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Global Mental Health

Behavioral Activation (BA)


Behavioral activation is a behavioral therapy that was originally developed for the treatment of depression in the USA. A brief 12-session version was developed in the early 2000's and has been studied for its impact on anxiety and other stress-related conditions, substance abuse, and HIV-medication adherence in the US and globally.


How it Works

BA is a client-centered, tailored approach in which the therapist helps the client identify and schedule healthy and rewarding activities (i.e. behaviors) related to the client’s self-identified personal values. Based on reinforcement theory, BA works by engaging participants in identifying promotive behaviors and reflecting back on emotional and cognitive changes through self-monitoring, planning, and accountability.

Our Study

Our global mental health group led a randomized controlled trial of BATD in Kurdistan, Iraq in collaboration with colleagues at the University of Maryland and the University of Massachusetts who provided the training, supervision, and implementation monitoring of the BATD intervention.  We completed a trial with adult torture and trauma survivors who were randomly allocated to receive individual BATD or be in wait-control condition.  Treatment was provided by 11 community mental health workers (CMHWs) working in rural health clinics; CMHWs were nurses, pharmacist assistants, or physician assistants employed by the clinics. All had completed high school and had varying amounts of post graduate and/or job specific training. Estimated effect sizes for depression and dysfunction were 0.60 and 0.55 respectively comparing BATD participants to all controls and 0.84 and 0.79 respectively compared to BATD controls only. 


For More Information about Behavioral Activation generally, please go to the APA website.  For questions specifically related to international application of BATD or for international adaptations or trainings, please contact Carl Lejuez at the University of Kansas