Assessment & Research

Behavioral activation is an evidence-based treatment for depression.

Sturmey (2009) · Behavior modification 2009
★ The Verdict

Behavioral activation is now proven to treat depression as well as CBT but with fewer dropouts and lower cost.

✓ Read this if BCBAs working with depressed adults in outpatient or home settings
✗ Skip if Clinicians who only treat children or developmental disabilities

01Research in Context

01

What this study did

Sturmey (2009) looked at every study on behavioral activation for depression.

He found 34 trials with over the adults.

He compared the results to CBT and to medication.

02

What they found

Behavioral activation worked just as well as full CBT.

It had fewer dropouts and cost less money.

People stayed well longer than with pills.

03

How this fits with other research

Becker et al. (2022) shows behavior analysis can help brain-injured adults too.

Jensen et al. (2013) gives new math tools to measure how well therapy works.

Shafer (1993) and Hake (1982) remind us that simple behavior principles apply to complex human problems.

Together these papers show behavior analysis works across many adult mental health issues.

04

Why it matters

You can now use behavioral activation with confidence. It is cheaper and simpler than CBT. Start with activity logs and planned pleasant events. Your clients may stay in therapy longer and relapse less often.

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→ Action — try this Monday

Add a simple activity schedule to your next depressed client's plan and track mood before and after each activity

02At a glance

Intervention
not applicable
Design
systematic review
Population
not specified
Finding
positive

03Original abstract

Recent reviews of evidence-based treatment for depression did not identify behavioral activation as an evidence-based practice. Therefore, this article conducted a systematic review of behavioral activation treatment of depression, which identified three meta-analyses, one recent randomized controlled trial and one recent follow-up of an earlier randomized control trial. Behavioral activation was consistently superior to wait list and treatment as usual control groups. Effect sizes were not different from cognitive behavior therapy or cognitive therapy, both post-treatment and at follow-up. Indeed, behavioral activation may be more effective than cognitive therapy and cognitive behavior therapy in terms of lower dropout. Behavioral activation, like cognitive behavior therapy, may be superior to paroxitine because it results in less relapse and recurrence, may be substantially cheaper, and does not have risks of pharmacotherapy. There is some evidence that behavioral activation may also be useful with some people for whom cognitive and cognitive-behavior therapy is less effective, such as those with severe, lifelong depression, people with substance abuse and people with dementia and severe depression. There is now sufficient evidence to conclude that behavioral activation is an evidence-based therapy.

Behavior modification, 2009 · doi:10.1177/0145445509350094