Behavioral ActivationAn Everyday Insight tool

What behavioral activation is

6 min read. Updated .

Behavioral activation is a way of working on low mood by changing what you do, one small step at a time.

When mood drops, people tend to pull back. They see friends less, put off chores, skip things they used to enjoy, and spend more time resting or scrolling. That makes sense in the moment, since everything feels harder. Over time, though, doing less means fewer good moments, more things piling up, and more time alone with your thoughts. Mood stays low, and doing things feels even harder.

Behavioral activation works on that loop from the outside in. Instead of waiting until you feel like doing something, you plan small, specific activities, do them as planned, and pay attention to how they actually went. Some will be enjoyable. Some will give you a sense of getting something done. Some will just keep a day on track.

It’s one of the most studied approaches for low mood and depression, and therapists use it on its own or as part of cognitive behavioral therapy. This site and the app help with the parts you do between sessions or on your own. It doesn’t replace care from a professional.

Where it comes from

In the early 1970s, Peter Lewinsohn and a colleague asked people to keep a daily record of their pleasant activities and their mood. Mood tended to be better on days with more of the activities a person enjoyed, and people who were depressed were doing fewer of them. Lewinsohn suggested that low mood grows partly out of a drop in what a day gives back, the moments that feel good or go well.

Around the same time, Charles Ferster described depression in terms of what people do and what their actions lead to. He noticed how much of a depressed person’s day can go to escaping or putting off things that feel bad, and how little is left for things that might bring something good.

For years after that, planning activities was one part of cognitive therapy for depression. In 1996, Neil Jacobson and his colleagues took that therapy apart to test its pieces. One group got only the activation part. A second got activation plus work on automatic thoughts. A third got the full cognitive therapy. The three groups did about equally well, and behavioral activation came out of that study as a treatment of its own.

Two main versions

Most therapists today work from one of two manuals.

The first is Behavioral Activation for Depression by Christopher Martell, Sona Dimidjian, and Ruth Herman-Dunn. Martell and Dimidjian both worked with Jacobson. It looks closely at each person’s days, at what keeps low mood going for them, and especially at avoidance. Its tools include tracking activities and mood, scheduling, breaking tasks into steps, working on avoidance patterns, and shifting attention from going over things in your head to what’s in front of you.

The second is the brief behavioral activation treatment by Carl Lejuez and colleagues, revised in 2011. It’s shorter and more structured. You write what matters to you in five areas of life, list activities that fit, rank them from easiest to hardest, and plan them day by day, starting at the easy end.

This app draws on both. Its screens and wording were written for Everyday Insight, and it doesn’t reproduce either manual’s forms.

What it looks like in practice

The steps are easy to describe. Doing them on a low day is the hard part.

As the weeks go on, the work usually turns to avoidance, the things people stay away from that keep life small, and to getting unstuck from going over the same thoughts. Most courses of treatment end with a plan for keeping it going.

A first week

Say evenings and weekends have mostly gone to the couch since a hard stretch at work. A first week might have four plans. A ten-minute walk after dinner on Monday. A call to your sister on Wednesday. Paying the electric bill on Thursday. The Saturday market with a friend.

By Sunday, two of them happened. The walk felt like a chore the whole way around the block, and afterward you were glad you went. Paying the bill took five minutes and lifted something that had been nagging at you for days. The call didn’t happen, because by Wednesday night you were worn out. The market fell through when your friend got sick.

That’s an ordinary first week, and nothing in it is a failure. You found out that weeknights are a hard time for calls, so next week’s call moves to Sunday morning. The walk stays on the plan. Saturday gets something you can do on your own, in case plans with someone fall through again.

What studies have looked at

Behavioral activation has been tested in more than a hundred randomized trials, mostly with adults with depression working with a clinician. The largest review so far found that it did better than comparison conditions and about as well as other talking therapies.

In a large trial in England, behavioral activation delivered by junior mental health workers did no worse than cognitive behavioral therapy delivered by experienced therapists. England’s National Institute for Health and Care Excellence lists behavioral activation, one to one or in a group, among its treatments for depression in adults.

It has also been studied with older adults, in groups, online, and with Spanish-speaking Latino adults in the United States. A review that looked past depression found effects on anxiety as well.

These are findings about behavioral activation as a method, mostly with a trained person guiding it. This app hasn’t been studied, and it can’t tell whether anything is changing for you. If your mood has been low for weeks, or it’s getting in the way of work, home, or the people around you, “When to get more help” has signs to watch for and where to turn.

References

Helpful links

Everyday Insight’s tools are for education and personal reflection. They are not therapy or medical care, and they are not for emergencies. In an emergency, call 911. If you are in crisis in the United States, call or text 988. Mental health resources

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Next readHow low mood and doing less feed each other Why pulling back makes sense in the moment and how, over weeks, it adds up to a smaller life and lower mood.