Behavioural activation for depression: Efficacy, effectiveness and dissemination
Abstract
Background Depression being a prevalent psychobiological disorder across the world, there is a need to identify effective, evidence-based treatments that are time and cost-effective in an effort to increase the population's accessibility to treatments. Low-intensity interventions, such as guided self-help treatments, hold promise for the dissemination of evidence-based treatments. Behavioural activation, a component of cognitive-behavioural therapy, is receiving increasing attention and empirical support as a stand-alone psychological treatment for depression. This article reviews behavioural activation's theoretical foundations and efficacy in light of determining its potential as a low-intensity intervention.Method A systematic review of articles on low-intensity behavioural activation interventions for depression was conducted using the PsychInfo, Medline and Embase databases. Behavioural activation's potential for dissemination as a guided self-help treatment is discussed and future avenues of research are stressed.Limitations Studies on the efficacy of behavioural activation as a guided self-help treatment are very limited to date and there are significant variations among existing studies.Conclusions Based on the research literature, it can be concluded that behavioural activation could be a viable option as a low-intensity guided self-help psychological treatment for mild to moderate depression. Further research is required to better understand the optimal parameters and client-therapist characteristics of this form of low-intensity intervention.
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Behavioural activation is a CBT technique aimed to improve activity levels and may have caused similar changes.
“Behavioural activation is a CBT technique aimed to improve activity levels and may have caused similar changes (Chartier & Provencher, 2013).”
From “I don’t want to take buprenorphine for the rest of my life”: Acceptance and Commitment Therapy for a Client Struggling to Reduce Low-Dose Buprenorphine (a Hermeneutic Single-Case Efficacy Design) (2023) · cites this paper as Chartier & Provencher, 2013
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“Regarding BA, meta-analyses demonstrate that this subcomponent of cognitive-behavioral therapy (CBT) is in itself comparable to the efficacy of other psychotherapies for the treatment of mild to moderate depression, including fullpackaged CBT (Chartier & Provencher, 2013; Mazzucchelli et al., 2009; Sugarman, 2016).”
Self-citationAcceptability of a lay-delivered intervention for depression in senior centers
Raue, P. J., Dawson, A., Hoeft, T. J., Russo, J. E., Ferguson, D., Green, L., Petersky, C., & Kaplan, C. (2019) · Aging & Mental Health · doi:10.1080/13607863.2019.1698515 · Cited by 15 · see citing works
“A uthor M anuscript A uthor M anuscript A uthor M anuscript A uthor M anuscript Lichtenberg, 2009; Chartier & Provencher, 2013; Gallagher & Thompson, 1982; Meeks, Looney, Van Haitsma & Teri, 2008; Snarki et al., 2011; Thompson, Gallagher & Breckenridge, 1987).”
BackgroundDigital Behavioral Activation Interventions During the Perinatal Period: Scoping Review
Mancinelli, E., Dell’Arciprete, G., Pattarozzi, D., Gabrielli, S., & Salcuni, S. (2023) · JMIR Pediatrics and Parenting · doi:10.2196/40937 · Cited by 17 · see citing works
“Both the efficacy and effectiveness of in-person BA as a treatment specific for depression have been widely proven [31], and the literature also provides promising evidence regarding its efficacy in perinatal depression, both in terms of improved outcomes [29,32] and of engagement and satisfaction [33].”
BackgroundDo-it-Yourself Activities and Subjective Well-Being
Collier, A. F., Wayment, H. A., & Wolf, M. (2020) · International Journal of Applied Positive Psychology · doi:10.1007/s41042-020-00035-7 · Cited by 15 · see citing works
“…bring pleasure (e.g., McAndrew et al. 2017) and behavioral activation, the encouragement of becoming more active and engaged in life, is a useful intervention strategy for people experiencing dysphoria and depression (e.g., Chartier and Provencher 2013; Martin and Oliver 2018; Soucy et al. 2013).”
BackgroundProblem gambling during Covid-19
Frisone, F., Alibrandi, A., & Settineri, S. (2020) · Mediterranean Journal of Clinical Psychology · doi:10.6092/2282-1619/mjcp-2457 · Cited by 15 · see citing works
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“Some studies have reported beneficial effects of DSME programs on mental health outcomes [17], which could be due to behavioural activation that is known to help improve people’s mood and stress levels [18].”
BackgroundMancinelli, E., Magnolini, S., Gabrielli, S., & Salcuni, S. (2024) · JMIR Formative Research · doi:10.2196/58653 · Cited by 21 · see citing works
Chapter 7. Cognitive-Behavioral Theories
Leahy, R. L., Clark, D. A., & Dozois, D. J. A. (2022) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615375233.gg07 · Cited by 12 · see citing works
Azizan, A., & Justine, M. (2015) · Journal of Gerontological Nursing · doi:10.3928/00989134-20151124-01 · Cited by 12 · see citing works
Fronto-striatal activity predicts anhedonia and positive empathy subtypes
Mirabito, G., Taiwo, Z., Bezdek, M. A., & Light, S. N. (2019) · Brain Imaging and Behavior · doi:10.1007/s11682-019-00081-z · Cited by 11 · see citing works
“Specifically, one behavioral intervention—Behavioral Activation—has demonstrable efficacy equal to that of Selective Serotonin Reuptake Inhibitors (SSRI’s) in treating MDD (Soucy Chartier and Provencher 2013), a disorder that frequently features anhedonia as a prominent symptom.”
BackgroundElucidating the Cognitive Mechanisms Underpinning Behavioural Activation
Myles, L. A. M., & Merlo, E. M. (2022) · International journal of psychological research · doi:10.21500/20112084.5400 · Cited by 10 · see citing works
“…127 lives is inversely related to symptoms of depression, such that those with greater perceived control exhibit reduce depressive symptomology (Bjørkløf et al., 2016; Cheng et al., 2013; Crandall et al., 2018; Kleinberg et al., 2013; Myles et al., 2020; Myles et al., 2021; Volz et al., 2018).”
BackgroundShenton, N., Redmond, T., Kroll, L., & Parry, S. L. (2021) · Clinical Child Psychology and Psychiatry · doi:10.1177/13591045211031743 · Cited by 10 · see citing works
An Active Inference Model of the Optimism Bias
Fisher, E. L., Whyte, C. J., & Hohwy, J. (2025) · Computational Psychiatry · doi:10.5334/cpsy.125 · Cited by 9 · see citing works
L’activation comportementale : un outil simple et efficace dans le traitement de la dépression
Dondé, C., Moirand, R., & Carre, A. (2017) · L Encéphale · doi:10.1016/j.encep.2017.02.006 · Cited by 9 · see citing works
Shudo, Y., & Yamamoto, T. (2017) · PLoS ONE · doi:10.1371/journal.pone.0185221 · Cited by 9 · see citing works
Segovia, F. A. R., & Benuto, L. T. (2022) · Behavior Therapy · doi:10.1016/j.beth.2022.03.003 · Cited by 7 · see citing works
Volunteer-led behavioural activation to reduce depression in residential care: a feasibility study
Bryant, C., Brown, L., Polacsek, M., Batchelor, F., Capon, H., & Dow, B. (2020) · Pilot and Feasibility Studies · doi:10.1186/s40814-020-00640-y · Cited by 7 · see citing works
Mancinelli, E., Gabrielli, S., & Salcuni, S. (2024) · JMIR Human Factors · doi:10.2196/50098 · Cited by 5 · see citing works
“BA is an empirically supported behavioral intervention created to lessen depression symptoms [19-22]; it is based on the idea that a greater awareness of the mutual influence between behavior and emotion can ultimately encourage behavioral change by increasing participation in joyful and adaptive…”
BackgroundCooper, Z., Johnson, L. C. M., Patel, S. A., Sosale, A., Tandon, N., Anjana, R. M., Poongothai, S., Sridhar, G. R., Mohan, V., Chwastiak, L., et al. (2025) · Journal of General Internal Medicine · doi:10.1007/s11606-025-09810-1 · Cited by 4 · see citing works
“Behavioral activation is a brief, evidence-based approach that helps individuals with depression and chronic illness develop skills to re-engage in personally meaningful and valued activities 30,31 .”
The Heterogeneity of Empathy: Possible Treatment for Anhedonia?
Light, S. N. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00185 · Cited by 4 · see citing works
User-centred design of clinical dashboards for guided iCBT
Wake, J. D., Rabbi, F., İnal, Y., & Nordgreen, T. (2022) · Innovations in Systems and Software Engineering · doi:10.1007/s11334-022-00454-6 · Cited by 4 · see citing works
Patient Experiences and Opinions of a Behavioral Activation Group Intervention for Depression
O’Neill, L., Samaan, Z., McCabe, K., Tabak, T. A., Key, B. L., Litke, K., Whattam, J., Garrick, L., Chalmers, S. A., Xie, F., et al. (2018) · Research on Social Work Practice · doi:10.1177/1049731517749942 · Cited by 4 · see citing works
Reusable Data Visualization Patterns for Clinical Practice
Rabbi, F., Wake, J. D., & Nordgreen, T. (2020) · Communications in computer and information science · doi:10.1007/978-3-030-58167-1_5 · Cited by 4 · see citing works
“Behavioural activation [9] is a sometimes standalone component of CBT and involves the “scheduling of pleasurable activities to increase contact with sources of positive reinforcement” [15, p.”
BackgroundMedina, S., Forero, C. G., Sanabria‐Mazo, J. P., Rodríguez‐Freire, C., Navarrete, J., O'Daly, O. G., Howard, M. A., & Luciano, J. V. (2025) · Brain and Behavior · doi:10.1002/brb3.70380 · Cited by 3 · see citing works
“It is also a new form of CBT that focuses on the promotion of patterns of behaviors that break cycles of anhedonia and negative reinforcement, usually stemming from avoidance behaviors and lethargic lifestyle (Soucy Chartier and Provencher 2013; Walsh et al. 2021).”
Shepherd, K., Pritty, B., Tickle, A., & Moghaddam, N. (2023) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-021-00729-2 · Cited by 3 · see citing works
“Behavioural activation is a CBT technique aimed to improve activity levels and may have caused similar changes (Chartier & Provencher, 2013).”
MethodSaracino, R. M., Park, E. Y., Demirjian, C., Jutagir, D. R., McConnell, K. M., Schofield, E., Raue, P. J., Lejuez, C. W., & Nelson, C. J. (2024) · Journal of Geriatric Oncology · doi:10.1016/j.jgo.2024.101719 · Cited by 4 · see citing works
Segovia, F. A. R., & Benuto, L. T. (2023) · Behavior Therapy · doi:10.1016/j.beth.2023.05.011 · Cited by 3 · see citing works
Paquette, C., Vierling, A., Kane, L. F., Abrego, P. L., Benson, K., Jordan, E., Baucom, D. H., Zule, W. A., & Daughters, S. B. (2024) · Journal of Substance Use and Addiction Treatment · doi:10.1016/j.josat.2024.209490 · Cited by 3 · see citing works
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Reducing suicidal ideation in young adults: online tools to address perceived burdensomeness
Rainbow, C., Blashki, G. A., & Melvin, G. A. (2022) · Australian Psychologist · doi:10.1080/00050067.2022.2135983 · Cited by 3 · see citing works
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Gum, A. M., Jensen, C., Schonfeld, L. I., Conner, K. O., & Guerra, L. (2022) · Journal of Clinical Psychology in Medical Settings · doi:10.1007/s10880-022-09864-x · Cited by 2 · see citing works
“First, behavioral activation has a strong empirical evidence base across a variety of service settings and with diverse populations (Chartier & Provencher, 2013; Dimidjian et al., 2011; Stein et al., 2021; Sturmey, 2009), including evidence of its effectiveness as a standalone behavioral…”
BackgroundSchladitz, K., Seibel, A., Luppa, M., Riedel-Heller, S. G., & Löbner, M. (2024) · International Journal of Obesity · doi:10.1038/s41366-024-01654-9 · Cited by 3 · see citing works
The Persian Checklist of Pleasant Events (PCPE): Development, Validity and Reliability.
Bakht, S., haji, T. M., Shirvan, E. G., & Ekhtiari, H. (2015) · Europe PMC (PubMed Central) · Cited by 2 · see citing works
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Tata Laksana ‘Behavioral Activation’ untuk Menurunkan Tingkat Depresi pada Pasien Stroke
Jayati, I. S., & Hadjam, M. N. R. (2016) · Gadjah Mada Journal of Professional Psychology (GamaJPP) · doi:10.22146/gamajpp.9208 · Cited by 1 · see citing works
Comprehensive Treatment of Depression: As Simple as the A-B-C’S
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Psilocybin increases optimistic engagement over time: computational modelling of behavior in ratsPreprint
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The progression and management of depression and anxiety in chronic hepatitis C patients.
Stewart, B. J. (2015) · Adelaide Research & Scholarship (AR&S) (University of Adelaide)
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The Clinical Utility of the Concept of Mental Hygiene in the Behavioral Treatment of Depression
Carona, C., & Fonseca, A. (2021) · Clínica y Salud · doi:10.5093/clysa2021a8
“Behavioral activation (BA) is one of the most well-established, time-efficient psychological treatments for depression (Chartier & Provencher, 2013; Lorenzo-Luaces & Dobson, 2019; Stein et al., 2020).”
BackgroundTratamiento no farmacológico de la depresión
Esteban, S. (2013) · Evidencia actualizacion en la práctica ambulatoria · doi:10.51987/evidencia.v16i2.6167
Fillmore, D. (2014) · UTA ResearchCommons (University of Texas Arlington)
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Menurunkan Perilaku Maladaptif Pada Gangguan Skizoafektif dengan Behavioral activation
Maulida, T., & Prabowo, A. (2023) · Procedia Studi Kasus dan Intervensi Psikologi · doi:10.22219/procedia.v11i3.27385
CONSTRUÇÃO DE UM MANUAL DE AUTOCUIDADO PARA GESTANTES EM SITUAÇÃO DE RUA
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A UNIÃO HOMOAFETIVA À LUZ DO PROJETO DE LEI 5.167/09: UMA ABORDAGEM HISTÓRICO-JURÍDICA E SOCIAL
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PRÁTICAS DE CUIDADOS ÀS POPULAÇÕES EM SITUAÇÕES DE VULNERABILIDADES
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TERAPIA COGNITIVO-COMPORTAMENTAL NO CUIDADO À MULHERES EM CONTEXTO DE VULNERABILIDADE
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The Role of Therapeutic Thoughts
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- Authors
- Soucy Chartier, I., & Provencher, M. D.
- Affiliations
- Institut Universitaire en Santé Mentale de Québec (CA)
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2013-03
- Volume
- 145
- Issue
- 3
- Pages
- 292-299
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2080439366
- Cited by
- 90
- References
- 66
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 13 · 2023: 4 · 2022: 8 · 2021: 9 · 2020: 12 · 2019: 9 · 2018: 4 · 2017: 8 · 2016: 1 · 2015: 9 · 2014: 3 · 2013: 2
- FWCI
- 1.04
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- behavioral activation, depression, guided self-help, low-intensity intervention, dissemination of evidence-based treatment, treatment efficacy, mild to moderate depression, cognitive behavioral therapy
- MeSH terms
- Depression, Humans, Self Care, Meta-Analysis as Topic, Cognitive Behavioral Therapy, Treatment Outcome
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