THERAPY

What is behavioural activation therapy?

Kat Nicholls
By Kat Nicholls,
updated on May 23, 2023

Group of friends hiking in the woods

Could behavioural activation help improve mental health? Here we explore what it is, how it can help and tips to try it yourself

Have you ever thought about your environment, how it shapes your actions and how these actions make you feel? This is what behaviourism, a brand of psychotherapy, looks at. From this school of thought, behavioural activation emerged.

Developed in the 70s by Peter Lewinsohn and his research team, behavioural activation was created to help those with depression. Most research has focused on how it can help depression, but it’s now also thought to be helpful for those with anxiety and substance abuse issues.

Today, behavioural activation is often used within cognitive behavioural therapy (a therapy that looks at the way behaviours and thoughts affect one another) but it can also be used as a stand-alone therapy.

The premise of this approach is that when we practise certain behaviours it can ‘activate’ a more positive state of mind. To put it simply, it’s about doing something you might not feel like doing, because you know it’ll help you feel better.

Those with depression will know how it can affect their ability to enjoy activities, prompting them to retreat and isolate themselves. The problem is, when you retreat in this way, the less helpful behaviours can make your symptoms of depression worse, trapping you in a vicious cycle.

Behavioural activation aims to break that cycle.

Who can it help?

As mentioned, behavioural activation has mostly been seen to support those with depression, anxiety and addiction. Though, it can also be a great form of self-care for those without a formal diagnosis. Helping to lift you from a rut and move from languishing to thriving.

If you do have a mental health condition, it’s important to consider what further support you may need. While behavioural activation can go a long way in helping you to change your behaviours, you may need additional forms of help to address the thinking (cognitive) side of things. This is why many therapists combine cognitive and behavioural approaches.

If you struggle with panic attacks, sudden changes in mood or thoughts about suicide, it’s best to do this work with the guidance of a mental health professional.

How does it help?

Behavioural activation looks to increase the sense of pleasure and meaning you experience. It can be easy to forget how good something makes us feel. By picking out and scheduling these activities, we can prompt ourselves to experience positive emotions and feel more motivated to keep doing them.

Some people also use this approach to replace less helpful behaviours. For example, instead of reaching for a bottle of wine at the end of a stressful day, behavioural activation can help you pick up a different way to relieve stress, like calling a friend.

Improving connection is also an important element of behavioural activation therapy. Mental health conditions like depression can often lead us to feel alone and misunderstood. Behavioural activation can help us step out of our self-imposed isolation and reconnect with those we care about.

How to try behavioural activation

If this is all sounding interesting to you, here are the steps to try behavioural activation for yourself.

Step 1: Monitor your activities

The first part of the process is to record what you do and how you feel. This is called activity monitoring and it can help you understand how your mood is affecting you, and what may be affecting your mood.

Try to note down everything you do for at least a week, and rate your mood at the time (0 being very low and 10 being really happy). Can you notice any patterns? Are there any activities that tend to make you feel better or worse? You can then start putting together a list of activities that make you feel good and activities that make you feel worse.

Try to keep in mind the longer-term effects, for example that bottle of wine at the end of a stressful day may feel good in the moment, but how did it affect you that night and the following morning?

Step 2: Set your values

What helps behavioural activation work well, is doing activities that align with your values. Take some time to think about what’s important to you in life and what behaviours could help you incorporate your values.

For example, if you value adventure, what activities could help you explore new experiences? Injecting your values into your behaviours can give you that sense of meaning that helps lift your mood and generate purpose.

If some of your behaviours can help you feel like you’re improving something (such as learning a new skill) this can be a brilliant way of feeling more accomplished and capable.

At this point, you should have a list of activities that make you feel good. Imagine this as a menu of sorts as we head onto the next step.

Step 3: Schedule your activities

Now it’s time to schedule your activities for the week. It can be helpful to consider how difficult an activity might feel so you can break up the tougher activities into more manageable steps, or ensure you aren’t trying to do too many difficult activities in a short space of time.

When it comes to scheduling your activities, try to be SMART about them and ensure they are:

  • Specific (what exactly will you do?)
  • Measurable (how long will you do it for?)
  • Attainable (is it possible?)
  • Relevant (how does it relate to your values?)
  • Time-bound (when will you do it?)

Step 4: Review your experience

After you’ve been through a week or so of activities, make some space to reflect on how it went. Did anything feel harder than you thought? Did you struggle to stick with the schedule?

It can be easy to criticise ourselves if we don’t stick to a plan, but remember that sometimes... life gets in the way. Try to be kind to yourself and consider what changes could make your schedule more doable in the future.

Regular reviews can help you spot new patterns in your mood and may reveal when it’s time to switch up an activity. This is an ongoing process of discovering what works for you and what doesn’t.

Tips to get the most from behavioural activation

  • Write down why you’re doing this and put it somewhere you’ll see it every day as motivation.
  • Have a variety of activities to choose from to stop you from getting bored.
  • Start slowly with easier tasks that feel doable and work your way up.
  • Get support from loved ones or a professional to hold you accountable.
  • Celebrate your achievements when you do an activity.

This may all sound quite simplistic and perhaps even obvious at first glance, but actually doing the things to help us feel better is often easier said than done. Behavioural activation offers us a framework so we have the best chance of honouring our promises to ourselves and becoming more proactive in our mental wellness.

Will you be giving it a try?

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