potentially reduce missed appointments. This work highlighted a need to reduce con -
cerns about their forthcoming appointment. Consequently, recipients were advised
to use a self-talk technique in response to appointment anxiety, that is, ‘as soon as I
feel concerned about attending my appointment (the if) I will ignore that feeling and
tell myself this is perfectly understandable (the then)’. Unlike the if-then planning
technique employed by Sheeran and Orbell (2000), this is not an action planning
technique – no behavioural response is targeted. It is a thought-regulation technique
designed to reduce cognitive elaboration of specified anxieties. Note too that it is not
an example of thought suppression (Wenzlaff and Wegner, 2000). Recipients were
not advised not to think about their appointment but rather to avoid elaborating
appointment-related concerns when they arose. By reducing the amount of time
recipients spend worrying about their appointment the technique could make it easier
for them to attend. Analyses showed that those who received a questionnaire containing
this if-then thought regulation tip were more likely to attend their psychotherapy
appointment with 75 per cent attending compared to 63 per cent in the control group.
These two experimental studies illustrate how simple self-regulatory techniques
using an if-then structure can help motivated people act on their intentions. They also
show how the needs of different groups (assessed in stage 1 of the intervention mapping
process) leads to identification of different change objectives (stage 2). In one case the
objective was to prompt appointment making, while in the other it was to increase
keeping previously made appointments. This, in turn, meant that the techniques
employed were designed to target distinct regulatory processes (stage 3) namely,
detailed action planning versus distraction from specified anxieties. Consequently, the
two techniques employed different practical delivery methods even though both were
included in questionnaires. This comparison illustrates the detailed decision-making
processes involved in intervention design even when short, simple techniques are
employed. Not unlike rocket science, behaviour change design requires careful
theoretical specification of mechanisms and processes combined with precise
engineering of change techniques adapted to address specific real-world behavioural
challenges facing particular target groups. Finally, these two studies illustrate how simple
techniques have the potential to change our responses to health services in ways that
could be cost-saving. We will consider outcome and economic evaluations when we
discuss stage 6 of the intervention mapping process below.
212 MOTIVATION AND BEHAVIOUR
new cognitions relevant to the salient contradiction and helps resolve it through
personal commitment to condom use in the future. Thus the strength of motivation
to resolve the contradiction prompts a desirable change in motivation and in key
preparatory behaviours (acquiring and carrying condoms).
A systematic review of experimental studies applying cognitive dissonance
theory in this way found that, across studies, significant positive effects were
observed across different cognitive and behavioural outcomes and suggested that
the effectiveness of such interventions may be moderated by gender such that
women tend to respond more positive to this technique than men (Freijy and
Kothe, 2013).