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What Is Behavioral Activation?

By Megan Shoop
Updated Feb 12, 2024
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Behavioral activation is a kind of therapy mainly used to treat those with chronic depression and post-traumatic stress disorder (PTSD). This kind of therapy generally examines a patient’s behavioral patterns for clues as to why he or she is depressed. Many behavioral activation therapists also search for actions that prevent the patient from functioning normally and contentedly in society. The next step usually involves discovering activities that the patient enjoys and finds fulfilling and comforting. The therapist usually helps the patient use these activities to overcome his or her internal blocks.

Many people who have experienced a traumatic event, or suffer from depression, avoid certain activities or have little motivation to extend themselves. In cases of PTSD, the patient may reject certain actions, situations, locations, and people that remind him or her of the event. This can have a minor to severe effect on the patient’s life. For instance, a PTSD patient who hates the smell of a certain cologne can usually avoid it and function more normally than a patient who avoids motorized transportation, like cars, buses, trains, and airplanes.

The same theory holds true for those who suffer from depression. These patients don’t necessarily avoid actions and places, but have little energy or desire to interact with others and be active. Behavioral activation therapy examines both patients to find things that they do enjoy doing, skills they have, and people or places they find rewarding. The therapist then helps each patient reconstruct his or her life around these things.

In a typical behavioral activation session, the therapist and patient may compile a list of acceptable, positive activities for the patient to perform. The therapist then helps the patient choose a certain number of these activities to incorporate into his or her daily life. The patient may only choose one or two activities in the first session, and then double or triple the number after several weeks. The point is to help restructure the patient’s emotional state by supporting him or her with positive experiences.

When the patient has completed all of the initial activities on the list, a behavioral activation therapist usually helps the patient add more. For a PTSD patient, this may involve completing a rewarding activity that includes something he or she normally avoids. For instance, in the above-mentioned situation, a therapist might suggest that the patient take a cab to a concert just a few blocks from his or her home. Gentle exposure and a positive outcome gradually help PTSD patients expand their comfort zones and become less restrained.

Depression patients may require a rewards system based within the therapy sessions. The therapist may come up with a token system, in which the patient completes a certain number of activities and receives something he or she wants. This works especially well with depressed children and teens because the parents can help by using the system at home.

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