1. Addiction UNIT 4: PSYA4 lcb@beauchamp.org.uk

2. Content The Psychology of Addictive Behaviour Models of Addictive Behaviour  Biological, cognitive and learning approaches to explaining initiation, maintenance and relapse, and their applications to smoking and gambling. Vulnerability to Addiction  Risk factors in the development of addiction, including stress, peers, age and personality.  Media influences on addictive behaviour. Reducing Addictive Behaviour  The theory of planned behaviour as a model for addiction prevention.  Types of intervention and their effectiveness, including biological, psychological and public health interventions.

3. Psychological Interventions Combination of behavioural and cognitive approaches. They are based on the assumption that if we are able to learn addictive behaviours, such as smoking and gambling, then we are also able to unlearn them. Focus on changing irrational/faulty cognitions into rational ones!

4. Role of operant conditioning The principles of operant conditioning have been applied in the treatment of addictive behaviours. The idea behind this treatment is that by giving people rewards for not engaging in the addictive behaviour, this will actually reduce the addcitive behaviour.

5. Supporting research: OC Sindelar et al (2007) Aim: investigated whether the provision of money as rewards would produce better patient outcome for people on a methadone treatment programme. Procedure: PTs were randomly allocated to two conditions; reward (experimental group) or no-reward (control group). They also received their usual care; a daily dose of methadone and individual and group counselling sessions. PTs in the reward condition drew for prizes of various monetary value every time they tested negative for drugs (urine sample).

6. Supporting research: OC Sindelar et al (2007) Findings: It was found that drug use dropped significantly in the reward condition, with the number of negative urine samples being 66% higher than in the control condition. Conclusion: this suggests that the principles of operant conditioning, in particular positive reinforcement, led to the reduction of addictive behaviour. I.e. if rewarded for not engaging in addiction, then behaviour was reduced.

7. CBT CBT is based on the idea that addictive behaviours are maintained by the person’s thoughts about these behaviours. The main goal of CBT is to help people change the way that they think about their addiction (cognition), and to learn new ways of coping more effectively with the circumstances that led to these behaviours in the past (behavioural), e.g. stressful situations.

8. Relapse Prevention (CBT) Relapse prevention involves several cognitive and behavioural strategies to help the individual stay away from the addictive behaviour and also to provide support for people who do relapse. Therapists help to identify situations that present a risk for relapse for the individual. They also provide the addict with techniques to learn how to cope with temptation (positive self- statements and distracting activities) combined with the use of covert modelling (e.g. practice the coping skills in one’s imagination).

9. Evaluation Behavioural therapy may eliminate the behaviour but not the problem The addiction could be due to an underlying psychological problem rather than a learned maladaptive behaviour (i.e. a behaviour that causes an individual harm). Behavioural therapies eliminate the addictive behaviour but not the problem, may simply start to engage in another addictive behaviour instead.

10. Evaluation Behavioural therapies often used in conjunction with other addictive treatments. It is difficult to evaluate the effectiveness of behavioural therapies as often combined with other techniques e.g. drugs.

11. Evaluation The effectiveness of CBT. Reasonably effective but more effective when in combination with medication. Feeney et al (2002) found that only 14% remained abstinent on CBT alone compared to 38% who received medication and CBT.

12. Exam focus Apply your psychological knowledge of biological and psychological interventions to the past-exam question (June 2012). In pairs, read the scenario and bullet point ideas in your booklets. 10 marks = 10 minutes.