Understanding Behavioral Activation

Understanding Behavioral Activation in CBT

Think back to a time when you’ve felt down, had a friend suggest an activity you can do together, and felt better after doing so. That is proof of the power behavioral activation holds. This concept is one of several methods embedded in Cognitive Behavioral Therapy (CBT), and involves the use of enjoyable activities to enhance mood while promoting positive behaviors and habits.

When difficult life circumstances arise, people may have a hard time participating the way they used to – whether in activities they find meaningful or traditionally ‘fun’ events like social outings. Behavioral activation encourages people to seek out these opportunities to assist in reframing their thoughts. There are three main steps involved in behavioral activation that individuals should understand, as they will help them engage more fully in CBT and meet their goals.

Identify how mood and behavior are connected

There is a distinct connection between how someone feels and the way they act. Let’s say someone is not feeling as confident as they usually do. They may withdraw from others, have difficulty performing at work, and take less time to care for themselves. But changes in behavior look different from person to person, which is why developing self-awareness is one of the first steps of CBT. Behavioral activation starts with outlining the actions you take and the activities you choose when you are in a good mood.

You will also need to connect the dots between the way you act when you aren’t feeling quite as great. Taking this time for reflection allows you to know yourself better. Your therapist can help you understand what behaviors may be helping your mood and which actions may need to be adjusted to live a healthier lifestyle. You will then take this information to the next step, where you will identify other areas of importance to you.

Highlight important values and goals

Another aspect of knowing yourself (and using that knowledge to grow) is recognizing your strengths and what you find important in life. These values and assets will then be used to make a plan for getting you where you want to go. Many people may already be aware of what makes them stand out from the crowd and what areas they excel in, but want to focus on making their goals more defined and achievable. Others may be even earlier in the exploration process and may need help understanding their strengths. No matter what part of values clarification you need help with, this step is crucial in developing your interests and finding what motivates you.

For example, someone who is a visual thinker and highly organized may enjoy carving out some time each week to plan, write out, and color code their family’s events into a calendar. This activity is likely to be calming and enjoyable for someone with good organizational skills. The visual component also utilizes their sensory-based strengths and can even involve adding drawings, doodles, and other imagery. The act of making a calendar may not necessarily encourage a sense of mastery on its own. But you can easily incorporate other components to present a bit of a challenge, such as adjusting the size of the calendar to fit on a different sized piece of paper each week or experimenting with a calendar app that you’re not familiar with. If you enjoy physically challenging yourself and consider yourself to be creative, upcycling scrap wood into various home goods or even pieces of furniture is a suitable example of activities that provide equal parts mastery and enjoyment. You may start with a template for some items in the beginning and later choose projects that require you to think more critically to create something.

Plan to regularly participate in activities

Once you determine what your strengths are and how they can be used to instill better mental health, planning will help you regularly engage in tasks that are beneficial for you. It may seem that planning takes some fun out of these enjoyable activities, but developing consistency surrounding leisure, self-care, and other generally healthy tasks is a great way to create habits. In the early stages, consistent participation in enjoyable and personally meaningful activities will be the most helpful in shifting negative emotions and behaviors to positive ones. As you turn to these tasks on a more regular basis, you will build some momentum and can participate in them more naturally.

Some people may prefer to use alarms or calendar reminders for this purpose. Accountability buddies are another great option to help with consistent participation, as this method has the added benefit of social interaction. No matter what activity you choose and how you remind yourself to stay on track, know that your brain is reaping the benefits of anything that is enjoyable.

Important considerations

Evidence shows the dopaminergic system is heavily involved in behavioral activation, meaning consistent leisure participation leads to the release of neurotransmitters such as dopamine and serotonin. These neurotransmitters contribute to a steady mood, feelings of reward and motivation, and the regulation of bodily processes like sleep and metabolism. This is why healthy habits in other areas of our lives (such as rest and eating) have such an impact on our emotional health.

The key focus of behavioral activation is finding tasks that are enjoyable and personally meaningful to you. Some people may view going to the gym as both pleasurable and meaningful toward reaching their goals, whether fitness, mental health, or beyond that. However, others may lack the connection with this type of activity from the start, which means it will not have much of a positive impact on them. This is perfectly normal. Building better mental health is not a one-size-fits-all process and there is no shame in trying various activities before selecting the ones that resonate the most with you. Just keep track of each activity so you know which you may want to move forward with.

It can be overwhelming to start anything new. Just as consistency is important for the best results, so is support. The professionals at Eastside CBT are here each step of the way as you get started with behavioral activation during your CBT journey. Reach out today to learn more.


References:

  1. Malik, K., Ibrahim, M., Bernstein, A., Venkatesh, R. K., Rai, T., Chorpita, B., & Patel, V. (2021). Behavioral Activation as an 'active ingredient' of interventions addressing depression and anxiety among young people: a systematic review and evidence synthesis. BMC Psychology, 9(1), 150. https://doi.org/10.1186/s40359-021-00655-x

  2. Ciharova, M., Furukawa, T. A., Efthimiou, O., Karyotaki, E., Miguel, C., Noma, H., Cipriani, A., Riper, H., & Cuijpers, P. (2021). Cognitive restructuring, behavioral activation and cognitive-behavioral therapy in the treatment of adult depression: A network meta-analysis. Journal of Consulting and Clinical Psychology, 89(6), 563–574. https://doi.org/10.1037/ccp0000654

  3. Therapist Aid. (n.d.). Behavioral Activation. Retrieved from https://www.therapistaid.com/therapy-guide/behavioral-activation-guide

  4. Psychology Today. (2023). Behavioral Activation. Retrieved from https://www.psychologytoday.com/us/therapy-types/behavioral-activation

  5. Beck Institute. (2021). Behavioral Activation Tip. Retrieved from https://beckinstitute.org/blog/behavioral-activation-tip/

  6. Seo, D., Patrick, C. J., & Kennealy, P. J. (2008). Role of serotonin and dopamine System interactions in the neurobiology of impulsive aggression and its comorbidity with other clinical disorders. Aggression and Violent Behavior, 13(5), 383–395. https://doi.org/10.1016/j.avb.2008.06.003

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