13. behavioural activation for depression

Question 1

behavioural model of depression: main focuses

Answer 1

• if-then contingencies (maintenance models)
• reciprocal association between env and actions + responses of other people in env
• not about behaviour, but about consequences (ideas of behavoural principles)

Question 2

what is fernster’s theory of depression?

Answer 2

decreased rate of response-contingent reinforcement lead to
1. turning inward
2. doing nothing
3. escape + avoidance (social, especially)

less reinforcement from env leads to sx of depression

Question 2

behavioural activation model

Answer 2

• behav resp reduce ability to experience positive reward from env
• tx focus on activation + processes that inhibit activation such as escape + avoidance + ruminative thinking – breaking cycle

Question 3

behavioural activation TX

when presenting tx model, what should you address?

Answer 3

• events + responses to events influence feelings - CBT
• lives with unbalanced problems and rewards can lead to depression
• people pull away when life less rewarding
  (pulling away can increase depression + make it hard to solve problems effectively (not thinking clearly)
• tx not just “doing more”, figuring out which activities would be most helpful

Question 4

planning + assessing behavioural activation tx

components of the daily monitoring form

Answer 4

• activity
• mastery (accomplishment)
• pleasure (hedonistic sense)

Question 5

behavioural activation tx

what are some contingencies that could maintain behaviour?

Answer 5

• positive reinforcement from fam/friends (accomodation of sx)
• negative reinforcement through escape/avoidance

Question 6

behavioural activation tx

questions to ask when using activity monitoring

Answer 6

• what would client be doing if they weren’t depressed
• what’s the relationship between specific activities + ratings of mastery and pleasure
• what’s the relationship between specific life contexts and ratings of mastery and pleasure
• how are avoidance and withdrawal contributing to depression (decreasing activities that don’t bring mastery or joy)

Question 7

your client is embarassed when listing things that they’ve done during the day/week. what can you say?

Answer 7

the point is to show them that their situation makes sense
no wonder you’re depressed, you’re not getting any reinforcement from your environment!

Question 8

things to maximize client success when activity scheduling

Answer 8

• public commitment
• structure environment
• arbitrary reinforcers
• aversive contingencies

Question 9

define:
- public commitment
- structure environment
- arbitrary reinforcers
- aversive contingencies

Answer 9

1. telling other people, keeping accountable
2. prepare as much as possible to carry out activity
3. rewarding yourself, better if natural enforcers
4. punishment (not ideal)

Question 10

behavioural activation tx

ACTION - what does it stand for, what does it do

Answer 10

targeting avoidance of tasks, emotions, interpersonal conflicts, etc
* assess whether behaviour is approach or avoidance
* choose to continue or try something new
* try the chosen behaviour
* integrate new behavour into routine - giving it fair chance
* observe results + monitor them
* never give up woohoo

assess
choose
try
integrate
observe
never give up!

Question 11

explain Dimidjian’s paper

Answer 11

• randomized BA, CT, AM, PLA
• (CT can use BA tech, BA didn’t use CT)
• (ask TA about this)