Treatment of Depression: Behavioral Activation

Question 1

Behavioral Activation, general

Answer 1

Ultimate goal is to help clients modify their behavior to increase contact with sources of positive reinforcement in their lives

Theory-driven as opposed to protocol-driven
Treatment does not follow required session-by-session format, but does follow general course over time

Question 2

Developing Treatment Goals

Answer 2

Identify and address basic avoidance patterns and areas of routine disruption

Address short and long-term goals

Start with behavior change that has the greatest likelihood of success

• ease of accomplishment
• level of importance in line with values and priorities

Question 3

Individualizing Activation and Engagement Targets

Answer 3

Functional analysis

What is maintaining the depression?

What is getting in the way of engaging and enjoying life?

What behaviors are good candidates for maximizing change?

Question 4

Repeatedly Applying and Troubleshooting Activation and Engagement Strategies

Answer 4

Activity scheduling

Self-monitoring

Graded task assignment – breakdown tasks and grade them appropriately in a stepwise progression from simple to complex
*very important to break down tasks in such a way that early success is guaranteed

Avoidance modification and problem solving

Question 5

Reviewing and Consolidating Treatment Gains

Answer 5

Focus on anticipating situations that may trigger depressive feelings and behaviors

Generate plans for coping

Review the basic BA model and tx methods

Ensure that client is leaving with a solid understanding of how to apply these tools in the future

Question 6

General Course of BA

Answer 6

1. Orienting to treatment
2. Developing treatment goals
3. Individualizing activation and engagement targets
4. Repeatedly applying and troubleshooting activation and engagement strategies
5. Reviewing and consolidating treatment gains

Question 7

BA Assumption and Objective

Answer 7

Progress on life goals is itself anti-depressive

Objective is to make progress on goals regardless of how one feels at a particular point in time

Therapist and patient work together to make progress on short-term goals regardless of how the client is feeling