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
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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/
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/
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/
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/
Valued Domains
Values are the “principles for living” that capture what matters most to people. Elucidating values can serve many therapeutic functions, such as ...
https://www.psychologytools.com/resource/valued-domains/
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/
Values: Connecting To What Matters
Values: Connecting To What Matters is a practical self-help guide which introduces the reader to a cornerstone of acceptance and commitment therapy (A ...
https://www.psychologytools.com/resource/values-connecting-to-what-matters-full-guide/
Choosing Your Values
Values are the “principles for living” that capture what matters most to people. Elucidating values can serve many therapeutic functions, includin ...
https://www.psychologytools.com/resource/choosing-your-values/
Exploring Valued Domains
Values are the “principles for living” that capture what matters most to people. Elucidating values can serve many therapeutic functions, such as ...
https://www.psychologytools.com/resource/exploring-valued-domains/
Changing Avoidance (Behavioral Activation)
Behavioral activation (BA) is a structured psychotherapeutic approach effective for a range of disorders, including depression (Ekers et al., 2014), a ...
https://www.psychologytools.com/resource/changing-avoidance-behavioral-activation/
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/
![[Free Guide] An Introduction To Values](https://media-engine-production-public.s3.eu-west-2.amazonaws.com/28518/conversions/%2A-an_introduction_to_values_en-gb_Guides_Cover-preview.jpg)
[Free Guide] An Introduction To Values
People’s lives feel unfulfilling or directionless if they’re not guided by values. An Introduction to Values is a practical self-help guide design ...
https://www.psychologytools.com/resource/an-introduction-to-values/
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/
Overcoming Depression (Second Edition): 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/
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/
Overcoming Depression (Second Edition): 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/
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/
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/
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/
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/
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/
Things To Do List
The Things To Do List is a form of activity record. Clients are instructed to generate a list of planned activities, assign a priority rating to each ...
https://www.psychologytools.com/resource/things-to-do-list/
Links to external resources
Psychology Tools makes every effort to check external links and review their content. However, we are not responsible for the quality or content of external links and cannot guarantee that these links will work all of the time.
Assessment
- Valued Living Questionnaire (Version 2) | Wilson, Groom | 2002
Guides and workbooks
- Get active feel good (behavioral activation) – CBT workbook from CEDAR | Paul Farrand, Adrian Taylor, Colin Greaves & Claire Pentecost | 2013
Information Handouts
- If you do anything 100 times you will get pretty good at it | TA-TUTOR.com
Presentations
- Behavioral activation: an effective intervention for late life depression | Dolores Gallagher-Thompson, Kim Bullock | 2012
- Behavioral activation for depression and PTSD | Amy Wagner
- Behavioral activation | David Fresco
- Brief behavioural activation (BA) treatment for depression (BATD) | Carl Lejuez | 2014
- Treating depression with behavior therapy: The implementation of behavioral activation | Christopher Martell, Sona Dimidjian, Steven Hollon archive.org
Self-Help Programmes
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Behavioral Activation For Depression
| Southwark Psychological Therapies Service | 2012
- Introduction to BA for depression
- Monitoring Activity And Mood
- Roadmap: The Activation Plan
- Finding Direction: Values, Flow, And Strengths
- Avoidance And Depression TRAPs
- Thinking Habits
- Next Steps
Treatment Guide
- Behavioural activation treatment for depression (BATD) manual | Lejuez, Hopko & Hopko | 2001
- Behavioural activation treatment for depression – revised (BATD-R) manual | Lejuez, Hopko, Acierno, Daughters, Pagoto | 2011
- Ten Year Revision of the Brief Behavioral Activation Treatment for Depression (BATD): Revised Treatment Manual (BATD-R) | Lejuez, Hopko, Acierno, Daughters, Pagoto | 2011
- A Brief Behavioral Activation Treatment for Depression: Treatment Manual | Lejuez, Hopko, Hopko | 2001
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 archive.org
- Behavioural activation treatment for depression: returning to contextual roots | Jacobson, Martell, Dimidjian | 2001
- Veale, D. (2008). Behavioral activation for depression. Advances in Psychiatric Treatment, 14, 29-36
- 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
- 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.
- Hopko, D. R., Ryba, M. M., McIndoo, C., & File, A. (2015). 14 Behavioral Activation. The Oxford Handbook of Cognitive and Behavioral Therapies, 229
- Ferster, C. B. (1973). A functional analysis of depression. American Psychologist, 28 (10), 857. | Ferster
- 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
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:
- activity monitoring
- activity scheduling / simple activation
- identifying and overcoming avoidance
- attending to client values to guide activation
- functional analysis to understand the function and reinforcers of behavior
- stimulus control interventions to modify the client’s environment in ways intended to evoke target behavior
- contingency management (shaping rewards and reinforcers)
- skills training (problem solving, skills training, social skills training)
- mindful valued activation (preventing emotional avoidance)
- relapse prevention
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.