Practitioner Development

Behavioral activation for the treatment of atypical depression: a pilot open trial.

Weinstock et al. (2011) · Behavior modification 2011
★ The Verdict

Sixteen weeks of behavioral activation cut depression and lifted functioning in adults with atypical depression, and later studies show the same recipe works for cancer survivors and people with intellectual disabilities.

✓ Read this if BCBAs in outpatient mental-health or medical clinics who see adults with mood issues.
✗ Skip if Practitioners working only with children or with severe problem behavior unrelated to mood.

01Research in Context

01

What this study did

Amore et al. (2011) ran an open pilot with ten adults who had atypical depression.

Clients met a therapist for sixteen weekly outpatient sessions of behavioral activation.

No control group was used; everyone received the treatment.

02

What they found

Depression scores dropped and daily functioning improved by the end of the sixteen weeks.

All ten participants stayed in the study, suggesting the plan was acceptable.

03

How this fits with other research

Lejuez et al. (2001) wrote the first manual for brief behavioral activation. Amore et al. (2011) simply followed that manual with a new group—adults with atypical depression.

Fernández-Rodríguez et al. (2021) later tested the same idea in cancer survivors using a randomized design. Their RCT showed BA still beats wait-list, proving the 2011 results hold up under tighter controls.

Boudreau et al. (2015) moved BA to adults with intellectual disabilities and added carer coaching. Outcomes stayed strong, showing the method stretches beyond the original atypical-depression sample.

04

Why it matters

If you treat adults with mood disorders, you now have a low-cost, sixteen-session playbook that works for atypical depression and has since succeeded with cancer and ID populations. Start with the Lejuez et al. (2001) manual, schedule one rewarding activity per client this week, and track mood before and after.

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Pick one valued activity with your client, set a specific day and time, and review mood ratings at the next visit.

02At a glance

Intervention
other
Design
pre post no control
Sample size
10
Population
other
Finding
positive

03Original abstract

Psychosocial interventions for atypical depression (AD) have been relatively ignored in the clinical research literature, despite evidence that the atypical subtype of major depression is marked by earlier age of onset, longer duration of mood episode, greater symptom severity, and poorer response to pharmacologic treatment. Given the symptom profile of AD, which is characterized by mood reactivity, psychomotor slowing, and interpersonal withdrawal, the authors argue that a behavioral activation (BA) intervention may be particularly well suited to this population. As an initial exploration of this hypothesis, the current study presents preliminary outcome data from 10 outpatients with AD who participated in an open pilot trial of BA over a 16-week period. Overall, results provide encouraging preliminary support for the feasibility, acceptability, and efficacy of BA for AD, with significant reductions in depressive symptoms and associated improvements in functional impairment and BA level. Study results are discussed in the context of existing treatments for AD, and areas for future treatment development are highlighted.

Behavior modification, 2011 · doi:10.1177/0145445511405646