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Behavioral Activation (BA)

Behavioral activation (BA) is an extremely effective treatment for depression. BA predates cognitive therapy approaches, and an influential component analysis study demonstrated outcomes for BA that were equivalent to cognitive therapy or cognitive behavioral therapy (CBT) treatments (Jacobson et al., 1996). Separate teams have developed and evaluated slightly different behavioral activation treatment approaches: behavioral activation (BA: Martell, Addis, & Jacobson, 2001), and behavioral activation treatment for depression (BATD: Lejuez, Hopko, & Hopko, 2001). All versions of BA share the technique of activity scheduling, which is designed to connect depressed individuals with positive reinforcers in their environment. The BA approach attends to the identification and overcoming of avoidance, whereas the BATD version attends especially to the contexts in which behavior occurs. Read more
Behavioral Activation (BA)
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Activity Diary (Hourly Time Intervals)

Activity diaries can be used for activity monitoring during an assessment phase of therapy, symptom monitoring during therapy, correlating activity wi ... https://www.psychologytools.com/resource/activity-diary-hourly-time-intervals

Worksheets

Activity Diary (No Time Intervals)

Activity diaries can be used for activity monitoring during an assessment phase of therapy, symptom monitoring during therapy, correlating activity wi ... https://www.psychologytools.com/resource/activity-diary-no-time-intervals

Worksheets

Activity Menu

Helping clients to choose which activities to target during behavioral activation (BA) can be accomplished in a variety of ways: activity monitoring c ... https://www.psychologytools.com/resource/activity-menu

Information handouts

Activity Planning

Research suggests that an activity is more likely to be completed if it is planned and scheduled in advance. The Activity Planning worksheet can be us ... https://www.psychologytools.com/resource/activity-planning

Worksheets

Activity Selection

Activity selection is a technique for rating the difficulty of different activities. It is a helpful tool when clients have difficulty choosing betwee ... https://www.psychologytools.com/resource/activity-selection

Worksheets

Behavioral Activation Activity Diary

Behavioral activation (BA) is an effective treatment for depression. Different behavioral activation protocols include a variety of treatment componen ... https://www.psychologytools.com/resource/behavioral-activation-activity-diary

Worksheets

Behavioral Activation Activity Planning Diary

Behavioral activation (BA) is an effective treatment for depression. Different behavioral activation protocols include a variety of treatment componen ... https://www.psychologytools.com/resource/behavioral-activation-activity-planning-diary

Worksheets

CBT Daily Activity Diary With Enjoyment And Mastery Ratings

Activity diaries can be used for activity monitoring during an assessment phase of therapy, symptom monitoring during therapy, correlating activity wi ... https://www.psychologytools.com/resource/cbt-daily-activity-diary-e-m

Worksheets

Mastery And Pleasure Activity Diary

Activity diaries can be used for activity monitoring during an assessment phase of therapy, symptom monitoring during therapy, correlating activity wi ... https://www.psychologytools.com/resource/mastery-and-pleasure-activity-diary

Worksheets

Overcoming Depression: Therapist Guide

Overcoming Depression – A Cognitive Therapy Approach comes in two volumes. This page is for the Therapist Guide. Click on the following link to acce ... https://www.psychologytools.com/resource/overcoming-depression-therapist-guide

Treatments That Work®

Overcoming Depression: Workbook

Overcoming Depression – A Cognitive Therapy Approach comes in two volumes. This page is for the Client Workbook. Click on the following link to acce ... https://www.psychologytools.com/resource/overcoming-depression-workbook

Treatments That Work®

Task Planning And Achievement Record

The Task Planning and Achievement Record can be used to plan daily tasks and record goal attainment. It is most suited for encouraging frequent or rep ... https://www.psychologytools.com/resource/task-planning-and-achievement-record

Worksheets

Things To Do List

The Things To Do List is a form of activity record. It encourages the client to think about the priority of each item and to record (and celebrate!) c ... https://www.psychologytools.com/resource/things-to-do-list

Worksheets

TRAP TRAC

TRAP & TRAC worksheets can be usefully used as part of a behavioral activation programme as a way of overcoming responses which result in avoidanc ... https://www.psychologytools.com/resource/trap-trac

Exercises

Using Behavioral Activation To Overcome Depression

Using Behavioral Activation To Overcome Depression is a guide written for clients who are currently depressed. It provides clear information about dep ... https://www.psychologytools.com/resource/using-behavioral-activation-to-overcome-depression

Guides

Values

Meaningful activity is value-driven. This ACT-informed worksheet explores the key domains of values and encourages clients to reflect upon what is imp ... https://www.psychologytools.com/resource/values

Exercises

What Keeps Depression Going?

The “What Keeps It Going?” series is a set of one-page diagrams explaining how common mental health conditions are maintained. Friendly and concis ... https://www.psychologytools.com/resource/what-keeps-depression-going

Information handouts

Intervention

Self-Help Programmes

Behavioral activation for depression

  1. Introduction to BA for depression download archived copy
  2. Monitoring activity and mood  download archived copy
  3. Roadmap: the activation plan  download archived copy
  4. Finding direction: values, flow, and strengths  download archived copy
  5. Avoidance and depression TRAPs  download archived copy
  6. Problem solving  download archived copy
  7. Thinking habits  download archived copy
  8. Next steps  download archived copy

Presentations

  • Treating depression with behavior therapy: The implementation of behavioral activation | Christopher Martell, Sona Dimidjian, Steven Hollon  download   archive.org
  • Brief behavioural activation (BA) treatment for depression (BATD) | Carl Lejuez | 2014 download archived copy
  • Behavioral activation | David Fresco  download archived copy
  • Behavioral activation for depression and PTSD | Amy Wagner download archived copy
  • Behavioral activation: an effective intervention for late life depression | Dolores Gallagher-Thompson, Kim Bullock | 2012 download archived copy

Recommended Reading

  • Dimidjian et al (2006). Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. Journal of Consulting and Clinical Psychology, 74(4), 658-670 download archive.org
  • Dobson, K. S., Hollon, S. D., Dimidjian, S., Schmaling, K. B., Kohlenberg, R. J., Gallop, R. J., … & Jacobson, N. S. (2008). Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the prevention of relapse and recurrence in major depression. Journal of consulting and clinical psychology, 76(3), 468 download
  • *Ferster, C. B. (1973). A functional analysis of depression. American Psychologist, 28 (10), 857. download archived copy
  • Hopko, D. R., Ryba, M. M., McIndoo, C., & File, A. (2015). 14 Behavioral Activation. The Oxford Handbook of Cognitive and Behavioral Therapies, 229 download
  • Jacobson, N. S., Martell, C. R., & Dimidjian, S. (2001). Behavioral activation treatment for depression: Returning to contextual roots. Clinical Psychology: science and practice, 8(3), 255-270. download archived copy
  • Jacobson, N. S., Dobson, K. S., Truax, P. A., Addis, M. E., Koerner, K., Gollan, J. K., Gortner, E., Prince, S. E. (1996). A component analysis of cognitive-behavioral treatment for depression. Journal of Consulting and Clinical Psychology, 64(2), 295-305 download archived copy
  • Veale, D. (2008). Behavioral activation for depression. Advances in Psychiatric Treatment, 14, 29-36 download download

What Is Behavioral Activation?

History of BA

BA has its origins in the Skinner’s radical behavioral approach (Skinner, 1953). In the 1970s behaviorists trained by Skinner developed behavioral models of depression that proposed that depression could be treated by re-establishing contact with positive reinforcement and by learning social skills that are helpful for maintaining contact with stable sources of positive reinforcement (Ferster, 1973; Lewinsohn, 1974; Lewinsohn, Antonuccio, Steinmetz-Breckenridge, & Teri, 1984). Aaron Beck recognized the value of behavioral techniques in the treatment of depression and incorporated them into the original cognitive therapy manual (Beck, Rush, Shaw, & Emery, 1979). The paradigm shift toward cognitive approaches meant that purely behavioral treatments received relatively less attention. However, in 1996 Jacobson and colleagues published a component analysis comparing activity scheduling / behavioral activation; cognitive restructuring; and a combination of activity scheduling, cognitive restructuring, and core belief modification. The surprising result was that the combined CBT condition performed no better than the behavioral or cognitive interventions alone. In the wake of the Jacobson component analysis Martell, Addis, and Jacobson published a BA treatment package Depression in Context: Strategies for Guided Actionin 2001. At the same time Lejuez, Hopko, and Hopko published an alternative BA package in 2001 titled Brief Behavioral Activation Treatment for Depression (BATD). Hopko, Lejuez, Ruggiero, and Eifert (2003) published a helpful comparison of the BA and BATD packages, and Kanter, Busch, and Rusch (2009) provide a helpful synthesis of BA and BATD concepts.

BA Interventions

Two different implementations of behavioral activation are widely used: BA and BATD. Intervention techniques in BA/BATD include:

References

  • Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford Press.
  • Ferster, C. B. (1973). A functional analysis of depression. American Psychologist, 28(10), 857–870.
  • Hopko, D. R., Lejuez, C. W., Ruggiero, K. J., & Eifert, G. H. (2003). Contemporary behavioral activation treatments for depression: Procedures, principles, and progress. Clinical Psychology Review, 23(5), 699–717.
  • Jacobson, N. S., Dobson, K. S., Truax, P. A., Addis, M. E., Koerner, K., Gollan, J. K., … & Prince, S. E. (1996). A component analysis of cognitive-behavioral treatment for depression. Journal of Consulting and Clinical Psychology, 64(2), 295–304.
  • Kanter, J. W., Busch, A. M., & Rusch, L. C. (2009). Behavioral activation. CBT Distinctive Features Series.New York: Routledge.
  • Lejuez, C. W., Hopko, D. R., & Hopko, S. D. (2001). A brief behavioral activation treatment for depression: Treatment manual. Behavior Modification, 25(2), 255–286.
  • Lewinsohn, P. (1974). A behavioral approach to depression. In R. J. Friedman & M. M. Katz (Eds.), Psychology of depression: Contemporary theory and research. Washington, DC: Winston.
  • Lewinsohn, P. M., Antonuccio, D. O., Steinmetz-Breckenridge, J., & Teri, L. (1984). The coping with depression course. Eugene, OR: Castalia Press.
  • Martell, C. R., Addis, M. E., & Jacobson, N. S. (2001). Depression in context: Strategies for guided action. New York: Norton.
  • Skinner, B. F. (1953). Science and human behavior (No. 92904). Simon and Schuster.