Behavioral activation

The only weird times back in the beginning was when I was remote and everybody else wasn't and they would have meetings and I would be on the TV screen like, hey guys, hey guys.

But, you know, I think that just the nature of getting to have meetings and getting to kind of really be intentional again about having purpose and connection together, you know, kind of, and I think values, right? So like we go back to values based, I'm still, I'm hearkening back to the behavioral activation podcast we had.

That, you know, when we at CDP have the shared value of promoting evidence based practice and that sort of constantly really kind of pulls us together and we want to be able to provide trainings and support around that.

There's this sort of like shared mission that I think helps build community because that's a value that we have.

That makes sense.

Yeah.

Well, so just for our listeners sake, the episode that Jenna was referencing is episode seven of this season with Shannon Blakey talking about behavioral activation, but I thought about that too because I think, so I have an experience I can share maybe that is related to that.

Story time with Kevin.

no matter what, and having some kind of morning activity, rituals, things that you do, that's very helpful.

And that does tie into the concept of behavioral activation, which is evidence-based treatment for depression, where the fact of simply, in short, setting goals and meeting them, even if they're small, and getting some movement in the body getting some activity in there.

Doing that on a regular basis can help boost and treat the depression.

Not boost the depression, boost the mood.

If you have early awakening frequently enough that enforcing a steady wake time isn't going to help your sleep-wake cycle, then that's when medications are probably indicated.

Absolutely.

Now, I do want to go into a little bit more detail about behavioral activation because I do think it's probably the simplest, most important thing you can teach in a short period of time.

So the concept, as you mentioned, is you really want to build a life of meaning and you want to engage in activities that make you feel better.

Okay.

The last one is then we move to behavioral activation.

So attention training is really helpful and is so important, but you have to marry it with this third step, which is behavioral activation, and this is where you actually re-engage in activities.

So if you're sitting there and your depression has you laying on the couch and you can't get up, you've practiced mindfulness, and now you've put your attention on the moment, we still need to break the cycle by getting you up off the couch and into your daily routine.

You can't stay on the couch.

But it will not help you break the pattern of depression.

When I have patients with depression, we actually create what we call an activity schedule, where we set a timer where they wake up every day at the same time, and they have routines that they practice even though depression is screaming at them that there's no point and you might as well lay on the couch and, uh, you know, everybody hates you and you're no good.

You're gonna do it anyway, right? You've, you've been practicing compassion, you've been practicing attention control, and now you're gonna practice behavioral activation by engaging in your day-to-day life.

Okay.

The pivot in behavioral activation isn't simply telling them to snap out of it.

The mechanism of change relies on testing a very specific hypothesis, which is that action can precede motivation.

Action precedes motivation.

Right.

This is where we step into the next room of our architectural model.

Beck realized that behavioral activation alone wasn't enough if the patient's cognitive processing was fundamentally distorted.

And here's where it gets really interesting.