Cognitive behavioral therapy (CBT) is a therapuetic approach to improving mental and behavioral health. The core philosophy is that behavior can be modified by noticing and correcting patterns in thought that influence the behavior. Modern CBT is typically associated with Albert Ellis and Alan Beck.
The structured and rules-based nature of CBT have made it a popular candidate for digital interventions and application by lightly-trained or even untrained practitioners.
Personalization refers to taking specific data from the individual in a behavioral intervention into account in offering a different experience vs. that given to others.
An experience may be personalized based on demographic data, psychographic data, behavioral performance, or other factors.
Defaults refer to what happens if a person makes no choice or goes with a pre-selected choice. The influence of defaults is a foundational component of behavioral economics.
Perhaps the most famous example of defaults is the difference between opt-in and opt-out organ donation programs. While not universal, several studies have found that the rate of organ donation consent in a population seems to be influenced by the default (i.e., what happens if a person does not check a box or change the pre-selected preference on a form).
Smart defaults do not only refer to one-off events, however. In the well-known Save More Tomorrow program, participants were not only included in a savings program by default, but the amount they saved was also changed over time automatically (again by default). Similarly, other behavior change programs have default settings that include at-home medication or food delivery, rules-based reminders on different platforms, etc.
Implementation intentions are specific details for when and how a behavior should or will be performed.
These are often formulated as ""if-then"" rules, such as:
- "if I crave something sweet, I'll have fruit instead of candy"
- "if I am in the mood for a cigarette, I'll wait 5 minutes—then, if I still want it, I can have one"
Other examples include studies where flu vaccination uptake was higher in groups of people nudged to make more specific plans (i.e. picking a specific time and date, along with a mode of transport to a specific clinic). The same general effect was observed with voting behaviors.
These are a generally low-cost tool to slightly improve the gap between intention and performance of a behavior.
Gamification refers to leveraging mechanics and other experiential elements typically associated with games in non-game contexts.
These can be fairly subtle (e.g. a progress bar for filing out a health risk questionnaire), moderate (e.g. achievements given for reaching personal finance goals, contests for steps walked as a team in a workplace wellness competition), or extreme (e.g. an augmented reality experience to treat chronic pain). At the extreme end, the distinction between a gamified experience and an actual game may be considered almost academic.
Group incentives refer to structure where an individual's likelihood or size of reward is influenced by others. The intention is to leverage positive peer pressure by causing compliant participants to influence less compliant participants to improve their behavior.
For example, sales teams may be offered a bonus based on an office's collective revenue generation or provided all individuals meet a baseline level of performance. Similarly a multi-site franchise may offer an incentive for whichever location improves their performance the most over the prior month.
Micro-incentives refers to small rewards, typically frequent and cash-based, given out on a per-behavior basis.
A prominent example is Wellth, a program for people with chronic illness delivered via app. Some participants are given around $2 each time they take a medication or measure their blood pressure and submit a photo.
In related studies, e.g. Petry et al. (2015), participants' compliance with these behaviors was significantly higher than those who did not receive the incentives, and the behaviors persisted several months after incentives were removed.
Micro-incentives can be layered with other reward approaches such as lotteries and non-financial incentives.
