STAGES OF BEHAVIOURAL ACTIVATION

The difference here for BA is that you don’t just select activities to try out from your self-monitoring records . Rather , you pay particular attention to your functional analysis . In behavioural activation you select activities that you think will do one or two things; reverse the cycle of avoidance ( caused by negative reinforcement) , or set up situations that you find rewarding ( increase positive reinforcement)

Like most other CBT( COGNITIVE BEHAVIOURAL THERAPY) and related techniques , we adopt a scientific approach. This just means being systematic about your choices and curious about the results of your plans. You analyse your situation carefully.

You predict what will happen if you change something , you then try out the changes systematically . Finally, you review what happened and decide whether to press on or to change your strategy . This experimental attitude helps you make further decisions.

The great thing about activity scheduling is that you have a lot of choice. If one thing does not have the desired effect, you can try something else . Activity scheduling is not just about doing more of the things you have stopped doing . Nor is it a test of endurance . Activity scheduling can of course re-introduce things you have stopped doing. It can also introduce new things that are consistent with your personal values. It can be aimed at breaking the ‘ trigger-behaviour-consequence ‘ pattern. Sometimes you can plan activity into a regular schedule. Other times you can set up a plan to respond in a different way from usual when a specific trigger occurs. Activity scheduling can be used to break habits, introduce new behaviours and prevent avoidance. it can even help stop you ruminating about your problems. Let’s examine these choices one by one.

1- Reducing avoidance

When you first start using behavioural activation to overcome depression , you may want to concentrate on basic activities that are just not happening for you at the moment . You can reduce avoidance directly by increasing your daily routines.

Althought these will not necessarily be pleasurable , routines do provide you with a safe emotional anchor. Simple things such as a regular walk , doing something tidying and cleaning up dishes may not be the most pleasurable activities , but they can begin the process of activation.

In fact it is very important that you do not wait to feel ready to do these things. You do them now to help you feel better over time. This is the outside -in principle working. Nonetheless , it is still important to identify activities that make sense to you, and that you also find desirable or useful.

One opportunity to reduce avoidance is when you have identified something absolutely essential that you need to do. An example might be getting a roadworthiness certificate for a car (in the UK , an MOT). Although you might be finding it really difficult to motivate yourself to do this, if you do not do it the consequences could be even more serious and could include a fine or having penalty points put on your driving licence. In this case, you need to break out of your pattern of avoidance immediately to address this one specific issue .

2- Introducing alternative behaviours

If you have identified that some behaviours are not helpful , you can decide to substitute them with different ones. There are three types of these alternative behaviours,

1. You can choose activities that you know are more likely to be positively reinforcing. These are things that you can predict will make you feel better. In general , at least initially , these should be things that you already know you like to do. Walking, talking to friends , cooking a meal , making something , reading a newspaper – there are almost as many things on such a list as there are people in the world. We are all different and your activities should be the ones you like to do.

2- You might choose an alternative behaviour that disrupts a situation where you get depressed . Here we are less concerned about doing a positive action. We are more interested in not doing something that makes your mood worse. So, for example, if you know that sitting down alone in the morning causes you to feel low , you can decide to put the radio on, go for a walk or do some jobs around the house.

The point is that doing one of these things disrupts the vicious circle of sitting down and low mood. These disrupting behaviours do not have to be in themselves rewarding . The objective is to interrupt the trigger-behviour-consequence sequence.

3- Finally, you might choose a behaviour that is the direct opposite of something that causes your mood to be lower . Suppose you are avoiding some paperwork at home or at work and this is making you feel worse about yourself. You could choose to do the paperwork – maybe not at all at once, but at least you could make a start.

Another example you would be if you find listening to music to make you feel sad. You could turn the radio off, return to a different channel or get up and leave the room where the radio on . Here, the alternative behaviour is the exact opposite of what makes you feel down.