1. Behavioral activation
Tara Cothran, Crane Havens, Talbott Johnson, Logan Freeman, and Deanna Fairbourne

2. Psychoeducation
Highlight the relationship between emotions, thoughts, and behaviors
Acting “outside in vs. inside out”
When engaging in client behavioral activation it is often important to have an apt explanation of the process. This aids in both getting clients on board with the intervention as well as ensuring they understand the mechanisms behind it.

3. The symptoms of depression are often maintained through the cyclical nature of avoidance and withdrawal. It is important to explain this cycle to the client in relation to the cognitive triad. Thoughts and emotions can play a role in a lack of a desire to engage in prosocial behavior. In addition to this lack of engagement also leads to further negative thoughts and emotions creating a vicious cycle.
Cycle of Depression

4. Reversing the cycle Inside Out vs. Outside In Prevent avoidance
It is important to behave in the way you want to feel rather than the way you actually feel. After explaining the cognitive triad thoroughly to the client, you can discuss how changing behaviors can be an important step in breaking the cycle of negative thoughts, distressing emotions, and maladaptive behavior.

5. Implementing Behavioral activation
Pick multiple activities that are easy to implement, enjoyable for the client, and are preferably social. One way to do this is to discuss activities that the client previously enjoyed as well as activities that they may have been wanting to do.

6. Activity log
Clients should keep an activity log that records the process of behavioral activation. This log includes a description of the activity as well as a rating of mood before, during and after. It is important to record information as quickly as possible following an activity to ensure accuracy.

7. Identifying obstacles and measuring progress
Completion
Feelings and Thoughts
Obstacles
After the client goes home and works on their activity list, the following appointment should focus on how the activities went. The therapist will ask the client questions about whether or not they were able to complete all of the activities. If not, what obstacles stopped them, and problem solves how to overcome them in the future. Another important factor is the discussion of how they felt during and after the activity. This will hopefully help the client create a preferred activity list and be more cognizant of the relationship between mood and behavior.

8. Eat. Pray. activate
The therapist increases the level of activities in accordance with the progression of the client’s treatment. Eventually, it is the hope of the therapist, that the client will have an improved mood and have the self motivation to continue to engage in social activities. Once the cycle of depression is broken, more complex issues can be tackled.