While a goal intention only to designate which goal you want to achieve (intent), one describes implementation intention on the work of the precise ways and means to overcome the discrepancy between the current and desired behavior (eg. As an extra serving of fruit in the Eat coffee break).  The implementation intentions therefore describe an exact when, where and how and are described as in the form of if-then plans (“If situation X occurs, I will show behavior Y”). We distinguish therefore two types of intentions: the goal intention ( Engl. Goal intention ) or intent and the implementation intention (Engl. Implementation intention) or the intent.

The implementation intentions are just a concept to explain the tension between intention and action . Many people decide to change their health behavior, but fail to do so. The relationship between goal intention and actual behavior is low. Goal intention explains only 20% to 30% of the variance in goal achievement. Past behavior is a more appropriate predictor of people’s future behavior than their goal intentions. A similar approach, which deals with intention and behavior, while still taking social norms, attitudes and behavior control into account, is the theory of planned behavior (Icek Ajzen).

Various variables determine the success of target achievement. For example, when working out target agreements, it depends on whether the goal has been formulated in a demanding, special way and will therefore be more successful or whether it is a demanding but vaguely formulated goal which will be less successful.

Studies have shown that if-then plans help people address their goals and help the process automate over time. For example in health behavior (consumption of fruit and vegetables). So far, research on implementation intentions has mainly focused on the initiation of goal striving, while the problem of shielding this goal striving and possible applications in the context of emotion regulation have been largely neglected..

Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) is a psycho-social intervention[1][2] that aims to improve mental health.[3] CBT focuses on challenging and changing unhelpful cognitive distortions (e.g. thoughts, beliefs, and attitudes) and behaviors, improving emotional regulation,[2][4] and the development of personal coping strategies that target solving current problems. Originally, it was designed to treat depression, but its uses have been expanded to include treatment of a number of mental health conditions, including anxiety.[5][6] CBT includes a number of cognitive or behavior psychotherapies that treat defined psychopathologies using evidence-based techniques and strategies.[7][8][9]

CBT is based on the combination of the basic principles from behavioral and cognitive psychology.[2] It is different from historical approaches to psychotherapy, such as the psychoanalytic approach where the therapist looks for the unconscious meaning behind the behaviors and then formulates a diagnosis. Instead, CBT is a “problem-focused” and “action-oriented” form of therapy, meaning it is used to treat specific problems related to a diagnosed mental disorder. The therapist’s role is to assist the client in finding and practicing effective strategies to address the identified goals and decrease symptoms of the disorder.[10] CBT is based on the belief that thought distortions and maladaptive behaviors play a role in the development and maintenance of psychological disorders,[3] and that symptoms and associated distress can be reduced by teaching new information-processing skills and coping mechanisms.[1][10][11]

Description

Mainstream cognitive behavioral therapy assumes that changing maladaptive thinking leads to change in behavior and affect,[39] but recent variants emphasize changes in one’s relationship to maladaptive thinking rather than changes in thinking itself.[40] The goal of cognitive behavioral therapy is not to diagnose a person with a particular disease, but to look at the person as a whole and decide what can be altered.

Cognitive distortions

Therapists or computer-based programs use CBT techniques to help people challenge their patterns and beliefs and replace errors in thinking, known as cognitive distortions, such as “overgeneralizing, magnifying negatives, minimizing positives and catastrophizing” with “more realistic and effective thoughts, thus decreasing emotional distress and self-defeating behavior”.[39] Cognitive distortions can be either a pseudo-discrimination belief or an over-generalization of something.[41] CBT techniques may also be used to help individuals take a more open, mindful, and aware posture toward cognitive distortions so as to diminish their impact.[40]

Skills

Mainstream CBT helps individuals replace “maladaptive… coping skills, cognitions, emotions and behaviors with more adaptive ones”,[42] by challenging an individual’s way of thinking and the way that they react to certain habits or behaviors,[43] but there is still controversy about the degree to which these traditional cognitive elements account for the effects seen with CBT over and above the earlier behavioral elements such as exposure and skills training.[44]

Phases in therapy

CBT can be seen as having six phases:[42]

1. Assessment or psychological assessment;
2. Reconceptualization;
3. Skills acquisition;
4. Skills consolidation and application training;
5. Generalization and maintenance;
6. Post-treatment assessment follow-up.

These steps are based on a system created by Kanfer and Saslow.[45] After identifying the behaviors that need changing, whether they be in excess or deficit, and treatment has occurred, the psychologist must identify whether or not the intervention succeeded. For example, “If the goal was to decrease the behavior, then there should be a decrease relative to the baseline. If the critical behavior remains at or above the baseline, then the intervention has failed.”[45]

The steps in the assessment phase include:

Step 1: Identify critical behaviors

Step 2: Determine whether critical behaviors are excesses or deficits

Step 3: Evaluate critical behaviors for frequency, duration, or intensity (obtain a baseline)

Step 4: If excess, attempt to decrease frequency, duration, or intensity of behaviors; if deficits, attempt to increase behaviors.[46]

The re-conceptualization phase makes up much of the “cognitive” portion of CBT.[42] A summary of modern CBT approaches is given by Hofmann.[47]

Delivery protocols

There are different protocols for delivering cognitive behavioral therapy, with important similarities among them.[48] Use of the term CBT may refer to different interventions, including “self-instructions (e.g. distraction, imagery, motivational self-talk), relaxation and/or biofeedback, development of adaptive coping strategies (e.g. minimizing negative or self-defeating thoughts), changing maladaptive beliefs about pain, and goal setting“.[42] Treatment is sometimes manualized, with brief, direct, and time-limited treatments for individual psychological disorders that are specific technique-driven.[49] CBT is used in both individual and group settings, and the techniques are often adapted for self-help applications. Some clinicians and researchers are cognitively oriented (e.g. cognitive restructuring), while others are more behaviorally oriented (e.g. in vivo exposure therapy). Interventions such as imaginal exposure therapy combine both approaches.[50][51]

Related techniques

CBT may be delivered in conjunction with a variety of diverse but related techniques such as exposure therapy, stress inoculation, cognitive processing therapy, cognitive therapy, relaxation training, dialectical behavior therapy, and acceptance and commitment therapy.[52][53] Some practitioners promote a form of mindful cognitive therapy which includes a greater emphasis on self-awareness as part of the therapeutic process.

Self-monitoring

Self monitoring is a method used in behavioral management in which individuals keep a record of their behavior (e.g., time spent, form and place of occurrence, feelings during performance), especially in connection with efforts to change or control the self. For example, a therapist may assign a client self-monitoring as homework to encourage better self-regulation by that person.

Self-regulation is reducing the intensity and or the frequency of those impulses by self-managing stress and negative environmental impact. Self-control is possible because of practices in self-regulation.

Theories of self-control can be described within the theory of self-regulation theory. The process of self-regulation creates various challenges for human beings. Self-control is one of these challenges.

For self-regulation to be successful, the following must occur:

• A person must decide which goals to pursue.
• A plan for the pursuit of that goal must be created.
• That plan must then be implemented.
• Decisions to continue or abandon that goal pursuit must be decided with success or failure feedback.

In the brain, the limbic system is in charge of the impulses to which human beings react. When this system is in action, the prefrontal cortex is shut down. Logical and rational thought are carried out by the prefrontal cortex. These parts of the brain do not work simultaneously. Reducing stress allows for the prefrontal cortex to get into action.

Self-regulation through increased abilities in various cognitive capacities allows for self-control behaviors to take more routes to goal achievement than impulse inhibition.

When stress is allowed to continue, our limbic system will take over, inducing more impulsive responses. When stress is managed correctly, it opens the door for reflective and higher-level goal attainment.

Self-regulation theory proposes the notion that human beings do not have a constant supply of resources to inhibit strong impulses. Throughout any given day, these resources are depleted through decision making and various forms of stress.

Improvements in conscious self-regulation (Baumeister, 2007) improve one’s ability to recognize and alter reactions in self-control.

The role of self-determination theory within the realm of self-regulation is important to note. Personal decisions in behavior change are vital to improvement. “Autonomous self-regulation of behavior does not deplete vitality as readily as the use of self-controlling regulation” (Ryan & Deci, 2008).

Contingency Contracting

The use of reinforcement to develop or extinguish behavior is operant conditioning and is very effective
when the rewards and punishments are controlled externally. When reinforcement is brought under the
person’s control, reward is administered but self punishment is rarely administered. People rarely self
administer punishment as they will tell themselves this the last time, or will justify their behavior and
attribute it to external causes. Thus in Contingency Contracting the punishment is contracted out to the
therapist or a friend. The person makes a contract with the therapist or friend that if they engage in the
undesirable behavior that a certain previously agreed upon punishment will be administered to them.
Monetary fines cold be imposed or An effective punishment is one that hurts the person and hence they learn not to repeat the undesired behavior^[1].

Relapse prevention

Relapse prevention (RP) is a cognitive-behavioral approach to relapse with the goal of identifying and preventing high-risk situations such as substance abuse, obsessive-compulsive behavior, sexual offending, obesity, and depression.[1] It is an important component in the treatment process for alcoholism, or alcohol dependence.[2][3]

Underlying assumptions

Relapse is seen as both an outcome and a transgression in the process of behavior change. An initial setback or lapse may translate into either a return to the previous problematic behavior, known as relapse,[4] or the individual turning again towards positive change, called prolapse.[1] A relapse often occurs in the following stages: emotional relapse, mental relapse, and finally, physical relapse. Each stage is characterized by feelings, thoughts, and actions that ultimately lead to the individual’s returning to their old behavior. [5]

Relapse is thought to be multi-determined, especially by self-efficacy, outcome expectancies, craving, motivation, coping, emotional states, and interpersonal factors. In particular, high self-efficacy, negative outcome expectancies, potent availability of coping skills following treatment, positive affect, and functional social support are expected to predict positive outcome. Craving has not historically been shown to serve as a strong predictor of relapse.[1]

A Cognitive-Behavioral Model of the Relapse Process.

Stimulus control