Behavioral Activation (BA)
Behavioral activation therapy (BA) is an approach that combats depression by harnessing your body’s responses to an active, productive schedule. Mood is affected powerfully by our actions, but our actions are also influenced by our mood. Depression often cycles out of control because a low mood can cause one to withdraw from activities. In the absence of those fulfilling activities, a person’s mood worsens, causing them to withdraw further. Behavioral activation breaks this cycle by encouraging a person to resume an appropriate schedule of activities. Participation in these activities helps boost mood.
Avoidance and Depression
Depression is both the cause and effect of avoidance behavior. When a person experiences depression, it is common for them to start their avoidance behavior with activities they associate with the cause of their depression. For example, a person who is depressed about losing a job might start by avoiding looking for a new job. Perhaps a friend asks them about their job plans, which causes them discomfort, so they now avoid that friend, and perhaps all friends for fear that the job issue will come up. The person may also avoid thinking about the issue with distraction behaviors, some of which can be self-destructive and ultimately lead to more avoidance. .
These are just a few examples of avoidance behavior, which can take many forms, but with these examples, it’s easy to see how each behavior contributes to increased depression. By not looking for a new job, the person remains unemployed, which heightens feelings of worthlessness. Avoiding friends makes the person feel isolated and alone. Distraction behaviors may take up time, but contribute to a sense of purposelessness.
Treating Depression with Behavioral Activation
Behavioral activation grew out of cognitive behavioral therapy (CBT) when researchers learned that the behavioral component of therapy was highly effective for treating depression. For many people, altering behavior is sufficient to produce the desired results. However, for some people, behavioral activation can be used in conjunction with CBT to improve effectiveness.
Typically BA involves careful observation of behaviors, utilizing an activity log that also tracks mood. Specific homework helps frame the treatment sessions and assists in providing a model of structured activity between sessions.
As sessions progress, patients come to appreciate the progress they are making, but they also learn how to perform functional analyses of their actions so that they can determine when they are avoiding activity and how that makes them feel.
People with chronic depression may avoid a wide range of activities, a pattern that may be a cause of their depression in and of itself. But even if there is no cause for their avoidance behaviors, the effect is the same: increasing levels of depression.
One component that modern behavioral activation shares with acceptance and commitment therapy (ACT) is that the therapist works with an individual to ascertain what matters to the individual. These values are then used to help direct the scheduled activities to help improve positive emotions and reduce negative ones.
Behavioral activation therapy typically takes place over a limited number of sessions, but the positive results can be long-lasting.