In short Behavioral Activation (BA) is a treatment for depression that follows research indicating that changes in activity and engagement can improve mood. Common sense would tell us that people do things because they are motivated, and it is difficult to be motivated when a person is depressed, so doing things is difficult. Research also tells us, however, that motivation follows action rather than the other way around. Thus, the treatment is geared toward helping people identify activities that may prove to be antidepressant for them and systematically help them to increase activity in order to improve their mood and motivation will follow.
The BA model proposes that life events, which can include specific trauma or loss, biological predispositions to depression, or the daily hassles of life, lead to individuals experiencing low levels of positive reinforcement in their lives. Furthermore, many behaviors used to cope with negative feelings that make the individual feel better in the short run but are detrimental in the long-run increase through a process of negative reinforcement. It is natural for a person that feels sad and is no longer finding pleasure in activities that were previously enjoyed to attempt to cope by withdrawing socially, ceasing to engage in activities and “shutting down”. The problem is that such coping strategies do not help alleviate depression, they make it worse.
BA targets inertia. When depression zaps motivation, the BA approach is to work from the “outside-in”, scheduling activities and using graded task assignments to allow the client to slowly begin to increase their chance of having activity positively reinforced.
BA targets avoidance. Behavioral analytic theory recognizes that the outcome or function of a behavior is more important than the form of the behavior. Formally, for example, sitting on the front stoop of one’s house resting your head in your hands is always just that – sitting. However, you may be sitting there waiting for a friend to pick you up to go to a show or you may be sitting there to escape from a nasty argument with a partner. In those two instances “just sitting” serves very different functions. In the first it functions as an approach behavior, engaging in life. In the second it is an escape or avoidance behavior. Avoidance behavior has not been a primary target of most treatments for depression, in BA it is the primary target.
