Motivation and emotion/Book/2022/Functional imagery training

Overview


Functional imagery training (FIT) is a modern style of psychotherapy designed to specifically address people’s motivations toward behaviour change (University of Plymouth, n.d.). FIT uses the motivational interviewing approach to train an individual to utilise mental imagery as a tool to increase their motivation toward achieving a desired goal. FIT is currently, academically and professionally, most prominantly applied to assisting people in weight loss; however, it is continuing to grow in popularity as well as gaining more clinical evidence of its impact in other areas. FIT utilises a combination of existing approaches to facilitate a change in mindset for the client that is stable through the patient’s future: motivational interviewing techniques, mental imagery, specifically in its relation to emotion and motivation/desire, and therapy tools like mental contrasting and implementation intentions.

FIT is supported by evidence-based research that has proven its efficacy over both traditional methods and its individual components, proving it is more than the sum of its parts. When compared to these measures FIT has shown up to 5 times the positive effect, as figure 1 highlights (Solbrig, et al., 2019). Most impressively though participants utilising the FIT technique have shown a significant and stable shift in mind set that continued to assist them in working toward their goals.

Focus questions:
 * What makes up FIT?
 * Why does the application of FIT increase weight loss effectiveness?
 * What other areas could FIT be applied to?

Background
The creation of FIT has involved many contributors and a vast array of research covering a multitude of topics. Most importantly, a culmination of successful research in psychological theories is the foundation that has formed FIT. Theories that underpin the efficacy of FIT include:
 * elaborated intrusion theory
 * mental imagery
 * visuo-spatial sketchpad (short-term memory)
 * motivational interviewing

Each of these theories was investigated individually for their potential in changing behaviour and stimulating motivation. A core group of researchers then began collaborating the existing research findings. The ultimate goal of this collaboration was to create an applicable technic that integrated proven psychological theory to stimulate positive and long-lasting behaviour change. With a commonwealth collaboration between researchers in England and Australia underway, FIT was formed from the hard work of these key contributors:
 * Professor Jackie Andrade was a crucial contributor to the development of FIT. Her research involving mental imagery and identifying how powerful it can be in emotional experience (specifically the elaborated intrusion theory), as well as how we can utilise that power as a positive means for motivation, laid the foundation for FIT development.
 * Dr. Linda Solbrig completed her doctorate thesis on FIT’s impact on weight loss. Dr. Solbrig has continued the expansion of FIT as an appliable therapy approach by offering access to training courses that teach the principles of FIT.
 * Professor John May collaborated at length with Professor Andrade and Professor Kavanagh in building a strong understanding of how we can impact behaviour change, particularly in the realm of mental imagery and addiction.
 * Professor David Kavanagh is a significant contributor in the field of motivation and emotion with research spanning several decades. Along with Professor Andrade and Dr. May, Professor Kavanagh’s work on the elaborated intrusion theory and goal orientated motivation developed the theory for FIT’s creation.

The elaborated intrusion theory
There are a number of psychological theories that contribute to the function of FIT, perhaps none more important than the elaborated intrusion theory. The elaborated intrusion theory is defined as: the experience of an individuals regular thought processes being interrupted, or intruded, by abrupt conscious imagery of cravings that have strong emotional associations (May, et al, 2012). It is the idea that cravings and desire start with a simple mental image that intrudes our daily thinking, meaning it is irrelevant to a current task (May, Andrade & Kavanagh, 2015). Due to the emotive power of the intruding image our brain begins to focus on the thought, developing and building it until it passes a desire and becomes a craving, essentially becoming the motivation for action. The elaboration stage is the critical component for behaviour change or control as the elaboration of the intrusive thought is the step that involves controlled processing while the initial intrusive thoughts are governed by automatic processing and therefore involuntary (May, Kavanagh, & Andrade, 2014).

Research by Shahriari et al. (2020) concluded that mental imagery is the strongest form of food craving inducing stimulant. This research highlights how simple the beginning of the craving cycle is because one simple intrusive thought initiates the process that motivates behaviour. Through research by our key contributors the power of the elaborated intrusion theory has been well established; FIT has been designed to utilise this same principle to train a participant to harness positive imagery toward goal achievement; this is made possible because intensity of cravings can be interrupted by competing tasks (May, Kavanagh, & Andrade, 2014).

Research
Participants being tested on FIT research can be measured using quantitative data because the design of FIT allows for tangible outcomes to be clearly measured. This makes FIT an excellent theory to conduct cost effective research. While the theoretical development of the FIT components has been conducted over decades, since its recent creation, FIT has steadily built its own body of research measuring its specific outcomes and effectiveness.

FIT has been tested in more environments than just weight loss; research continues to expand developing stronger support for its efficacy and identifying its limitations. Applying FIT to other health motivations like exercise or chronic conditions has shown varying degrees of effect (Rhodes, et al., 2021; Parham, et al., 2018). Rhodes, et al, (2018) conducted a trial using FIT to improve the grit (defined as courage and resolve, or strength of character) in professional sportspeople. They found that the participants in the FIT group consistently increased their grit over the course of the season while those in the control group of no influence remained stable.

Early stages of research are showing positive signs for FIT's influence on problematic alcohol use (Shuai, et al., 2021). Currently there is a research project being put together requesting participants with alcohol dependency to join the trial with the hope that FIT can have a positive impact on decreasing use. Details on this study can be here.

Method
The FIT method is made up of a clear structure that is replicable and measurable. It uses motivational interviewing as the framework to recognise obstacles preventing the desired change, visualises them, followed by recognising and visualising solutions for these obstacles. Most importantly the process allows the individual to experience the full range of emotions associated with failing and achieving their goals. Finally, it uses the imagery techniques to visualise the participants desired goal with a focus on the powerful emotions associated with its achievement.

Important to consider:

FIT doesn’t just rely on the final destination. Obviously, there is significant consideration for the long-term goal achievement, but the impact of change starts immediately with implementation of short-term change that begins working toward the final goal. It feels good to achieve goals we set, so why not start right away?!

Motivational Interviewing
Motivational interviewing is a talk therapy technique. It was developed in the 1980’s by William R. Miller and Stephen Rollnick. It is a client-centered counselling style focusing on the motivation of changing specific behaviours. This is achieved by utilising a directive style of counselling, rather than a traditional non-directive exploration of the client’s needs, emotions and experiences (Rollnick, n.d.).

A counsellor will utilise the four processes of motivational interviewing to assist in identifying their problematic behaviour, create solutions for the behaviour and an implementation plan for change.

There are four stages of motivational interviewing:


 * 1) Engaging, which involves rapport building with the client;
 * 2) Focusing, client and therapist collaborate to decide what is the main focus of the work they will do together
 * 3) Evoking, therapist works to encourage the client in identifying the reasons change is necessary
 * 4) Planning, therapist encourages client to identify what can be done to achieve their goals and assists in creating a plan with these ideas.

Mental imagery
The critical step in FIT creating the long-lasting effects. Mental imagery is the method of utilising memory and imagination to visualise scenarios that invoke an experience independent of any external stimulus (Pearson & Krans, 2017). The technique has been proven to have a powerful relationship with anxiety and to experience novel as well as remembered scenarios vividly (Holmes & Mathews, 2005). Research shows that mental imagery has strong relations to motivation increases as well as an increase in activity completion (Renner, et al., 2019). It is theorised that mental imagery shares strong ties with perception which allows the implementation of the technique to elicit a mental perception of experience, meaning mental imagery can create a genuine experience in the mind of an individual practicing the technique (Pearson et al., 2015). For a first-hand experience of mental imagery try out the lemon exercise.

Mental contrasting
Mental contrasting is a very important technique applied during the FIT process that builds the individuals goal conviction. The goal of mental contrasting is for the individual to understand the gap between their desired goals and their current reality, in relation to achieving that goal. The most important step of mental contrasting is the client establishing a timeline to achieve their goal and then identifying both how they will feel if they achieve their goal and how they feel if they do not achieve their goal. Research has shown that when expectation of success is high, goal pursuit is strong, making it significantly more likely to achieve the goal (Kappes, et al, 2013). Seeing a clear contrast in achieved state to current state develops the necessary motivation to realistically plan for goal attainment.

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Case study
Trisha chose to participate in the FIT study because she turned 59 which meant she was approaching the age her mother died, 60. Trisha remembered the impact of her mother dying well and didn't want to leave her daughter in a similar situation just because she couldn't get her weight under control. Using the FIT techniques Trisha was able to visualise her goal of wearing a dress she bought for her daughters graduation. More specifically, she was able to imagine the feeling she would have wearing the dress to fuel her motivation on days she didn't want to exercise. }}

Implementation - Why FIT works
FIT is proving to be a highly effective method of talk therapy that practitioners can use to stimulate genuine mindset change for clients. So, why does it work, how do you learn the skills and who can implement them?

The success of FIT is based on the principle that your working memory, specifically your visuo-spatial sketchpad, capacity can only accommodate one emotive image at a time. The visuo-spatial sketchpad works well at its given task, but its function has been shown to be overwhelmed when facing multiple emotive images (Lilley, et al, 2009). This is where the success of FIT lies, in its ability to utilise the limited capacity within the visuo-spatial sketchpad and implement a trade of negative images for positive images to stimulate constructive goal motivation.

To harness the power of imagery with the visuo-spatial sketchpad, FIT utilises motivational interviewing to form its blueprint or skeleton. At each stage of the motivational interviewing conversation, mental imagery is applied to emphasise the emotive response generated. Teaching the ability to override the involuntary intrusive thought ensuring emotions are used to stimulate motivation toward the desired goal and not the current state is how the elaborated intrusion theory is applied.

FIT is not exclusively for therapists. Any situation that requires a change in motivation or mind set is encouraged to utilise the FIT model. Areas like: sports coaching, professional team leaders, school teachers, and more could successfully implement FIT within their discipline. Currently a practitioner is required to be accredited in the FIT delivery technique before they are endorsed to use the method in a professional setting. Fortunately, Dr. Linda Solbrig offers an affordable online training program, here, that is accessible to a wide range of professional fields.

Conclusion
Functional imagery training is a modern therapy style that is full of potential. In its early stages of development, it showed significant effect when applied to individuals striving to achieve weight loss goals, so much so that it is able to be professionally applied and widely accessible to those needing assistance with weight management. Excitingly, research continues to test FIT's efficacy in a hope that it can show similar levels of significant impact in other areas of intrusive thought behaviour, like addiction and compulsion. With the combination of motivational interviewing, mental imagery and mental contrasting, FIT utilises the principles of the elaborated intrusion theory and working memory to teach individuals how to take control of their own thought processes and build intrinsic motivation for behaviour change through goal achievement. Without any other intervention FIT significantly increases weight loss achievement because it teaches the participant to develop skills in managing their intrusive thoughts. This allows for the achievement of regular short-term goals that work toward achieving their desired end goal and in the process change their own behaviour permanently.