activity in the occipital cortex. This study highlights the longevity of the treatment plan and how effective it is after time has passed.

Smith et al. (1991) conducted a study in which 249 patients underwent aversion therapy (nausea-inducing drugs or mild electric shocks). They were compared with patients who had received counselling as treatment. After 6 and 12 months, the patients who received aversion therapy had higher alcohol abstinence rates than the patients who received counselling. This demonstrates the effectiveness of aversion therapy, especially when compared to other treatment plans.

Bordnick et al. (2004) found that aversion therapy (chemical, covert sensitization, and faradic) was effective in treating addiction to cocaine compared to a control relaxation group when studying and allocating 70 participants. Again, this demonstrates the effectiveness of aversion therapy, highlighting how the therapy can also apply to different addictions.

Evaluation of aversion therapy

Let us consider the strengths and weaknesses of aversion therapy.

Strengths

  • There is research evidence that shows aversion therapy can be an effective treatment, as we demonstrated above with the studies by Elkins et al. (2017), Smith et al. (1991) and Bordnick et al. (2004).
  • It uses strict ethical guidelines to ensure those who are participating in therapy are fully aware of their ability to withdraw, and what the therapy might entail. Still, the ethical issues remain in that the therapy may breach some of these guidelines still, as it induces stress, anxiety, potential pain and humiliation.

Weaknesses

  • Patients can easily start the undesired behaviour again after aversion therapy is stopped. We also do not have much research that indicates how long-term the effects of aversion therapy are, and not all addictions can use aversion therapy effectively, suggesting it can be ineffective.
  • Aversion therapy has some ethical issues (as we touched upon above) in that it could be considered as using 'punishment' as a form of treatment. During therapy, there should be no harm physically or psychologically caused to the patient; however, the aversive stimulus may cause stress, anxiety, humiliation, or pain. The aversion stimulus also causes physical discomfort such as drugs that cause nausea or vomiting and pain from mild electric shocks.
  • There are strict ethical guidelines for working with vulnerable patients, such as those with addictions. Patients' addictions may influence their understanding of what the therapy involves, such as those with a drug addiction who may not be able to think clearly. Patients can also stop the therapy at any time but therapists may not make this point clear to them.
  • Aversion therapy may get rid of the behaviour but does not treat the underlying causes of the behaviour. Thus, the original undesired behaviour may be treated but may very well show up as a different form of addiction.
  • There is an unbalance of power between therapist and patient, patients are compliant to the therapist undergoing aversive stimulus the therapist prescribes them.

Aversion therapy - Key takeaways

  • Aversion therapy is a type of therapy based on the principles of behaviourism.
  • It is based on classical conditioning. Undesired behaviour is paired with an aversive stimulus to produce an intense dislike (aversion) to the behaviour.
  • Aversive stimuli include mild electric shocks, drugs that produce unpleasant sensations like nausea, and unpleasant tastes and smells.
  • Research has shown that aversion therapy is effective; however, this might only be in the short term. Patients may be able to stop undesired behaviour while being exposed to the aversive stimulus during therapy but once they are out in the world and the therapy has stopped it is very easy to start the undesired behaviour again.

Frequently Asked Questions about Behavioural interventions

A1: Aversion therapy is a type of therapy based on the principles of behaviourism, specifically classical conditioning. Undesired behaviour is paired with an aversive stimulus to produce an intense dislike (aversion) to the behaviour. 

A2: Addictions to alcohol are usually treated by pairing the alcohol with drugs, such as Antabuse, that produce nausea or vomiting. Other aversive stimuli used in treating undesired behaviours are mild electric shocks and unpleasant tastes or smells.

Q3: Why is aversion therapy controversial?

A3: Aversion therapy is controversial in that it could be considered as using 'punishment' as a form of treatment. The therapy also causes patients physical harm and may cause psychological harm if not monitored properly. 

A4: Aversion therapy may be effective in the short-term but long-term effectiveness is still somewhat unclear. Aversion may be successful while being exposed to the aversive stimulus in therapy but once the patient is out in the world without the help of the aversive stimulus, it is harder to avoid the undesired behaviour. 

A5: An example of aversion therapy is using mild electric shocks to treat gambling addiction. For the gambling behaviour, the therapist could ask the patient to write down behaviours associated with gambling on cards. Neutral behaviours are written on other cards. The patient reads the cards and each time they encounter a gambling-related card they give themselves an electric shock. 

Final Behavioural interventions Quiz

Question

What kind of conditioning is aversion therapy based on?

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Answer

Classical conditioning

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Question

Fill in the blanks: an _____ is paired with _____ to produce _____ to the behaviour.

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Answer

An undesired behaviour is paired with an aversive stimulus to produce an intense dislike (aversion) to the behaviour.

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Question

What can aversive stimulus include?

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Answer

Mild electric shocks, drugs that produce unpleasant sensations like nausea, and unpleasant tastes and smells. 

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Question

In the example of alcohol addiction, at first alcohol is a neutral stimulus but after aversion therapy what kind of stimulus does alcohol change into?

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Answer

Conditioned stimulus

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Question

When the effects of the aversive stimulus become associated with the undesired behaviour, what kind of response is this?

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Answer

Conditioned response

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Question

In the study by Elkins et al. (2017) what percentage of patients were still sober one year after aversion therapy?

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Answer

69%

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Question

Why may aversion therapy not be effective in the long-term?

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Answer

Aversion may be successful while undergoing the therapy but once the patient is out in the world without the help of the aversive stimulus, it is harder to avoid the undesired behaviour.

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Question

In the study by Smith et al. (1997) did the patients who received aversion therapy have higher abstinence rates after 6 and 12 months than those who received counselling?

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Answer

Yes

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Question

What are the ethical issues with aversion therapy?

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Answer

Aversion therapy could be considered as using 'punishment' as a form of treatment. aversive stimulus may cause stress, anxiety, humiliation or pain and also causes physical discomfort. There are strict ethical guidelines for working with vulnerable patients, such as those with addictions, patients' addictions may influence their understanding of what the therapy involves. Patients can also stop the therapy at any time but therapists may not make this point clear to them. 

 

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Question

In aversion therapy why is there an unbalance of power between therapist and client?

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Answer

Patients are compliant to the therapist undergoing aversive stimulus the therapist prescribes them. 

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