Peipert : Behavioral activation as an unguided single-session intervention
Behavioral activation as an unguided single-session intervention
Indiana University Bloomington
Lauren Rutter, PhD
Lorenzo Lorenzo-Luaces, PhD Indiana University Bloomington
Behavioral activation (BA) is an empirically supported treatment for depression. However, traditional mental health care (e.g., one-on-one psychotherapy with a professional) cannot address the public health burden of untreated mental disorders. Single session interventions (SSIs), which may not require the use of a professional, have the potential to address the public health burden of mental disorders by serving as a more accessible tool for mental health care. The Common Elements Toolbox (COMET) is an SSI delivered online and self-guided (e.g., without the guidance of a professional or paraprofessional). COMET contains CBT and positive psychology elements, including BA. It is unclear, however, how patients complete BA delivered as an unguided SSI.
Using data from an 8-week randomized controlled trial of COMET-SSI with online workers, we conducted a content analysis of the activities generated from the BA portion of the intervention. 409 participants brainstormed three possible activities, then choose one to schedule. Two experts in CBT used qualitative content analysis to code activity types into established BA themes. Discrepancies between raters were resolved through discussion until complete consensus was achieved. Additionally, we compared the self-generated activities to a BA dictionary using Linguistic Inquiry and Word Count (LIWC), an established natural language processing tool, to quantify the similarity of the self-guided BA content to those used in online text-based counseling sessions.
Results yielded 9 different activity types, including sedentary hobbies (41%), physical (29%), active hobbies (18%), social (6%), task-oriented (3%), psychological/emotional (1%), spiritual (0.6%), volunteering (0.2%), and academic (0.1%). LIWC analysis found an average lexicon overlap of 17% between the self-guided BA activities and those in the BA dictionary.
Implications of this work include providing more psychoeducation and specificity in what constitutes BA.
Translational/Human Health Impact:
Results suggest that there may be considerable differences between self-guided BA compared to traditional BA psychotherapy.