Coping with and reducing addiction and impulse control disorder

Behavioural 

Token economy – beahaviour modification technique which is based on the systematic positive reinforcement of a target behaviour. It uses tokens, which can be exchanged for rewards or privileges.

• Petty et al (2000) researched 42 alcohol-dependent older adults in an outpatient setting and found that standard treatment lead to 22% of people completing it and a 29% success rate. On the other hand, standard treatment along with token economy lead to 84% completing it and a 69% success rate. 

Aversion therapy – based on the idea of classical conditioning that undesirable behaviour is paired with aversive stimuli. For example, alcoholics would need to associate the smell or taste of alcohol with vomit by giving them an emetic drug.

• Howard (2001) treated 82 alcoholics with an emetic drug for 10 days and found that the belief that drinking bought positive outcomes was reduced, confidence to avoid drinking was increased and those who were used to alcohol-related nausea showed less effectiveness.

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Cognitive – behavioural therapy for kleptomania

The main CBT techniques for kleptomaniacs are:

• Covert sensitisation – when patients have to visualise an aversive image with the impulsive behaviours. This is based on the idea that the two will be associated and the actions will decrease.
• Imaginal desensitisation – patients are taught relaxation techniques while visualing the impulsive behaviours. This is based on the idea that impulsion and relaxation cannot happen at the same time and the latter takes over when people have the urges.

KOHN (2000) conducted a case study on a man with kleptomania who also had:

• Depression
• Suicidal ideas
• Potential legal complications

These were treated with covert sensitisation, behavioural chaining, problem solving, cognitive restructuring and homework.

After CBT, the symptoms decreased significantly and a four-month follow up showed positive results with no kleptomania episodes.

Juminez-Muroia et al (2011) reported that CBT worked well with male slot-machines addicts over a 16-week period.

Also, Van Deursen et al (2013) concluded that online CBT-based programmes for alcoholics showed good levels of success.