By Christopher R. Martell PhD ABPP, Sona Dimidjian PhD, Ruth Herman-Dunn PhD, Peter M. Lewinsohn Phd
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Additional info for Behavioral Activation for Depression: A Clinician's Guide
The isolation was antecedent to feeling irritable and overwhelmed with worry, which kept her awake nights. She then stayed in bed later or distracted herself with computer games. Walking her dog when she was tired resulted in her being irritable with the dog, and that in turn made her feel guilty and less likely to walk the dog or even call friends. This cycle suggested that addressing the behavior of avoiding friends, passively playing computer games rather than facing the situations that made her anxious, and walking her dog all were important behaviors that could be antidepressant as she was guided through a plan for behavior change.
1 describe the basic guidelines to BA therapy. BA therapists firmly subscribe to the principle that changing what clients do will have a positive impact on their feelings (Principle 1). Therapists present clients with an initial case conceptualization and seek their buy-in for the treatment, using the framework that changes in life can lead to depression and that there are natural reactions to life changes that result in coping efforts that keep people stuck (Principle 2). By monitoring the client’s behavior and mood connections closely, therapists focus in on keys to behavior change by noticing what precedes and follows important behaviors (Principle 3), structuring and scheduling relevant activities (Principle 4), making small changes and building on those (Principle 5), and targeting behaviors that are likely to be naturally rewarded in the client’s environment (Principle 6).
As the description of Alicia’s case proceeds, you can follow the general course of her treatment with her BA therapist. Changes in Alicia’s life multiplied and her mood worsened as she began to disengage from people and activities that used to bring pleasure and stimulation to her life. Since moving into the smaller apartment, Alicia also had stopped inviting any of her friends to visit. She was embarrassed by the size of the unit and the cheap construction of the building. Her neighborhood was safe but in an undesirable section of town that she and her friends used to snicker at and referred to as “the runway” because it was near the airport.
Behavioral Activation for Depression: A Clinician's Guide by Christopher R. Martell PhD ABPP, Sona Dimidjian PhD, Ruth Herman-Dunn PhD, Peter M. Lewinsohn Phd