By Christopher R. Martell PhD ABPP, Sona Dimidjian PhD, Ruth Herman-Dunn PhD, Peter M. Lewinsohn Phd
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Additional resources for Behavioral Activation for Depression: A Clinician's Guide
She had ceased to engage in a behavior that was previously rewarding to her. Alicia also gained about 15 pounds and felt out of shape. She would think about taking the dog for a walk and then talk herself out of going. She spent much of her time distracting herself with computer games or reading even though she knew she needed to find employment. When she had taken the lower-paying temporary job and moved into a small apartment, not only did she feel guilty about keeping her dog cooped up, but also her guilt contributed to avoiding her friends.
Near the end of therapy the structure of the sessions includes a focus on consolidating gains and planning for relapse prevention. After a course of BA the therapist and client will be able to anticipate triggers for behaviors that increase depressive symptoms and develop a plan for alternative activities that can help the client to cope in these situations. BA is also characterized by a number of key structural and stylistic strategies. For instance, in her second session with Alicia, Beth expressed genuine warmth and interest in Alicia’s experience.
In contrast, this is a distinct difference in BA, where activity is encouraged hopefully to bring the client into contact with positive reinforcers that will maintain or increase further antidepressant activity. Both CT and BA ask clients to engage in behavioral experiments. However, in BA the client is asked to conduct experiments to evaluate the outcome, impact on mood, impact on goals, and so forth. In CT, clients are asked to conduct “experiments” in order to test their depressive assumptions and expectations.