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Behavioural activation for depression

David Veale is an honorary senior lecturer at the Institute of Psychiatry, King’s College London and a consultant psychiatrist in cognitive–behavioural therapy at the South London and Maudsley Trust (Centre for Anxiety Disorders and Trauma, The Maudsley Hospital, 99 Denmark Hill, London SE5 8AF, UK. Email: David.Veale{at}iop.kcl.ac.uk; website: http://www.veale.co.uk) and the Priory Hospital North London. He is currently President of the British Association of Behavioural and Cognitive Psychotherapies.

A formal therapy for depression, behavioural activation focuses on activity scheduling to encourage patients to approach activities that they are avoiding and on analysing the function of cognitive processes (e.g. rumination) that serve as a form of avoidance. Patients are thus refocused on their goals and valued directions in life. The main advantage of behavioural activation over traditional cognitive–behavioural therapy for depression is that it may be easier to train staff in it and it can be used in both in-patient and out-patient settings. This article describes the theory and rationale of behavioural activation, its evidence base and how to develop a formulation that guides the strategy.