There are three core components of FIT.

1.

Imagery-based motivational interviewing

Developing awareness of discrepancy between current behaviour and core values and goals, through imagery of ideal self and future downsides of continuing current behaviour.

Note: this is the only place in FIT where negative imagery is elicited. Although fears of future problems might motivate change in the short-term, there is considerable evidence that so-called ‘fear appeals’ are ineffective in the longer term. A key tenet of FIT, and of its foundations in Elaborated Intrusion theory, is that people continue imagining an idea because doing so brings them some of the pleasure or reward of actually putting that idea into practice. We believe that positive imagery is self-sustaining while negative imagery will soon fade.

Building motivation through imagery of benefits of change, drawing attention to how hypothetical change could bring the individual closer to their ideal self

·         Developing ideas about change into a concrete plan that can be imagined vividly

·         Encouraging setting of proximal sub-goals by eliciting and imagining benefits of change over the next few days or weeks

·         Building confidence by imagining past successes, planning for obstacles, and integrating previously successful strategies into the plan

·         Eliciting commitment to the goal

2.

Imagery-based relapse prevention


Through imagery, eliciting ideas about potential obstacles to change

·         Evoking strategies that were successful in the past and imagining using them to overcome current or future obstacles

·         In situations where cravings might be a problem, using the cravings buster exercise to train the deliberate switching of attention from craving imagery to goal imagery

·         When there are successes on the current path to change, however small, incorporating memories of those successes into the goal imagery

·         As progress is made, continuing to anticipate risky situations and use imagery to develop and rehearse coping strategies


3.

Functional Imagery Training​


·         Through components 1 and 2 in therapy session(s), helping the client to develop emotionally-charged, multi-sensory imagery of the goal and the path towards it.

·         Developing a habit of episodic future imagery by pairing imagery with an everyday behavioural cue such as washing hands, climbing stairs, or making a drink

·         Using booster calls, text messages, or the Goal in Mind smartphone application to update the goal imagery by incorporating new sub-goals and successes.

·         Using the Goal in Mind app to encourage regular goal setting and imagery practice

In addition to these core components of FIT, there are three optional components for dealing with specific problems.

Mindfulness


In the initial stages of a quit attempt, it is possible that goal imagery might evoke unmanageable cravings – thinking about alcohol reduction might trigger powerful imagery of alcohol, for example. If this is felt to be a risk for an individual, mindfulness practice could help them to accept and ignore that imagery while developing awareness of other, pleasurable sensory perceptions of the environment around them. Maintaining positive mood is central to FIT as it is the means of maintaining motivation, not only for behaviour change but also for the cognitive changes that drive it. Mindfulness may help maintain mood while the individual develops their ability to imagine change and deal with immediate temptations. A mindfulness audio is included in the Goal in Mind app.

Imagery rescripting


The elicitation of positive, ideal self imagery in FIT can be seen as a form of imagery rescripting in cases where an individual’s view of their future self is quite negative.

Imagery rescripting might also be helpful for individuals whose progress is hampered by a specific, distressing or traumatic image of a past event. If the recollection of that event elicits significant guilt or shame, it may undermine the person’s self-efficacy and put them at risk of engaging in the dysfunctional behavior to alleviate the negative mood. In that situation only (not as a routine inclusion in the treatment), we might use image rescripting, where the individual creates an image of another person making the unwanted action, and they offer that person compassion. Then we would flip the image to a recurrence of the context, but where the person is coping effectively and avoiding the negative outcome. Thus the rescripted image of the past event serves as an intermediate step towards developing functional imagery of coping with obstacles on the path towards change.

Imagery-based cognitive therapy


Imagery can be used to help individuals test and change their cognitions about functional and dysfunctional behaviours. For example, if an individual has overly positive expectancies about drinking excessively, we might elicit images to help them relive past events or anticipate future events and evaluate more realistically the contribution of their drinking.

It is important to emphasise though, that at heart FIT is not about changing people’s cognitions but about helping them to discover and enhance existing incentives and recalled successes.