Going cold turkey

Applied behaviour analysis allows the adaptation of behaviour by the application of antecedes and consequences. Positively reinforcing a behaviour will increase the likelihood of that particular behaviour being repeated, the positive reinforcer is perceived as a reward, and is desired by the individual, hence causing behaviour repetition (Skinner et al, 1997). Extinction aims to omit undesirable behaviour by removing a reward that an individual has learnt to associate with a certain behaviour (Hart et al, 1964). Reinforcement can occur naturally or can be manipulated by an experimenter or any outside source, to alter behaviour.

Consider a counsellor in addiction therapy. Three stages are involved in recovery from alcohol addiction. The first is complete detoxification; “going cold turkey”. This is hard to maintain as cravings will persist. The second stage involves counselling that will focus on the individual’s ability to maintain detoxification. The counsellor will use a method of extinction to eliminate the positive reinforcements associated with alcohol; sufficing cravings, and problem avoidance. Then create a positive reinforcement for sobriety (Community reinforcement approach; Miller et al, 1999). The therapist will outline activities and hobbies for the client to engage in that they will find rewarding; such activities are those that the patient used to enjoy but has not been able to do them due to their drinking habits. Therefore the therapist ultimately replaces time the patient would spend drinking with a rewarding activity; positively reinforcing sobriety. It is important that the counsellor outlines details of the activity specifically, for instance length of time. For reinforcers to be successful in adapting behaviour they must be definitive. Further to this the reinforcer should coincide with the detoxification as it is crucial sobriety is immediately reinforced. The behaviour of the client will be closely monitored as the counsellor must adapt the reinforcing activity if it does not work, or the client no longer finds it rewarding.

The third step of rehabilitation focuses on group therapy such as AA meetings, whereby the sufferer can discuss their addiction and how they are dealing with abstinence from alcohol with other addicts. In this scenario social influence could have a negative reinforcing effect; whereby if the individual relapses they may perceive to have let down a number of people in the group; therefore the consequence of relapse remains prevalent to the patient, and they may remain sober to avoid such a consequence.   

Hart, B. M., Allen, K. E., Buell, J. S., Harris, F. R., & Wolf, M. M. (1964). Effects of social reinforcement on operant crying. Journal of Experimental Child Psychology, 1(2), 145-153.

Miller, W. R., Meyers, R. J., & Hiller-Sturmhofel, S. (1999). The community-reinforcement approach. Alcohol Research and Health, 23(2), 116-121. Skinner, B. F., Ferster, C. B., & Ferster, C. B. (1997). Schedules of reinforcement. Copley Publishing Group. Katie Mullord