Behavioral activation (BA) is a type of talk therapy. It’s often considered part of cognitive behavioral therapy (CBT). However, while CBT is focused on changing your thoughts and then your behaviors, BA is focused on changing your actions.
This therapy is used mainly to treat depression. Its main aim is to help you do things that bring you joy.
BA is based on the theory that doing what you enjoy will help you get out of the downward spiral of depression.
Clinical depression affects about 350 million people around the world and is the second-largest cause of disability. Behavioral activation is a cost-effective therapeutic option that could bring treatment to millions around the world.
During BA, you and your therapist will work together to discover your unique values, motivations, and goals. You’ll use this information to develop a personal, step-by-step treatment plan to assist you in choosing activities that lead to positive rewards.
When you receive benefits or feel good while doing an activity, it makes you want to do that activity again and possibly try new activities.
As you repeat behaviors that create positive experiences, it will help you feel better and will help break the patterns that lead you to feel depressed.
Behavioral activation works by helping individuals become more active and engaged in their lives with the goal of changing the way they feel. Therapists who use BA believe that depression is in part caused by a lack of positive reinforcement and an increase in avoidance behaviors.
There are two main approaches to behavioral activation for depression. Washington BA and Brief BA Treatment for Depression (BATD).
Washington BA focuses on how your surrounding environment and your unhealthy coping behaviors are believed to keep you feeling depressed.
The unhealthy behaviors are mostly rooted in avoiding feelings like fear, sadness, and anxiety. They cause you to feel separated from your surroundings.
Therapists who use this type of BA help you develop a broad range of techniques for dealing with your depression. They also help you analyze why you tend to fall back on certain behaviors that ultimately increase your depression.
BATD is less specific to the individual. It’s focused simply on reinforcing or supporting non-depressive behaviors and on discouraging or not reinforcing depressive behaviors.
There are eight techniques involved in behavior activation.
Behavioral Activation Techniques
- activity monitoring
- activity scheduling
- contingency management
- values and goal assessment
- skill training, such as problem solving
- targeting verbal behaviors
- targeting avoidance
In most cases, you keep a log of these techniques and report back to your therapist.
Activity scheduling is meant to be individual for you. For example, you might find joy from hiking, having coffee with a friend, or cooking, so you would make specific plans to do one or more of these.
You might value things like family, education, or health. Knowing what you value can help you think of things you would like to do and that would be important to you.
The targeting avoidance step can help you understand why you avoid certain situations and activities and help you plan ways to deal with those situations rather than avoiding them.
Since behavioral activation is customized for each person, it may help with other disorders as well as depression.
As you assess your values and abilities, you and your therapist can come up with new coping strategies. BA can help with major depressive disorder (MDD) and personality disorders.
BA is also used to treat anxiety, especially if depression and anxiety overlap.
Studies have shown that behavioral activation is as effective as cognitive behavioral therapy (CBT).
A trial in the UK gave half the participants CBT and the other half BA. Around two-thirds of the participants in both groups said they felt at least 50 percent better.
After three follow-ups there was still no difference between the results of the two groups. The latest follow-up was 18 months out.
These statistics are especially encouraging since BA costs less than CBT. Behavioral activation costs about 20 percent less than CBT, which means more people can potentially be helped.
BA also improves one’s quality of life (QOL). However, researchers aren’t sure if BA directly improves QOL, or if it’s improved because the depression is better.
There are no medical risks to trying behavioral activation therapy. That being said, adapting how you live your life has the risk of being overwhelming when you start.
As with any therapy, emotions can come to the surface in unexpected ways. Your therapist will help you work through these feelings. It does get easier.
Behavioral activation therapy is often used alongside or instead of cognitive behavioral therapy (CBT). It’s generally less expensive than CBT, and studies show it’s just as effective.
It’s mainly used to treat depression but it can help with other mood disorders.
Behavioral activation uses the theory that actively doing the things that interest you will minimize your depressive feelings. With research that indicates that it works, it’s a solid treatment choice to consider for those looking for new ways to improve their depression.