Problem Area: Depression

2015 EST Status: Treatment pending re-evaluation Very strong: High-quality evidence that treatment improves symptoms and functional outcomes at post-treatment and follow-up; little risk of harm; requires reasonable amount of resources; effective in non-research settings

Strong: Moderate- to high-quality evidence that treatment improves symptoms OR functional outcomes; not a high risk of harm; reasonable use of resources

Weak: Low or very low-quality evidence that treatment produces clinically meaningful effects on symptoms or functional outcomes; Gains from the treatment may not warrant resources involved

Insufficient Evidence: No meta-analytic study could be identified

Insufficient Evidence: Existing meta-analyses are not of sufficient quality

Treatment pending re-evaluation

1998 EST Status: Strong Research Support Strong: Support from two well-designed studies conducted by independent investigators.

Modest: Support from one well-designed study or several adequately designed studies.

Controversial: Conflicting results, or claims regarding mechanisms are unsupported.

Strength of Research Support

Empirical Review Status
2015 Criteria
(Tolin et al. Recommendation)
Very Strong
Strong
Weak
Insufficient Evidence
Treatment pending re-evaluation
1998 Criteria
(Chambless et al. EST)
Strong
Modest
Controversial

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Brief Summary

  • Basic premise: When people get depressed, they may increasingly disengage from their routines and withdraw from their environment. Over time, this avoidance exacerbates depressed mood, as individuals lose opportunities to be positively reinforced through pleasant experiences, social activity, or experiences of mastery.
  • Essence of therapy: Behavioral Activation (BA) seeks to increase the patient’s contact with sources of reward by helping them get more active and, in so doing, improve one’s life context. One version of BA (BATD) is briefer, focusing specifically on identifying values that will guide the selection of activities. In addition to a focus on increasing activities, the second version of BA also works on identifying processes that inhibit activation/encourage avoidance and teaching problem solving skills.
  • Length: Full BA: 20-24 sessions; BATD: 8-15 sessions

Treatment Resources

Editors: Rachel Hershenberg, PhD; Stephanie Goldstein, BS

Note: The resources provided below are intended to supplement not replace foundational training in mental health treatment and evidence-based practice

Treatment Manuals / Outlines

Treatment Manuals
  • Brief Behavioral Activation Treatment for Depression (BATD; Lejuez, Hopko, & Hopko, 2000)
  • Brief Behavioral Activation Treatment for Depression: 10 Year Revision (Lejuez, Hopko, Acierno, Daughters, & Pagoto, 2011)
  • Brief Behavioral Activation Treatment for Depression – Revised (Lejuez & Hopko, 2013)
  • Behavioral Activation for Latinos (Kanter, Santiago-Rivera, Santons, Hurtado, West, Nagy, et al., 2014)
  • Group Behavioral Activation Treatment (Porter, Spates, & Smitham, 2004)
    • Client Manual
    • Therapist Manual
Books Available for Purchase Through External Sites

Training Materials and Workshops

Measures, Handouts and Worksheets

  • Review of Measures (Manos, Kanter, & Busch, 2010)
  • Behavioral Activation for Depression Scale
    • Behavioral Activation for Depression Scale – Short Form and Instructions
  • Environmental Reward Observation Scale
  • Reward Probability Index

Self-help Books

  • Building a Meaningful Life (BAML) Through Behavioral Activation
    • For information about the project and an overview, click here
    • To preview the program for free, sign up here 

Important Note: The books listed above are based on empirically-supported in-person treatments. They have not necessarily been evaluated empirically either by themselves or in conjunction with in-person treatment. We list them as a resource for clinicians who assign them as an adjunct to conducting in-person treatment.

Video Demonstrations

Video Repository
  • Derek Hopko role plays how to discuss the treatment rationale with a patient; to purchase the whole video, click here

Clinical Trials

Meta-analyses and Systematic Reviews

Other Treatment Resources