In yesterday's post "Targeting behavioural activation better both for decreasing depression and increasing wellbeing (first post)", I suggested that there are at least three (and probably many more) interesting ways that could make behavioural activation (BA) both more targeted and potentially more effective.  I wrote about aiming BA particularly to "problem solve" triggering factors (especially interpersonal ones) that seemed to have contributed to deterioration in a subject's psychological state.  I also mentioned the recent Mazzuchelli et al paper "Behavioral activation interventions for well-being: a meta-analysis"  showing how helpful BA can also be at building wellbeing as well as treating depression.

There are a series of meta-analyses showing that "behavioural activation" (BA) is a good treatment for depression and that it is as effective as best-established approaches like full cognitive behavioural therapy - see, for example, last year's paper by Trevor and colleagues "Behavioral activation treatments for depression in adults: a meta-analysis and review".  BA involves encouraging increased engagement in enjoyable activities.  Subjects may be asked to keep a record of their daily activities and associated feelings - for example, feelings of achievement and enjoyment.  The downloadable charts and handouts further down this website's "Problem solving and behavioural activation" page illustrate this well-known approach.

I read a lot of research.  When I find an article of particular interest I download it to my bibliographic database - EndNote - which currently contains over 14,300 abstracts. 

I wrote a post yesterday introducing some of the ideas and research on implementation intentions.  Today I extend this in more practical how-to-do-it directions:

what are implementation intentions?
"Goal intentions" involve aiming for some desired future outcome.  They are of the form "I intend to attain goal X".  Unfortunately we know only too well that making such intentions does not necessarily mean that we will reach our goals.  As the old saying goes "There's many a slip between cup and lip".  A major review of 422 relevant research studies found that goal intentions accounted for only an average 28% of the variance in achievement of successful outcome (Sheeran, 2002).  Subsequent research suggests that even this figure of 28% is an overestimate (Webb and Sheeran, 2006).  The conclusion is clear - forming a strong goal intention to achieve some desired outcome in no way guarantees success. 

Here are a series of forms, questionnaires and handouts that I use regularly in my work.  The problem solving diagram is a recurring theme - both at the start of therapy and as a sheet to return to when reviewing and considering additional therapeutic options.  Other sheets are classic variants on the tools used by many cognitive behavioural therapists - with occasional alternatives and additions, that I've come up with over the years, thrown in as well.

This is the 5^th in a series of blog posts about the 10^th September SIGN draft guideline day on "Non-pharmacological management of depression."  On the day, the