Behavioural activation therapyWe talk a lot in this blog about the cyclical nature of depression and anxiety – how the way you feel controls the way you act, and the way you act then controls the way you feel.

This cycle can easily spiral downwards when it comes to mental health because our emotions are intrinsically linked to our actions and when we feel “down” we act “down”.

A lot of our work with those who come to Robert St Clinic because of depression is tied into Cognitive Behavioural Therapy (CBT) – indeed we’ve recently discussed how CBT is now recommended as the first-line treatment for depression – where clients are taught skills and behaviours to challenge the negative thoughts that help propel this spiral downwards.

But a study just out of the UK and published in The Lancet has shown that the behavioural side to CBT may be just as useful as having it combined to the more convoluted psychological treatments. This side is known as behavioural activation or BA – and the study of 440 adults (half of whom received CBT and half BA) from throughout the UK found that the outcomes of treatment over 12 months were largely indistinguishable. And, what’s more, it’s cheaper:

“We found that BA, a simpler psychological treatment than CBT, can be delivered by junior mental health workers with less intensive and costly training, with no lesser effect than CBT. Effective psychological therapy for depression can be delivered without the need for costly and highly trained professionals.”

So how does BA work?

Simply put, emotions play an important part providing us with a map to our behaviour – happiness lets us know when we’ve done something beneficial; sadness lets us know when we’ve lost something we value; anxiety lets us know to be wary of dangers; and guilt lets us act considerately within society.

But our behaviour also impacts on our emotions – the more positive things we do, the happier we become; the more we avoid danger, the more anxious we become; the more we avoid those things we value, the sadder we become; and the more we lack consideration for others, the more guilty we become.

Depression can lead to inactivity and lack of personal interaction – and that in turn leads to a feeling of having lost touch with your emotions, and, hence, that spiral of hopelessness and withdrawal.

BA aims to stop this cycle by increasing the valued behaviour that makes us happier by having a client take note of those activities and then raising their frequency in day-to-day life.

For example, someone suffering with depression would:

  1. Recognise, monitor and record how depression fluctuates with different activities.
  2. Note activities associated with better moods.
  3. Schedule and carry out more of those “positive” activities, recognising the balance between pleasure and achievement-based activities.
  4. Provide positive rewards for completing positive activities.

The simple thesis to BA is that behaviour has to change before emotions can change – and its very simplicity makes it an ideal treatment plan for those who feel their depression is overwhelming.

For more information about depression services at Robert St Clinic and our varied range of treatments and practitioners, call us on 09 973 5950, email us via or leave a message via the website.