Behavioral activation

Children and young people with depression tend to withdraw from and avoid engaging in activities. Behavior activation (BA) assumes that doing more, including more pleasurable and rewarding activities, is therapeutic. Behavior activation can be used as a standalone treatment or as a component of a package of care. In this chapter, we describe the different types of behavior activation including Washington BA (Adolescent Behavioral Activation Program, A-BAP) and Brief Behavioral Activation Treatment for Depression (Brief BA). We then summarize the current evidence with reference to published systematic reviews and recent trials. BA requires a shared rationale for treatment; we describe and illustrate ways to introduce the BA approach to children, young people, and families. We discuss strategies for increasing engagement and collaboration, including goal-setting, social support, and incentives and then illustrate what A-BAP and Brief BA might look like in practice through a case example. We conclude by considering some of the challenges that practitioners may face when using BA, with suggestions of how these may be overcome.