Behavioural activation

Also known as Behavioral activation · BA · Activity scheduling · BATD · Behavioural activation treatment for depression · TRAP TRAC

Exam-exhaustive fellowship reference on behavioural activation for depression — functional model (Ferster, Lewinsohn), Jacobson dismantling, contemporary BA and BATD protocols, TRAP/TRAC technique, Dimidjian/Dobson RCTs, COBRA non-inferiority, meta-analyses and Cochrane, non-specialist delivery, combination with antidepressants, CASC/MEQ skills. FRANZCP-primary, globally tagged.

high16 referencesUpdated 26 July 202611 min readVerification in progress

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10 MCQs

Meet the patient

A 52-year-old accountant has been off work for nine weeks. He gets up at noon, sits on the sofa in his dressing gown, watches the news loop twice, and goes back to bed. He tells you he will "start trying again" when he feels more like himself. His PHQ-9 is 19. He tried an SSRI for two weeks and stopped because he felt nothing.^[1]^[14]

The registrar heard "I'll start when I have the energy" and booked him for cognitive therapy in three months. The examiner's question is one field built itself around: what if waiting for motivation is exactly what is keeping him depressed?^[8]^[14]

References16Show

[1]Dimidjian S, Hollon SD, Dobson KS, et al. Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression J Consult Clin Psychol, 2006.PMID 16881773
[2]Dobson KS, Hollon SD, Dimidjian S, et al. Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the prevention of relapse and recurrence in major depression J Consult Clin Psychol, 2008.PMID 18540740
[3]Jacobson NS, Dobson KS, Truax PA, et al. A component analysis of cognitive-behavioral treatment for depression J Consult Clin Psychol, 1996.PMID 8871414
[4]Gortner ET, Gollan JK, Dobson KS, Jacobson NS Cognitive-behavioral treatment for depression: relapse prevention J Consult Clin Psychol, 1998.PMID 9583341
[5]Richards DA, Ekers D, McMillan D, et al. Cost and Outcome of Behavioural Activation versus Cognitive Behavioural Therapy for Depression (COBRA): a randomised, controlled, non-inferiority trial Lancet, 2016.PMID 27461440
[6]Ekers D, Webster L, Van Straten A, Cuijpers P, Richards D, Gilbody S Behavioural activation for depression; an update of meta-analysis of effectiveness and sub group analysis PLoS One, 2014.PMID 24936656
[7]Ekers D, Richards D, Gilbody S A meta-analysis of randomized trials of behavioural treatment of depression Psychol Med, 2008.PMID 17903337
[8]Ferster CB A functional anlysis of depression Am Psychol, 1973.PMID 4753644
[9]Cuijpers P, van Straten A, Warmerdam L Behavioral activation treatments of depression: a meta-analysis Clin Psychol Rev, 2007.PMID 17184887
[10]Lejuez CW, Hopko DR, Hopko SD A brief behavioral activation treatment for depression. Treatment manual Behav Modif, 2001.PMID 11317637
[11]Lejuez CW, Hopko DR, Acierno R, Daughters SB, Pagoto SL Ten year revision of the brief behavioral activation treatment for depression: revised treatment manual Behav Modif, 2011.PMID 21324944
[12]Uphoff E, Ekers D, Robertson L, et al. Behavioural activation therapy for depression in adults Cochrane Database Syst Rev, 2020.PMID 32628293
[13]Ekers D, Richards D, McMillan D, Bland JM, Gilbody S Behavioural activation delivered by the non-specialist: phase II randomised controlled trial Br J Psychiatry, 2011.PMID 21200079
[14]Dimidjian S, Barrera M Jr, Martell C, Muñoz RF, Lewinsohn PM The origins and current status of behavioral activation treatments for depression Annu Rev Clin Psychol, 2011.PMID 21275642
[15]Kanter JW, Manos RC, Bowe WM, Baruch DE, Busch AM, Rusch LC What is behavioral activation? A review of the empirical literature Clin Psychol Rev, 2010.PMID 20677369
[16]Mazzucchelli TG, Kane RT, Rees CS Behavioral activation interventions for well-being: A meta-analysis J Posit Psychol, 2010.PMID 20539837