Using Behavioral Activation To Overcome Depression

Behavioral activation is a structured, evidence-based approach that helps clients break the cycle of depression by reconnecting with meaningful activities and values.

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Workbook (PDF)

A workbook containing elements of psychoeducation and skills-development.

Overview

Using Behavioral Activation To Overcome Depression provides clinicians and clients with a clear and accessible guide to behavioral activation (BA) principles. Depression often leads to withdrawal from pleasurable or important activities, reinforcing low mood and isolation. This resource offers a systematic approach to increasing engagement with life again, by focusing on planning and completing activities linked to pleasure, achievement, and connection.

Based on well-established psychological research, the guide emphasises that action often precedes improvements in mood, and that even small steps can create powerful change over time.

Why Use This Resource?

This resource supports clinical practice by:

  • Providing a clear, structured framework for implementing behavioral activation with clients.
  • Helping clients understand the connection between their activity levels, values, and mood.
  • Offering tools for activity monitoring, planning, and goal setting to support behavior change.
  • Encouraging a compassionate, values-based approach to restoring wellbeing.

Key Benefits

Structure

Offers a step-by-step framework to guide clients out of the inactivity trap.

Motivation

Supports clients in building momentum even when motivation is low.

Values

Connection Links activity planning to personal values for deeper, lasting change.

Practical

Tools Includes activity diaries, planning sheets, and values exercises for use in sessions.

Who is this for?

Depression

Helping clients increase activity and change cycles of low mood.

Persistent Depressive Disorder (Dysthymia)

Supporting gradual, sustainable behavioural changes.

Seasonal Affective Disorder

Encouraging engagement with life-affirming activities during low seasons.

Integrating it into your practice

01

Psychoeducation

Introduce the vicious cycle of depression and the principles of BA.

02

Monitoring

Support clients in recording daily activities and mood patterns.

03

Values Exploration

Help clients reconnect with what matters most to them.

04

Activity Planning

Co-create achievable schedules that incorporate meaningful activities.

05

Problem Solving

Identify and overcome barriers to action.

06

Review and Reflect

Regularly track progress, adjust plans, and celebrate successes.

Theoretical Background & Therapist Guidance

Behavioral activation (BA) is grounded in behavioral models of depression (Lewinsohn, 1974; Martell et al., 2001). It proposes that a reduction in positive reinforcement from the environment contributes to the onset and maintenance of depressive symptoms. Withdrawal and inactivity reduce opportunities for pleasure, mastery, and social connection, which in turn intensify low mood.

BA aims to reverse this cycle by helping clients schedule and engage in behaviours that are likely to produce positive outcomes, even when motivation is initially low. Empirical evidence demonstrates that BA is as effective as cognitive therapy and antidepressant medication for many individuals with depression (Dimidjian et al., 2011; Ekers et al., 2014).

Central to this approach is the understanding that behavior change often precedes improvements in mood. Activity is strategically chosen based on personal values, enhancing both motivation and meaningful engagement over time. The emphasis on planning and execution — despite emotional inertia — is key to breaking the depression-maintenance cycle.

This resource supports clinicians by offering structured, practical interventions to increase behavioural activation and reconnect clients with sources of pleasure, achievement, and connection.

What's inside

  • Comprehensive guide to behavioral activation principles and steps.
  • Activity monitoring worksheets for tracking mood and behavior patterns.
  • Values identification exercises to align activities with personal values.
  • Activity planning templates for structured scheduling.
  • Practical tips for overcoming barriers and sustaining progress.
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FAQs

Behavioral activation is a psychological approach that encourages engagement in meaningful activities to counteract depression and low mood.
Encourage clients to start with small, manageable activities, emphasise linking actions to personal values, and remind them that action often needs to come before motivation improves.
BA is effective for various forms of depression, helping clients at different severity levels re-engage with life.

How This Resource Improves Clinical Outcomes

By using this resource in their clinical practice, therapists can:

  • Facilitate structured increases in activity, countering withdrawal and inactivity.
  • Build self-efficacy through action, problem-solving, and values-based goal setting.
  • Help clients see improvements over time, even when motivation is initially low.
  • Offer practical, collaborative tools that keep therapy sessions focused and client-centred.
  • Encourage sustainable behaviour change aligned with core values, reducing relapse risk.

References And Further Reading

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.
  • Elfrey, M. K., & Ziegelstein, R. C. (2009). The "inactivity trap". General Hospital Psychiatry, 31(4), 303.
  • Roshanaei-Moghaddam, B., Katon, W. J., & Russo, J. (2009). The longitudinal effects of depression on physical activity. General Hospital Psychiatry, 31(4), 306–315.
  • Spijker, J. A. N., De Graaf, R., Bijl, R. V., Beekman, A. T., Ormel, J., & Nolen, W. A. (2002). Duration of major depressive episodes in the general population: results from The Netherlands Mental Health Survey and Incidence Study (NEMESIS). The British Journal of Psychiatry, 181(3), 208–213.
  • Ekers, D., Webster, L., Van Straten, A., Cuijpers, P., Richards, D., & Gilbody, S. (2014). Behavioural activation for depression; an update of meta-analysis of effectiveness and sub group analysis. PloS one, 9(6), e100100.
  • Kanter, J. W., Manos, R. C., Bowe, W. M., Baruch, D. E., Busch, A. M., & Rusch, L. C. (2010). What is behavioral activation?: A review of the empirical literature. Clinical Psychology Review, 30(6), 608–620.
  • Dimidjian, S., Barrera Jr, M., Martell, C., Muñoz, R. F., & Lewinsohn, P. M. (2011). The origins and current status of behavioral activation treatments for depression. Annual Review of Clinical Psychology, 7, 1–38.
  • Lewinsohn, P. M. (1974). A behavioral approach to depression. In R. J. Friedman & M. M. Katz (Eds.), The Psychology of Depression: Contemporary Theory and Research (pp. 157–178). Wiley.