What is behavioral activation (BA) therapy for the treatment of major depressive disorder (clinical depression)?

Updated: Aug 06, 2020
  • Author: Jerry L Halverson, MD; Chief Editor: David Bienenfeld, MD  more...
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BA is based on early functional descriptions of depression by Lewinsohn [36] and Ferster [37] that emphasized the role of positive and negative reinforcement in depression, [121] suggesting that individuals with depression have deficient response-contingent positive reinforcement and engage in problematic avoidance behaviors. Modern BA treatments developed in response to a component analysis by Jacobson et al. [122] who found that the behavioral techniques in cognitive-behavioral therapy (CBT) were as effective as the full CBT package. While several different versions of BA exist, all emphasize the role of activity monitoring and activity scheduling in order to increase engagement in activities suggested to improve mood (see Kanter et al. for a review of specific tools used within different BA treatments [123] ). While early variants of BA emphasized activity scheduling that focused on increasing engagement in pleasant events (e.g., Lewinsohn [36] ), more recent versions haveemphasizedincorporating activities related to one’s values (e.g., Lejuez, Hopko, & Hopko, [124] ). Patients are typically given activity assignments to complete between sessions, with increasing difficulty over time. At times, activity assignments may be arranged along an activity hierarchy (e.g., Lejuez et al. [124] ). Mindfulness strategies may be incorporated to address rumination. [38]

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