Behavioural activation LICBT

Question 1

What is BA?

Answer 1

Richards 2010

Increasing activity level
Addressing avoidance constructively but kindly

Question 2

Jacobson et al 2001

Answer 2

Addressing avoidance without exacerbating negative beliefs about failing and is not overwhelming

Disruption to routine contributes to low mood

Clients feel they should feel less tired before starting BA

Question 3

Similar to…

Answer 3

Activity scheduling Beck 1979

Question 4

Richards 2010a

Answer 4

Routine, necessary & pleasurable

Routine and necessary activities differences are often unclear to clients

Increasing activity level
Addressing avoidance constructively but kindly

Question 5

6 steps of BA

Answer 5

1 Rationale

• acknowledge difficulties
• provide examples

2. Routine, Necessary & pleasurable
   - Richards 2010a
   - Necessary offers a sense of mastery and achievement
3. Devise Hierarchy
   - Least to most challenging
   - Graded approach avoiding contributing to the cycle
4. Plan some activities
   - diary
   - SMART
5. Carry our planned activities
   - not all planned activities may be achievable
   - encourage flexibility
6. Review outcome
   - provides encouragement
   - facilitates learning
   - reinforces the importance

Question 6

Drawbacks of BA

Answer 6

1. Clients feeling they should be less tired before starting (Jacobson et al 2001)
   Solution: explore and educated sleeping and depression before.
   Analogy: jumpstarting a dead car battery
2. Goals are too ambitious Westbrook et al 2007
3. Lack of pleasure
   Persistence is key (Westbrook et al 2007)
4. Goals dependent on others’ or the weather etc
   Solution: persistence!! (Kinsella et al 2009)

Question 7

Offering examples with case studies can improve the reception of BA

Answer 7

Williams 2009

Question 8

Addressing avoidance without exacerbating negative beliefs about failing and is not overwhelming

Disruption to routine contributes to low mood

Clients feel they should feel less tired before starting BA

Disruptions to routine can contribute to low mood

Answer 8

Jacobson et al 2001

Question 9

What is the difference between necessary and routine activities?

Answer 9

Necessary- achieve a sense of mastery, when activities are avoided they build up eg work, paying bills etc

Routine- frequent basis: household tasks or self-care

Question 10

Jacobson 1996

Answer 10

Landmark study, isolated BA as a stand-alone treatment, evidence suggesting it had equivalent outcomes to full CBT and maintained for 6 months

Prior to that was CBT- HICBT

High- always starts with activity planning and then onto schema work

Question 11

COBRA

Answer 11

Cost and outcome of BA

Simple mode of effective treatment

Question 12

Critique

Answer 12

Vicious flower- action might be strong

Rumination maybe the problem- CR

Question 13

Westbrook et al 2007

Answer 13

Goals are too ambitious or unrealistically high

Papworth 2013- can lead to clients feeling overwhelmed and carrying out none of the activities

Lack of pleasure
Persistence is key

Question 14

(Kinsella et al 2009)

Answer 14

Goals dependent on others’ or the weather etc

Solution: persistence!!

Question 15

Cuijpers et al; 2007a

Eckers et al 2008

Answer 15

As effective as CBT for depression

More effective than counselling and psychotherapy

More beneficial than CBT as it is simple and does not require any complex skills from practitioner or patient

Question 16

Hopko et al 2003

Answer 16

shown to be as effective as a brief treatment