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Health Differences Across the Lifespan 2 Study Guide Therapeutic graded exposure: Therapeutic graded exposure is similar to the systematic desensitization, except relaxation training is not involved and treatment is carried out in a real-life context. The individual must be in contact with the warning stimulus to learn firsthand that dangerous consequences will not ensue. Exposure is graded according to the hierarchy. Aversion Therapy Aversion therapy is another way to use classical conditioning. It reduces the frequency of the undesirable behavior, such as smoking or over eating, by teaching the client to pair an unpleasant stimulus that results in undesirable response. Types of aversion therapy include: • Overt sensitization: This is a type of aversion therapy that produces unpleasant consequences for undesirable behavior. For example, if an individual consumes alcohol while on Antabuse therapy, symptoms of severe nausea, vomiting, dyspnea, palpitation, and headache will occur. Instead of a euphoria feeling normally experienced from the alcohol, the individual receives a punishment that is intended to extinguish the unacceptable behavior. • Covert sensitization: This technique is under the patient’s control and can be used whenever it is required. The individual learns throughmental imagery to visualize nauseating scenes and even to induce a mild feeling of nausea. It is most effective when paired with relaxation exercises that are performed instead of the undesirable behavior. Preparation for aversion therapy: Depending upon his/her customary practice, a therapist administering aversion therapy may establish a behavioral contract defining the treatment, objectives, expected outcome, and what will be required of the patient. The patient may be asked to keep a behavioral diary to establish a baseline measure of the behavior targeted for change. The patient undergoing this type of treatment should have enough information beforehand to give full consent for the procedure. Patients with medical problems, or who are otherwise vulnerable to potentially damaging physical side effects of the more intense aversive stimuli, should consult their primary care doctor first. Aftercare: Patients completing the initial phase of aversion therapy are often asked by the therapist to return periodically over the following six to twelve months for booster sessions to prevent relapse. Risks: Patients with cardiac, pulmonary, or gastrointestinal problems may experience a worsening of their symptoms, depending upon the characteristics and strength of the aversive stimuli. Some therapists have reported that patients undergoing aversion therapy, especially treatment that uses powerful chemical or pharmacological aversive stimuli, have become negative and aggressive. Example Someone who wants to stop smoking might go to a therapist who uses a quit smoking technique, in which the client is allowed to smoke but must take a puff on the cigarette every five or six seconds. As nicotine is a poison, such rapid smoking produces nausea and dizziness, both unpleasant responses. Use of the drug Disulfiram to treat alcoholism is another example of aversion therapy. This prescribed medicine results in several aversive reactions when combined with alcohol. The person may experience nausea, vomiting, anxiety, and even more serious symptoms making this drug an effective

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