An alternative goal-setting technique for addictive behaviour interventions: The Chronos Approach

ABSTRACT

Psychological interventions for addictive behaviours (i.e., alcohol, smoking, gambling) typically focus on reducing the frequency of that target behaviour. Individuals generally set a “count goal” and then monitor the frequency of these behaviours via a process of counting/recording (i.e., number of alcoholic drinks, number of dollars gambled). We argue that this approach, although a key feature of interventions, presents a range of challenges, including: confusion regarding what constitutes a count; remembering to keep count; and remembering to stop at a certain count. We argue that these inherent features of “count goals” may serve to undermine treatment effectiveness for addictive behaviours and potentially other behaviour change interventions. Furthermore, given counting of specific behaviours occurs frequently within digital interventions (e.g., steps, cigarettes, drinks), these issues may be further exacerbated within mHealth (interventions delivered through mobile digital devices). In this article, we offer an alternative to setting “count goals” as part of a behavioural intervention. This approach directly limits a problem behaviour by constraining the time period, and rate of that behaviour, with no requirement to count or record the frequency of the behaviour—we refer to this as the “Chronos Approach.” We suggest that this approach lends itself particularly well to mHealth interventions, whereby daily reminders and timed alerts can be easily programmed into a smartphone. We discuss the advantages of this method and illustrate how it can be effectively incorporated into mHealth behaviour interventions, providing a specific example of an alcohol reduction smartphone app wherein the Chronos Approach has been implemented.

KEY POINTS

1. Settings count goals (i.e., limiting the number of alcoholic drinks consumed), and then counting the particular frequency of this target behaviour, is a key component of psychological interventions for addictive behaviours. We propose that these count goals may at times negatively impact treatment adherence, data quality, and clinical outcomes. This is particularly relevant for digital interventions, where a greater emphasis is placed on counting particular behaviours (e.g., number of dollars gambled, alcoholic drinks).

2. We offer an alternative to count goals, referred to as the “Chronos Approach.” This method focuses on assisting individuals to limit the frequency of a problem behaviour without the need to set a count goal and then engage in frequent monitoring, thereby potentially circumventing the typical drawbacks of count goals.

3. The Chronos Approach limits the time period and rate at which a problem behaviour can occur, affording a functional synergism with digital platforms that can be programmed to cue goal adherence, supported by behaviour change strategies that can be delivered at specific times within daily life, and tailored to the individual.

KEYWORDS:

• Addictive behaviours
• alcohol problems
• Chronos Approach
• digital health
• goal‐setting
• interventions
• smartphone
• time‐based goals

Acknowledgements

We would like to thank Professors Ron Borland and Charles Abraham for their helpful comments on this manuscript, and Dr Kate Hall for her clinical advice.

Conflict of interest

None.

Data availability statement

Not applicable‐ no data was included in this manuscript.