Behavioural activation therapy for depression in adults

Uphoff, Eleonora; Ekers, David; Robertson, Lindsay; Dawson, Sarah; Sanger, Emily; South, Emily; Samaan, Zainab; Richards, David; Meader, Nick; Churchill, Rachel

doi:10.1002/14651858.cd013305.pub2

Cited by 48 publications

(59 citation statements)

References 156 publications

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“…Behavioural Activation (BA) is being trialled because it has been shown to be as effective as cognitive-behavioural (CBT) therapy in high-income settings (37)(38)(39). BA is easier to deliver than CBT since it does not require extensive training or complex counselling skills.…”

Section: The Insika Yomama Interventionmentioning

confidence: 99%

An evaluation of a combined psychological and parenting intervention for HIV-positive women depressed in the perinatal period, to enhance child development and reduce maternal depression: Study Protocol for the Insika Yomama Cluster Randomised Controlled Trial

Rochat

Dube

Herbst

et al. 2021

Preprint

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Background: The combination of poverty, HIV and depression in the perinatal period represents a major public health challenge in many Southern African countries. In some areas, up to a third of HIV-positive women experience perinatal depression. Perinatal depression is associated with negative effects on parenting and key domains of child development including cognitive, behavioural and growth, especially in socio-economically disadvantaged communities. Several studies have documented the benefits of psychological interventions for perinatal depression in low- and middle-income countries, but none have evaluated an integrated psychological and parenting intervention for HIV-positive women using task-sharing. This randomised controlled trial aims to evaluate the effect of a home-based intervention, combining a psychological treatment for depression and a parenting programme for perinatally depressed HIV-positive women. Methods: This study is a cluster-randomised controlled trial, consisting of 48-60 geospatial clusters. A total of 528 pregnant HIV-positive women aged ≥16 years who meet the criteria for depression on the Edinburgh Postnatal Depression Scale (EPDS, score ≥9)) are recruited from antenatal clinics in rural KwaZulu-Natal, South Africa. The geospatial clusters are randomised on an allocation ratio of 1:1 to either the intervention or Enhanced Standard of Care. The intervention group receives 10 home-based counselling sessions by a lay-counsellor (4 antenatal and 6 postnatal sessions) and a booster session at 16 months. The intervention combines Behavioural Activation for depression with a parenting programme, adapted from the UNICEF/WHO Care for Child Development programme. The ESoC group receives two antenatal and two postnatal support and advice telephone calls. The co-primary outcomes are child cognitive development at 24 months assessed on the cognitive sub-scale of the Bayley Scales of Infant Development-Third Edition and maternal depression at 12 months measured by the EPDS. Analysis: The primary analysis will be a modified Intention-to-Treat analysis. The primary outcomes will be analysed using mixed-effects linear regression. Discussion: If this treatment is successful, policymakers could use this model of mental health-care delivered by lay-counsellors within HIV treatment programmes to provide more comprehensive services for families affected by HIV.

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Section: The Insika Yomama Interventionmentioning

confidence: 99%

An evaluation of a combined psychological and parenting intervention for HIV-positive women depressed in the perinatal period, to enhance child development and reduce maternal depression: Study Protocol for the Insika Yomama Cluster Randomised Controlled Trial

Rochat

Dube

Herbst

et al. 2021

Preprint

Self Cite

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“…One such effective psychotherapeutic intervention for depression is behavioral activation (BA). The empirical evidence for BA is both extensive and convincing; it can be offered either as a stand-alone treatment or within the setting of cognitive behavioral therapy (CBT) [11][12][13]. BA is based on Lewinsohn et al's [14,15] theory of depression, which purports that when a person is depressed, they tend to engage less in pleasant or meaningful activities, resulting in them experiencing less pleasure, which, in turn, leads to an increased depressed mood, and so on.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Through BA, patients learn from self-monitoring their everyday activities and related mood that the way they behave affects the way they feel, while conversely, the way they feel affects the way they behave [11,12,16]. Therapists motivate their patients to schedule and engage in everyday pleasant activities [12,17]. Patients are informed that engaging in these activities may not lead them to immediately experience greater pleasure and that experiencing pleasure may not enhance their mood straightaway.…”

Section: Introductionmentioning

confidence: 99%

“…Patients are informed that engaging in these activities may not lead them to immediately experience greater pleasure and that experiencing pleasure may not enhance their mood straightaway. Rather, they are told that this is a process that requires time and that positive results will follow in due course as they continue to engage in pleasurable activities [12,17]. The circle of BA, as it is referred to in Lewinsohn et al's [14,15] model is shown in the right panel of Figure 1.…”

Section: Introductionmentioning

confidence: 99%

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Examining the Theoretical Framework of Behavioral Activation for Major Depressive Disorder: Smartphone-Based Ecological Momentary Assessment Study

Genugten¹,

Schuurmans²,

Hoogendoorn³

et al. 2021

JMIR Ment Health

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Background Behavioral activation (BA), either as a stand-alone treatment or as part of cognitive behavioral therapy, has been shown to be effective for treating depression. The theoretical underpinnings of BA derive from Lewinsohn et al’s theory of depression. The central premise of BA is that having patients engage in more pleasant activities leads to them experiencing more pleasure and elevates their mood, which, in turn, leads to further (behavioral) activation. However, there is a dearth of empirical evidence about the theoretical framework of BA. Objective This study aims to examine the assumed (temporal) associations of the 3 constructs in the theoretical framework of BA. Methods Data were collected as part of the “European Comparative Effectiveness Research on Internet-based Depression Treatment versus treatment-as-usual” trial among patients who were randomly assigned to receive blended cognitive behavioral therapy (bCBT). As part of bCBT, patients completed weekly assessments of their level of engagement in pleasant activities, the pleasure they experienced as a result of these activities, and their mood over the course of the treatment using a smartphone-based ecological momentary assessment (EMA) application. Longitudinal cross-lagged and cross-sectional associations of 240 patients were examined using random intercept cross-lagged panel models. Results The analyses did not reveal any statistically significant cross-lagged coefficients (all P>.05). Statistically significant cross-sectional positive associations between activities, pleasure, and mood levels were identified. Moreover, the levels of engagement in activities, pleasure, and mood slightly increased over the duration of the treatment. In addition, mood seemed to carry over, over time, while both levels of engagement in activities and pleasurable experiences did not. Conclusions The results were partially in accordance with the theoretical framework of BA, insofar as the analyses revealed cross-sectional relationships between levels of engagement in activities, pleasurable experiences deriving from these activities, and enhanced mood. However, given that no statistically significant temporal relationships were revealed, no conclusions could be drawn about potential causality. A shorter measurement interval (eg, daily rather than weekly EMA reports) might be more attuned to detecting potential underlying temporal pathways. Future research should use an EMA methodology to further investigate temporal associations, based on theory and how treatments are presented to patients. Trial Registration ClinicalTrials.gov, NCT02542891, https://clinicaltrials.gov/ct2/show/NCT02542891; German Clinical Trials Register, DRKS00006866, https://tinyurl.com/ybja3xz7; Netherlands Trials Register, NTR4962, https://www.trialregister.nl/trial/4838; ClinicalTrials.Gov, NCT02389660, https://clinicaltrials.gov/ct2/show/NCT02389660; ClinicalTrials.gov, NCT02361684, https://clinicaltrials.gov/ct2/show/NCT02361684; ClinicalTrials.gov, NCT02449447, https://clinicaltrials.gov/ct2/show/NCT02449447; ClinicalTrials.gov, NCT02410616, https://clinicaltrials.gov/ct2/show/NCT02410616; ISRCTN registry, ISRCTN12388725, https://www.isrctn.com/ISRCTN12388725

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Psychological treatments for depression and anxiety in dementia and mild cognitive impairment

Orgeta

Leung

López‐Martínez

et al. 2022

Cochrane Database of Systematic Reviews

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Behavioural activation therapy for depression in adults

Abstract: Trusted evidence. Informed decisions. Better health.

Cited by 48 publications

References 156 publications

An evaluation of a combined psychological and parenting intervention for HIV-positive women depressed in the perinatal period, to enhance child development and reduce maternal depression: Study Protocol for the Insika Yomama Cluster Randomised Controlled Trial

An evaluation of a combined psychological and parenting intervention for HIV-positive women depressed in the perinatal period, to enhance child development and reduce maternal depression: Study Protocol for the Insika Yomama Cluster Randomised Controlled Trial

Examining the Theoretical Framework of Behavioral Activation for Major Depressive Disorder: Smartphone-Based Ecological Momentary Assessment Study

Psychological treatments for depression and anxiety in dementia and mild cognitive impairment

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