Behavioral Activation

Medically Reviewed by: Marjorie Gies, M.D., Psychiatrist & Medical Director

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Behavioral Activation

Behavioral activation is a treatment option to improve your mental health. It’s one aspect of cognitive-behavioral therapy, but it can be used in isolation. Most of the medical research geared toward better understanding the use of behavioral activation and its therapeutic applications has focused on helping people with depression, particularly people who lose interest in their hobbies and things they previously enjoyed.

When things you previously loved no longer bring you joy, it can intensify existing symptoms of depression. Hobbies that you once loved, and activities that once cultivated social connections and boosted your self-esteem can play an essential role in helping you overcome depression. But when those same activities contribute to the problem at hand, you might consider using behavioral activation.

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What is Behavioral Activation Therapy?

Behavioral activation centers on your behavior, hence the name. This is an area of psychology that focuses on how your environment shapes your behavior and subsequently shapes your mental health. But, what is behavioral activation therapy and its theory?

Good Behaviors
The leading theory behind this therapy is that individuals can deliberately practice certain behaviors, and in so doing, they can activate a positive emotional response. Engaging in healthy and fulfilling activities that make you feel good on a biological level is considered a positive experience. When you engage in more and more positive experiences, you increase your activity level. All of this works together to boost your emotional state and help you overcome depression.

Bad Behaviors
Similarly, if you engage in activities that make you feel bad, then you’re more likely to engage in destructive activities because of how you feel at the moment. Suppose you, for example, sit down and eat an entire sleeve of Oreo cookies in direct response to feeling terrible about being overweight. In that case, you are more likely to continue that bad behavior since you are already in a negative state.

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Why Casa Serena Uses Behavioral Activation Treatment

Behavioral activation can be used to treat things like depression or addiction because it replaces addiction behaviors with healthier behaviors. The more you replace destructive behaviors with good ones, and the more you create those positive experiences, the more likely you are to repeat this pattern of behavior and walk away feeling healthier most of the time. At a Santa Barbara rehab like Casa Serena, our staff uses behavioral activation treatment because of the power it has to improve emotional states and reverse negative patterns of behavior.

Changes to the Brain

With drug and alcohol addiction, one of the biggest problems is the changes to your brain. Drugs and alcohol hijack your reward system, giving you significant boosts of happy chemicals that should be associated with pleasurable hobbies or activities like hanging out with friends, eating right, or exercising. Instead, you get those same feelings from using. With behavioral activation therapy, you can learn to pivot those behaviors back toward the healthier, happier activities and away from substance abuse.

The Facts

A 2018 randomized controlled trial found that using behavior activation therapy for a partial substance abuse treatment was effective. Of the hundreds of participants, participating in behavioral activation therapy resulted in significantly higher rates of abstinence for three months, six months, and 12 months after treatment. Participants had fewer adverse consequences from their substance abuse at the 12-month mark. They were able to reduce depressive symptoms and remain abstinent long after their residential treatment ended, no matter their condition or the severity of their addiction.

Our Process

So what is behavioral activation therapy, and what activities are there? The activities we integrate for behavioral activation therapy will vary from one person to another. So what your activities look like could be very different from other participants in the same rehab center. The overall goal is to help people increase positive feelings and associations with different activities.

Improving Positive Behaviors

Someone struggling with substance abuse and depression might have loved singing, but now they find it difficult to get up the motivation to sing with the choir, let alone just sing in their house. Eventually, they might stop singing altogether, and this reinforces the depressive symptoms of hopelessness and takes away an activity that has so many benefits psychologically, emotionally, and physically. So with our program, that same person might be encouraged to sing for just a few minutes, sing a line or two with a therapist or with another member. Each day they do a little bit more, reinforcing the idea that they are fully capable of doing it and hoping to improve physical activity, mood, and overall positivity.

Replacing Negative Behaviors

You might also work to replace negative behaviors. If you usually turn to alcohol when you are stressed, you can use behavioral activation treatment to work with our team and find an activity you can do for stress relief. That activity might be yoga, art therapy, music therapy, or other medications. These activities are not only pleasurable but help alleviate your stress and give you a positive replacement for previously negative behaviors.

Improving Relationships

Another aspect of our behavior activation treatment helps you improve the relationships you may have lost along the way. If you struggle with substance abuse or mental health disorders, you might pull away from those close to you and avoid social activities. This can exacerbate feelings of loneliness and intensify depression. The longer you avoid people, the more difficult it can be, which is why this type of therapy might include commitments to quality time spent with a family member, regular phone calls or meetings with friends, and even a weekly social engagement.

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What to Expect from Behavior Activation Treatment

When you come to our facility, our team will work with you to better figure out what your values are, what activities give you a sense of mastery or personal achievement, and what you like to do most.

It might take time to discover what these values are and what activities would be most meaningful for you throughout the course of your behavioral activation therapy. We might ask you to ponder questions like:

What matters most to you in life?
What is the one thing you would be devastated if you couldn’t do?
How would you live if you had nothing in your way?
Who do you look up to? What is it about them you like most?

Your personal values are what matter most to you. Personal values help you build a foundation of emotional resiliency, and they can guide you in determining what activities you should do and what positive rewards you can gain. Once we have a better understanding of your values, we can help create a list of activities that you can begin to integrate. For example:

If family is of great personal value to you, your behavioral activation therapy might include activities like:

Spending dedicated time with your family
Actively parenting
Communicating with your family on a scheduled basis

If social relationships are of value to you, your behavioral activation therapy might encourage you to:

End relationships that are harmful
Set up healthy boundaries with people in your life
Meet new people

If your local community or activism is an important value for you, behavioral activation therapy could include:

Requirements to attend community events
Activities where you help others in need
Volunteer efforts

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Our Women's Mental Health Treatment Center Can Help

At Casa Serena, we help people who are struggling with co-occurring mental health disorders in Santa Barbara. Too often, facilities focus exclusively on the physical recovery from substance abuse, but they fail to improve mental health disorders. Our Southern California women’s treatment process is collaborative. We have clinicians, therapists, and psychiatrists who work together to help you find a personalized plan. We understand that the symptoms of co-occurring mental health disorders can make addiction treatment complicated, which is why different treatment modalities might integrate evidence-based therapy like behavior activation treatment for your plan.

We can help you tackle things like generalized anxiety, depression, antisocial personality disorder, eating disorders, and even PTSD by integrating behavioral activation treatment into your plan. Let our team work with you to find supportive holistic treatment plans as part of your health and wellness program, your residential or outpatient treatment plan, your trauma or detox program, or your lifetime aftercare. Let Casa Serena help you tackle your mental health and substance abuse problems at the same time.

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