Overview 

Kleptomania is a psychological condition in which a person repeatedly acts on impulses to steal items even though the items are not needed. The person experiences a persistent inability to resist urges and a strong temptation to steal items that are not necessary for personal use or have no market value. Typical thefts often have some kind of personal gain, but in the case of kleptomania, which is driven by internal psychological impulses, it is frequently accompanied by anxiety, tension, and subsequent relief while stealing and feeling terrible, regret, remorse, compunction, contrition, self-loathing, shame or fear of arrest after the theft. The condition can be stressful and draining for those affected because it can interfere with their personal, professional, and social lives.¹ 

Psychotherapy plays a major role in the treatment, with cognitive-behavioural therapy (CBT) serving as the major line of approach, as the condition has a psychological framework. This article highlights the role of psychotherapy in treating kleptomania and explores alternative psychotherapeutic strategies and other approaches that may complement or enhance the treatment of kleptomania. As there is no particular medication for kleptomania, psychotherapy plays a crucial role in the treatment of this disease.

Understanding kleptomania

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), kleptomania is classified under the category of impulse-control and conduct disorders. It is distinct from shoplifting or theft, which is linked to antisocial behaviour, poverty, or rebellion. It is a rare condition that happens in roughly 0.3%-0.6% of the general population, and it mostly affects adolescents.^1,2

The causes of this condition are unknown. Some researchers suggest that it might be due to some changes in brain structure or brain chemistry, as well as combined symptoms of another mental condition, genetics, or a learned habit hard to break.³

Criteria for diagnosis 

The criteria include:⁴ 

• Continuous failure to resist the urge to steal things which have no personal gain
• Before committing theft, there will be an increasing sense of anxiety and tension 
• During the act, there will be a sense of pleasure, satisfaction, or relief
• Feeling of regret and remorse after the act of stealing
• These kinds of behaviours are not caused by anger, vengeance, delusion, or hallucinations

It can often be associated with other psychological conditions like mood disorders, anxiety disorders, eating disorders, substance abuse, and obsessive-compulsive disorder.

Treatment 

The person with kleptomania has a sense of fear, humiliation or embarrassment to seek a health care provider, which can make it hard to seek treatment.

As there is little evidence available for kleptomania, the treatment is based on combining psychotherapy and medication.

Medications like opioid antagonists, selective serotonin reuptake inhibitors (SSRIs), anti-seizure drugs, and lithium can be helpful. Electroconvulsive therapy is also found to be effective to an extent.⁵

Psychotherapy, mainly cognitive-behavioural therapy, helps in the treatment of kleptomania.⁶

Cognitive-behavioural therapy (CBT)

CBT, a form of psychotherapy, is considered effective in the treatment of kleptomania. The main purpose of CBT is to recognise the unhealthy beliefs and the negative behaviour and replace them with healthy and positive ones. It also helps to build the skills necessary to control the urges in kleptomania. 

By altering the cognitive distortions, individuals can develop healthier behavioural responses. The main strength of cognitive and behavioural therapy is the use of operationally defined behaviours, functional assessments, and functional analyses.^6,7

Techniques of CBT for kleptomania

Cognitive restructuring

This technique involves identifying and challenging irrational or unhelpful thoughts that trigger the urge to steal. For example, beliefs such as "I can't help myself" or "stealing relieves my stress" are examined and replaced with more positive thoughts like "I have control over my actions" or "there are healthier ways to manage stress."

Behavioural experiments and exposure therapy

Patients are gradually exposed to environments or triggers associated with stealing while practising alternative responses. For instance, a client may visit a store with a therapist or support person and use coping strategies to resist the urge to steal.

Stimulus control training/ counter conditioning

This focuses on enhancing the patient's ability to delay or resist the urge to steal. Techniques may include distraction, relaxation exercises, or engaging in substitute behaviours (e.g., squeezing a stress ball, calling a friend).

Covert sensitisation/ aversion therapy

The person is asked to picture themselves in the position of stealing and then facing negative consequences, such as being caught or holding breath until they become uncomfortable or associating the urge to steal with things which are nauseating, or mildly painful practices like snapping a rubber band on the wrist during the urge to steal. This technique helps to gradually reduce the urge to steal.

Preventing relapses

Since kleptomania tends to be chronic and relapsing, clients are taught to recognise high-risk situations and develop concrete strategies to manage them. Relapse prevention also involves building insight into personal triggers and setting realistic goals.

Psychoeducation

Educating the patient and their family members about the nature of kleptomania helps reduce stigma and fosters a supportive recovery environment.

Case studies and clinical trials have highlighted the success of CBT in significantly reducing the frequency and intensity of kleptomania episodes and also help to prevent relapses. 

Other approaches to psychotherapy

In the treatment of kleptomania, CBT remains an effective therapy. Other therapeutic modalities may also be helpful, especially when comorbid conditions are present.^8,9

Psychoanalysis therapy

This therapy delves into unconscious conflicts and unresolved early life experiences that may contribute to kleptomania. For instance, stealing may be unconsciously linked to feelings of deprivation or unmet emotional needs from childhood. Through exploration of past experiences and therapeutic insight, patients can develop a deeper understanding of their behaviours and emotional drivers.

Dialectical behaviour therapy (DBT)

DBT mainly focuses on mindfulness, proper flow of emotions, tolerance towards any hardship and interpersonal effectiveness. These skills help individuals manage the intense emotions that often precede kleptomania episodes.

Motivational interviewing (MI)

Some individuals with kleptomania may struggle with the fear of seeking treatment and the fear of being judged or punished for their behaviours. MI is a client-centred approach that helps patients explore their motivations, resolve ambivalence, and enhance commitment to change. 

Group therapy

When people with similar experiences share their concerns without any judgment, it reduces the feeling of being isolated and helps share emotions and experiences. Sharing their innermost emotions can be therapeutic. Support groups specifically for kleptomania can reinforce recovery-oriented behaviours and offer accountability.

Family therapy

When kleptomania affects adolescents or occurs within a family context, family therapy can address communication patterns, conflicts, and support systems. It also helps family members understand the disorder, reduce blame, and foster a more supportive environment.

Hypnosis

Hypnosis helps the patient with kleptomania to understand the root cause of the disease, and it helps to access the subconscious mind. By addressing the underlying factor, it is easy for the therapist to treat the disease.

Challenges in treatment

Treating kleptomania poses several challenges. Individuals may be hesitant to seek help due to shame, fear of legal consequences, or denial of the problem. Building a trusting therapeutic relationship is essential for the treatment. Therapists must maintain a nonjudgmental and empathetic stance, recognising the compulsive nature of the behaviour.

Another challenge is the chronic and relapsing nature of kleptomania. Even with effective treatment, relapses can occur. Therefore, ongoing support, regular follow-ups, and booster sessions may be necessary to maintain progress.

The importance of early intervention

Early identification and intervention can prevent the progression of kleptomania and reduce its long-term impact. Mental health professionals, primary care providers, and educators should be aware of the signs and symptoms to facilitate timely referral and treatment. Public education can also help reduce stigma and encourage individuals to seek help without fear of judgment.

FAQs

How do you treat a kleptomaniac?

Treatment mainly involves a combination of medicine and psychotherapy.

Is kleptomania an obsessive-compulsive disorder (OCD)?

It has features in common with OCD and is also categorised under impulse control disorder. 

Is kleptomania a crime?

Even though there is an underlying psychological problem in kleptomania, stealing is considered a crime, and the person can be held legally accountable.

Summary 

Kleptomania is a serious but treatable mental health condition rooted in psychological and emotional factors. Cognitive-behavioural therapy remains the most effective psychotherapeutic approach, offering structured, evidence-based strategies to help individuals manage their impulses and develop healthier coping mechanisms. Other modalities, including psychodynamic therapy, DBT, MI, and family therapy, can provide valuable support depending on individual needs and other comorbid conditions. 

A compassionate, empathic, and personalised treatment plan is essential for helping individuals overcome kleptomania and lead more fulfilling lives. Since there is little evidence available for kleptomania, more research, clinical awareness, and validated efforts are needed to improve the outcomes and ensure that individuals with kleptomania receive the support and care they need.