Behavioral Activation

Background

For all of us, it is important to stay engaged in positive, rewarding, and meaningful activities on a daily basis. This healthy habit makes natural sense yet can be difficult to manage when we are stressed or have physical, emotional, or cognitive health challenges.

Behavioral Activation is a psychological treatment approach that helps us connect with and routinely involve ourselves in personally rewarding activities. Many mental health problems can make it challenging to concentrate on, engage in, and appreciate positive experiences. This is sometimes called reward dysregulation by scientists and may involve parts of the brain that process emotions and stress reactions. First developed and still used as a very effective treatment strategy for depression, clinical research now shows that this approach can also help with a range of mental health concerns such as posttraumatic stress disorder (PTSD), anxiety, chronic pain, eating disorders, distressed relationships, and others.

Importantly, Behavioral Activation treatment involves a therapeutic strategy that helps individuals of all ages (children, teens, young adults, adults, older adults) and across diverse cultural contexts and heritages. This means that Behavioral Activation is considered a research-supported means of helping people from a wide range of ethnic/racial and religious backgrounds, along with individuals who identify as LGBTQ+, are veterans, have low income, and live in rural areas. Because this treatment approach is always tailored to what matters for each person, research shows that Behavioral Activation helps diverse individuals in Western societies as well as across the globe.

Treatment

Behavioral Activation is a low-intensity, short-term treatment approach that usually consists of 10 or fewer sessions. Behavioral Activation involves specific actions and steps that go beyond “staying busy” or “doing nice things for yourself.” Specific steps are taken to create and maintain daily lives that include fulfilling, valuable, and meaningful activities. Activities are often tailored to individuals’ personal values and do not necessarily need to cost any money. Even seemingly small rewarding activities can have a powerful, positive impact as they build over time. Developing the habit of engaging in rewarding activities may retrain our brains to better pay attention to the positive aspects of each day and improve overall life satisfaction.

Behavioral Activation may be offered by therapists for individuals, families, or groups and can also be provided in community settings by health workers and volunteers. Sometimes members of one’s chosen family or friends are included to help support these efforts. It is also possible for some people to use Behavioral Activation on their own, such as with the help of a book (i.e., bibliotherapy) or by using smartphone apps or web-based interventions.

Behavioral Activation commonly involves a series of steps:

Keep track of daily activities and mood for a specific limited period of time.
Review notes to figure out which activities improve mood and quality of life.
Consider restarting past rewarding activities (that may have been stopped for a variety of reasons).
Look over developed lists of positive activities to get new ideas.
Proactively schedule and plan for rewarding activities each day.
Develop specific strategies to build motivation and overcome procrastination and avoidance.
Troubleshoot and resolve problems that get in the way of rewarding activities.
Continue this approach over time so that it becomes a healthy daily habit.

Resources for Increasing Positive Activities Across the Lifespan

(in addition to others available by searching online)
For children through age 11:

Pleasant Events Calendar for Kids from the Greater Good Science Center of UC Berkeley

For teens aged 12–18:

Behavioral Activation with Adolescents: A Clinician’s Guide

For adults aged 18–25:

Big List of Pleasurable Activities

For adults aged 26–64:

Coming soon!

For adults aged 65 and older:

California Older Person’s Positive Experience Scale-Revised (COPPES-R)

Prepared By ABCT members from the University of Missouri-St. Louis:
Julia Fitzpatrick
Arielle Guillod
Lia Jackson
Ann Steffen

Related Fact Sheets

What is Cognitive Behavior Therapy?

Behavior Therapy and Cognitive Behavior Therapy are types of treatment that are based firmly on research findings. These approaches aid people in achieving specific changes or goals.

Changes or goals might involve:

A way of acting: like smoking less or being more outgoing;
A way of feeling: like helping a person to be less scared, less depressed, or less anxious;
A way of thinking: like learning to problem-solve or get rid of self-defeating thoughts;
A way of dealing with physical or medical problems: like lessening back pain or helping a person stick to a doctor’s suggestions.

Behavior Therapists and Cognitive Behavior Therapists usually focus more on the current situation and its solution, rather than the past. They concentrate on a person’s views and beliefs about their life, not on personality traits. Behavior Therapists and Cognitive Behavior Therapists treat individuals, parents, children, couples, and families. Replacing ways of living that do not work well with ways of living that work, and giving people more control over their lives, are common goals of behavior and cognitive behavior therapy.

How to Get Help

If you are looking for help, either for yourself or someone else, you may be tempted to call someone who advertises in a local publication or who comes up from a search of the Internet. You may, or may not, find a competent therapist in this manner. It is wise to check on the credentials of a psychotherapist. It is expected that competent therapists hold advanced academic degrees. They should be listed as members of professional organizations, such as the Association for Behavioral and Cognitive Therapies or the American Psychological Association. Of course, they should be licensed to practice in your state. You can find competent specialists who are affiliated with local universities or mental health facilities or who are listed on the websites of professional organizations. You may, of course, visit our website (www.abct.org) and click on “Find a CBT Therapist”

The Association for Behavioral and Cognitive Therapies (ABCT) is an interdisciplinary organization committed to the advancement of a scientific approach to the understanding and amelioration of problems of the human condition. These aims are achieved through the investigation and application of behavioral, cognitive, and other evidence-based principles to assessment, prevention, and treatment.