Behavioral Activation (BA)

ideal candidates

• People whose depression involves avoiding things and pulling away from others
• Those preferring structured, practical, homework-based therapy
• Primary care or low-intensity care settings needing brief, scalable therapy

screening required

• Depression severity (e.g., PHQ-9)
• Suicide risk assessment
• Rule out mania/psychosis

Preparation

Procedure

1. Activity monitoring to map mood–behavior links.
2. Values clarification and selection of meaningful domains (work, relationships, health, recreation).
3. Activity scheduling with graded task assignment and hierarchy building.
4. Functional analysis (A-B-C) of avoidance patterns; replace with approach behaviors.
5. Problem-solving barriers; incorporate exposure to avoided situations.
6. Review, reinforce successes, and adjust plan weekly.

practitioner

• Licensed therapists trained in BA/CBT; clinicians in collaborative care models

facility

• Outpatient clinics
• Primary care
• Telehealth
• Group settings

Concurrent Therapies

• Medication management
• ACT or CBT skills
• Problem-Solving Therapy
• Exercise programs

Key Studies

• Dimidjian et al. (2006): BA as effective as antidepressant medication and superior to CBT for severe depression.
• Ekers et al. (2014, 2016): BA effective in primary care and low-intensity delivery; non-inferior to CBT.
• Jacobson et al. (1996): Component analysis showing behavioral activation components account for much of CBT’s efficacy.