Hostname: page-component-7b7567c8c-7pwfn Total loading time: 0 Render date: 2026-11-15T04:55:18.747Z Has data issue: false hasContentIssue false
  • English
  • Français

Covert Sensitization: Alternative Treatment Procedures for Alcoholism

Published online by Cambridge University Press:  16 June 2009

William R. Miller and
Michael J. Dougher
William R. Miller
Affiliation:
Department of Psychology, University of New Mexico
Michael J. Dougher
Affiliation:
Department of Psychology, University of New Mexico
Get accessRights & Permissions [Opens in a new window]

Abstract

Twenty-nine outpatients (24 men) with a history of problem-drinking and alcohol dependence were assigned at random to one of three covert sensitization procedures varying in the nature of stimulus elements in aversion scenes. Group 1 received standard nausea imagery, whereas Group 2 received similar scenes “assisted” by noxious odors. Imagery used in Group 3 scenes was unrelated to nausea but focused instead on disturbing potential consequences of drinking. The occurrence of conditioned aversion responses (CR) was verified by observational, self-report and physiological measures. The observed pattern and frequency of conditioning corresponded closely to data reported by Elkins (1980). Favourable outcomes at 18 months (abstinent, controlled or improved) were observed in 45, 56 and 67% of clients in each group, respectively. The groups did not differ significantly in effectiveness. Within both of the nausea sensitization groups (1 and 2), successful remission at 18 months occurred only in individuals who had shown CR, whereas in emotive sensitization (Group 3) there was no apparent relationship between conditioning and outcome.

Information

Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 17 , Issue 3 , July 1989, pp. 203 - 220
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 1989

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

American Psychiatric Association (1980). Diagnostic and Statistical Manual Disorders (3rd. ed.). Washington D.C.: Author.Google Scholar
Anant, S. S. (1967). A note on the treatment of alcoholics by a verbal aversion technique. Canadian Psychologist 1, 19–22.CrossRefGoogle Scholar
Anant, S. S. (1968 a). Alcoholics Anonymous and aversion therapy. Canada's Mental Health 16, 23–27.Google Scholar
Anant, S. S. (1968 b). The use of verbal aversion (negative conditioning) with an alcoholic: A case report. Behavior Research and Therapy 6, 395–396.Google ScholarPubMed
Ashem, B. and Donner, L. (1968). Covert sensitization with alcoholics: A controlled replication. Behaviour Research and Therapy 6, 7–12.CrossRefGoogle ScholarPubMed
Baker, T. B. and Cannon, D. S. (1979). Taste aversion therapy with alcoholics: Tenchiques and evidence of a conditioned response. Behaviour Research and Therapy 17, 229–242.CrossRefGoogle ScholarPubMed
Baker, T. B., Cannon, D. S., Stephenson, G. M. and Droubay, E. (1978). Procedures for taste aversion therapy for alcoholism. Procedures for taste aversion therapy for alcoholism. American Journal of Psychiatry 135, 1439.CrossRefGoogle ScholarPubMed
Baker, T. B., Cannon, D. S., Tiffany, S. T. and Gino, A. (1984). Cardiac response as an index of the effect of aversion therapy. Behaviour Research and Therapy 22, 403–411.CrossRefGoogle ScholarPubMed
Bandura, A. (1969). Principles of Behavior Modification. New York: Holt.Google Scholar
Bernstein, I. L. (1978). Learned taste aversions in children receiving chemotherapy. Science 200, 1302–1303.CrossRefGoogle ScholarPubMed
Boland, F. J., Mellor, C. S. and Revusky, S. (1978). Chemical aversion treatment of alcoholism: Lithium as the aversive agent. Behaviour Research and Therapy 16, 401–409.CrossRefGoogle ScholarPubMed
Callahan, E. J. and Leitenberg, H. (1973). Aversion therapy for sexual deviation: Contingent shock and covert sensitization. Journal of Abnormal Psychology 81, 60–73.CrossRefGoogle ScholarPubMed
Cannon, D. S. and Baker, T. B. (1981). Emetic and electric shock alcohol aversion therapy: Assessment of conditioning. Journal of Consulting and Clinical Psychology 49, 20–33.CrossRefGoogle ScholarPubMed
Cannon, D. S., Baker, T. B., Gino, A. and Nathan, P. E. (1986). Alcoholaversion therapy: Relation between strength of aversion and abstinence. Journal of Consulting and Clinical Psychology 54, 825–830.CrossRefGoogle ScholarPubMed
Cannon, D. S., Baker, T. B. and Wehl, C. K. (1981). Emetic and electric shock alcohol aversion therapy: Six- and twelve-month follow-up. Journal of Consulting and Clinical Psychology 39, 360–368.CrossRefGoogle Scholar
Cautela, J. R. (1966). Treatment of compulsive behavior by covert sensitization. Psychological Record 16, 33–41.CrossRefGoogle Scholar
Cautela, J. R. (1967). Covert sensitization. Psychological Reports 20, 459–468.CrossRefGoogle ScholarPubMed
Cautela, J. R. (1970). The treatment of alcoholism by covert sensitization. Psychotherapy: Theory, Research and Practice 7, 86–90.CrossRefGoogle Scholar
Cautela, J. R. and Wisocki, P. A. (1971). Covert sensitization for the treatment of sexual deviations. Psychological Record 21, 37–48.CrossRefGoogle Scholar
Clarke, J. C. and Hayes, D. (1984). Covert sensitization, stimulus relevance and the equipotentiality premise. Behaviour Research and Therapy 22, 451–454.CrossRefGoogle ScholarPubMed
Cummings, C., Gordon, J. R. and Marlatt, G. A. (1980). Relapse: Prevention and prediction. In The Addictive Behaviors: Treatment of Alcoholism, Drug Abuse, Smoking and Obesity, Miller, W. R. (Ed.), (pp. 291–321). Oxford: Pergamon Press.Google Scholar
Dougher, M. J., Crossen, J. R. and Garland, R. J. (1987). An experimental test of Cautela's operant account of covert sensitization. Behavioral Psychotherapy, 14, 226–248.CrossRefGoogle Scholar
Dougher, M. J.Crossen, J. R., Ferraro, D. P. and Garland, R. J. (1987). The effects of covert sensitization on preference for sexual stimuli: A preliminary analog experiment. Journal of Behavior Therapy and Experimental Psychiatry, 18, 4, 638–649.CrossRefGoogle Scholar
Elkins, R. K. (1980). Covert sensitization and alcoholism: Contributions of successful conditioning to subsequent abstinence maintenance. Addictive Behaviors 5, 67–89.CrossRefGoogle ScholarPubMed
Fleiger, D. L. and Zingle, H. W. (1973). Covert sensitization treatment with alcoholics. Canadian Counsellor 7, 269–277.Google Scholar
Garb, J. L. and Stunkard, A. J. (1974). Taste aversions in man. American Journal of Psychiatry 131, 1204–1207.Google ScholarPubMed
Garcia, J. and Koelling, R. A. (1966). Relation of cue to consequence in avoidance learning. Psychonomic Science 4, 123–124.CrossRefGoogle Scholar
Glover, J. H. and McCue, P. A. (1977). Electrical aversion therapy with alcoholics: A comparative follow-up study. British Journal of Psychiatry 130, 297–286.CrossRefGoogle ScholarPubMed
Gottheil, E., Thornton, C. C., Skoloda, T. E. and Alterman, A. I. (1982). American Journal of Psychiatry 139, 560–565.CrossRefGoogle Scholar
Hallam, R. and Rachman, S. (1972). Theoretical problems of aversion therapy. Behaviour Research and Therapy 10, 341–353.CrossRefGoogle ScholarPubMed
Hallam, R., Rachman, S. and Falkowski, W. (1972). Subjective, attitudinal and physiological effects of electrical aversion therapy. Behaviour Research and Therapy 10, 1–13.CrossRefGoogle ScholarPubMed
Hedberg, A. G. and Campbell, L. M. (1974). A comparison of four behavioral treatment approaches to alcoholism. Journal of Behavior Therapy and Experimental Psychiatry 5, 251–256.CrossRefGoogle Scholar
Hester, R. K. and Miller, W. R. (Eds) (1988). Handbook of Alcoholism Treatment Approaches: Effective Alternatives. Elmsford, NY: Pergamon Press.Google Scholar
Kantorovich, N. (1930). An attempt at associative-reflex therapy in alcoholism. Psychological Abstracts 4, 493.Google Scholar
Kazdin, A. E. and Smith, G. A. (1979). Covert conditioning: A review and evaluation. Archives of Behavior Research and Therapy 2, 57–98.CrossRefGoogle Scholar
Little, L. M. and Curran, J. P. (1978). Covert sensitization: A clinical procedure in need of some explanations. Psychological Bulletin 85, 513–531.CrossRefGoogle ScholarPubMed
MacCulloch, M. J., Feldman, M. P., Orford, J. F. and MacCulloch, M. L. (1966). Anticipatory avoidance learning in the treatment of alcoholism: A record of therapeutic failure. Behaviour Research and Therapy 4, 187–196.CrossRefGoogle ScholarPubMed
Maltezky, B. M. (1974). Assisted covert sensitization for drug abuse. International Journal of the Addictions 9, 411–429.CrossRefGoogle Scholar
Marlatt, G. A. and Gordon, J. R. (1985). Relapse Prevention: Maintenance Strategies in the Treatment of Addictive Behaviors. New York: Guilford Press.Google Scholar
Marquis, J. M. Fear Survey Schedule. Unpublished manuscript, Palo Alto, CA: Veterans Administration Medical Center.Google Scholar
Matthews, D. B. and Miller, W. R. (1979). Estimating blood alcohol concentration: Two computer programs and their applications in therapy and research. Addictive Behaviors 4, 55–60.CrossRefGoogle Scholar
Miller, M. M. (1959). Treatment of chronic alcoholism by hypnotic aversion. Journal of the American Medical Association 171, 1492–1495.CrossRefGoogle ScholarPubMed
Miller, M. M. (1976). Hypnoaversion treatment in alcoholism, nicotinism and weight control. Journal of the National Medical Association 68, 129–130.Google ScholarPubMed
Miller, W. R. (1978). Behavioral treatment of problem drinkers: A comparative outcome study of three controlled drinking therapies. Journal of Consulting and Clinical Psychology 46, 74–86.CrossRefGoogle ScholarPubMed
Miller, W. R. (1983). Controlled drinking: A history and critical review. Journal of Studies on Alcohol 44, 68–83.CrossRefGoogle ScholarPubMed
Miller, W. R., Crawford, V. L. and Taylor, C. A. (1979). Significant others as corroborative sources for problem drinkers. Addictive Behaviors 4, 67–70.CrossRefGoogle ScholarPubMed
Miller, W. R. and Hester, R. K. (1980). Treating the problem drinker: Modern approaches. In The Addictive Behaviors: Treatment of Alcoholism, Drug Abuse, Smoking and Obesity, Miller, W. R. (Ed.), (pp. 11–141). Oxford: Pergamon Press.Google Scholar
Miller, W. R. and Hester, R. K. (1986). The effectiveness of alcoholism treatment: What research reveals. Treating Addictive Behaviors: Processes of Change, In Miller, W. R. and Heather, N. (Eds), (pp. 121–174). New York: Plenum Press.CrossRefGoogle Scholar
Miller, W. R., Leckman, A. L. and Tinkcom, M. (1988). Long-term follow-up of behavioral self-control training. Manuscript submitted for publication, University of New Mexico.Google Scholar
Miller, W. R. and Marlatt, G. A. (1984). Manual for the Comprehensive Drinker Profile. Odessa, FL: Psychological Assessment Resources.Google Scholar
Miller, W. R. and Marlatt, G. A. (1987 a) Follow-up Drinker Profile. Odessa, FL: Psychological Assessment Resources.Google Scholar
Miller, W. R. and Marlatt, G. A. (1987 b). Collateral Information Form. Odessa, FL: Psychological Assessment Resources.Google Scholar
Miller, W. R. and Muñoz, R. F. (1982). How to Control Your Drinking (Rev. ed.). Albuquerque: University of New Mexico Press.Google Scholar
Miller, W. R. and Olson, J. (1982). Schedule of Aversive Consequences of Drinking. Unpublished manuscript, University of New Mexico.Google Scholar
Neuberger, O. W., Hasha, N., Matarazzo, J. D., Schmitz, R. E. and Pratt, H. H. (1981). Behavioral-chemical treatment of alcoholism: An outcome replication. Journal of Studies on Alcohol 42, 806–810.CrossRefGoogle Scholar
Neuberger, O. W., Matarazzo, J. D., Schmitz, R. E. and Pratt, H. H. (1980). One year follow-up of total abstinence in chronic alcoholic patients following emetic counterconditioning. Alcoholism: Clinical and Experimental Research 4, 306–312.CrossRefGoogle Scholar
Neuberger, O. W., Miller, S. I., Schmitz, R. E., Matarazzo, J. D., Pratt, H. and Hasha, W. (1982). Replicable abstinence rates in an alcoholism treatment program. Journal of the American Medical Association 248, 960–963.CrossRefGoogle Scholar
Olson, R. P., Ganley, R., Devine, V. T. and Dorsey, G. C. Jr. (1981). Longterm effects of behavioral versus insight therapy with inpatient alcoholics. Journal of Consulting and Clinical Psychology, 49, 866–877.CrossRefGoogle ScholarPubMed
Piorkowsky, G. K. and Mann, E. T. (1975). Issues in treatment efficacy research with alcoholics. Perceptual and Motor Skills 41, 695–700.CrossRefGoogle Scholar
Polich, J. M., Amour, D. J. and Braiker, H. B. (1981). The Course of Alcoholism: Four Years After Treatment. New York: Wiley.Google Scholar
Regester, D. C. (1971). Changes in autonomics responsivity and drinking behavior of alcoholics as a function of aversion therapy. Dissertation Abstracts International 32, 1225b.Google Scholar
Richard, G. P. (1983). Behavioural Treatment of Excessive Drinking. Unpublished doctoral dissertation, University of New South Wales.Google Scholar
Rimmele, C., Miller, W. R. and Dougher, M. J. (1989). Aversion therapies. In Handbook of Alcoholism Treatment Approaches: Effective Alternatives, Hester, R. K. and Miller, W. R. (Eds). Elmsford NY: Pergamon Press.Google Scholar
Sanchez-Craig, M. and Walker, K. (1982). Teaching coping skills to chronic alcoholics in a coeducational halfway house: II. Assessment of programme effects. British Journal of Addiction 77, 35–50.CrossRefGoogle Scholar
Sanderson, R. E., Campbell, D. and Laverty, S. G. (1963). An investigation of a new aversive conditioning treatment for alcoholism. Quarterly Journal of Studies on Alcohol 24, 261–275.CrossRefGoogle ScholarPubMed
Selzer, M. L. (1971). The Michigan Alcoholism Screening Test: The quest for a new diagnostic instrument. American Journal of Psychiatry 127, 1653–1658.CrossRefGoogle ScholarPubMed
Smith, R. E. and Gregory, P. B. (1976). Covert sensitization by induced anxiety in the treatment of an alcoholic. Journal of Behavior Therapy and Experimental Psychiatry 7, 31–33.CrossRefGoogle Scholar
Telch, M. J., Hannon, R. and Telch, C. F. (1984). A comparison of cessation strategies for the outpatient alcoholic. Addictive Behaviors 9, 103–109.CrossRefGoogle ScholarPubMed
Tepfer, K. S. and Levine, B. A. (1977). Covert sensitization with internal aversive cues in the treatment of chronic alcoholism. Psychological Reports 41, 92–94.CrossRefGoogle ScholarPubMed
Voegtlin, W. L. (1940). The treatment of alcoholism by establishing a conditioned reflex. American Journal of the Medical Sciences 199, 802–810.CrossRefGoogle Scholar
Vogler, R. E., Lunde, S. E., Johnson, G. R. and Martin, P. L. (1970). Electrical aversion conditioning with chronic alcoholics. Journal of Consulting and Clinical Psychology 34, 302–307.CrossRefGoogle ScholarPubMed
Vogler, R. E., Lunde, S. E. and Martin, P. L. (1971). Electrical aversion conditioning with chronic alcoholics: Follow-up and suggestions for research. Journal of Consulting and Clinical Psychology 36, 450.CrossRefGoogle ScholarPubMed
Wiens, A. N. and Menustik, C. W. (1983). Treatment outcome and patient characteristics in an aversion therapy program for alcoholism. American Psychologist 38, 1089–1096.CrossRefGoogle Scholar
Wilson, G. T. (1987). Chemical aversion conditioning as a treatment for alcoholism: A re-analysis. Behaviour Research and Therapy 25, 503–516.CrossRefGoogle ScholarPubMed
Wilson, G. T. and Tracey, D. A. (1976). An experimental analysis of aversive imagery versus electrical aversive conditioning in the treatment of chronic alcoholics. 52Behaviour Research and Therapy 14, 41–51.Google ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.