Behavioral activation therapy for return to work in medication-responsive chronic depression with persistent psychosocial dysfunction

Hellerstein, David J.; Erickson, Greg; Stewart, Jonathan W.; McGrath, Patrick J.; Hunnicutt-Ferguson, Kallio; Reynolds, Stephen A.; O'Shea, Donna; Chen, Ying; Withers, Amy; Wang, Yuanjia

doi:10.1016/j.comppsych.2014.10.015

Cited by 20 publications

(15 citation statements)

References 48 publications

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“…Though the efficacy of BA as a treatment for depression is well-established, only recently have clinical trials of BA begun to include measures designed to assess treatment mechanisms. The bulk of studies that do assess mechanistic constructs do so with self-report measures (e.g., Armento & Hopko, 2007; Daughters et al, 2008; Dimidjian et al, 2017; Hellerstein et al, 2015; Hershenberg et al, 2018; Weinstock et al, 2011). Though self-report measures provide critical insight into mechanisms of action, there may be mechanisms of action that cannot be accurately perceived (and thus reported) by patients, including subtle changes in behavior and perception that may be best measured by behavioral and/or biological means.…”

Section: Resultsmentioning

confidence: 99%

“…Empirical studies provide some support for this model. BA is associated with increased self-reported goal-directed behavior, as measured by the Behavioral Activation for Depression Scale (BADS; Kanter, Mulick, Busch, Berlin, & Martell, 2007) across several trials (e.g., Dimidjian et al, 2017; Hellerstein et al, 2015; Hershenberg, Smith, Goodson, & Thase, 2018; Weinstock, Munroe, & Miller, 2011). Likewise, BA is associated with increased frequency of rewarding experiences, as measured on the Environmental Reward Observation Scale (EROS; Armento & Hopko, 2007) in diverse samples, including substance users (Daughters et al, 2008), veterans (Hershenberg et al, 2018), students (Armento, McNulty, & Hopko, 2012), and pregnant women (Dimidjian et al, 2017).…”

Section: Activation As the Mechanism Of Change In Bamentioning

confidence: 99%

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Reward Network Modulation as a Mechanism of Change in Behavioral Activation

et al. 2018

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Behavioral Activation (BA) is a contemporary third-wave psychosocial treatment approach that emphasizes helping individuals become more active in ways that are meaningful to them as a means of improving mood and quality of life. BA has been designated as a well-established, validated treatment for depression by the American Psychological Association following several decades of accumulated empirical support demonstrating that BA techniques successfully reduce depression symptoms and produce other desirable outcomes across a variety of populations and contexts. The purported mechanism of change underlying BA treatment lies in increasing activation, which in turn increases contact with positive reinforcement thereby reversing the cycle of depression. Current studies are further investigating how increasing activation and subsequent contact with mood reinforcers can influence mood and behavior. Specifically, there is growing evidence that BA modifies function of reward-related networks in the brain, and that these changes are associated with clinical improvement. Herein, we provide a brief history of BA, describe the primary components of BA treatment, and describe BA’s purported mechanisms of change at behavioral, neural, and subjective activation levels. We present limitations as well as gaps in the current state of knowledge regarding mechanisms of action of BA.

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Section: Resultsmentioning

confidence: 99%

Section: Activation As the Mechanism Of Change In Bamentioning

confidence: 99%

Reward Network Modulation as a Mechanism of Change in Behavioral Activation

et al. 2018

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“…Numerous investigations have supported the use of behavioral activation as an effective treatment for depression [ 31 ]. There are also indications that behavioral activation might improve return-to-work outcomes in individuals with chronic depression [ 32 ]. The behavioral activation component of the treatment program focused on goal setting, structuring and scheduling activities, increasing success and achievement experiences, and problem-solving.…”

Section: Methodsmentioning

confidence: 99%

Risk-targeted behavioral activation for the management of work disability associated with comorbid pain and depression: a feasibility study

Sullivan

Wideman

Gauthier³

et al. 2022

Pilot Feasibility Stud

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Purpose The purpose of the present study was to conduct a preliminary evaluation of the feasibility and impact of a risk-targeted behavioral activation intervention for work-disabled individuals with comorbid pain and depression. Methods The design of the study was a single-arm non-randomized trial. The sample consisted of 66 work-disabled individuals with comorbid pain and depression. The treatment program consisted of a 10-week standardized behavioral activation intervention supplemented by techniques to target two psychosocial risk factors for delayed recovery, namely, catastrophic thinking and perceptions of injustice. Measures of pain severity, depression, catastrophic thinking, perceived injustice, and self-reported disability were completed pre-, mid-, and post-treatment. Satisfaction with treatment was assessed at post-treatment. Return to work was assessed at 6-month follow-up. Results The drop-out rate was 18%. At treatment termination, 91% of participants indicated that they were “very” or “completely” satisfied with their involvement in the treatment program. Significant reductions in pain (Cohen’s d = 0.71), depression (d = 0.86), catastrophic thinking (d = 1.1), and perceived injustice (d = 1.0) were observed through the course of treatment. In multivariate analyses, treatment-related reductions in depression, catastrophic thinking, and perceived injustice, but not pain, contributed significant unique variance to the prediction of return-to-work outcomes. Conclusions Risk-targeted behavioral activation was found to be an acceptable and effective intervention for work-disabled individuals with comorbid pain and depression. The findings suggest that interventions targeting psychosocial risk factors for pain and depression might contribute to more positive recovery outcomes in work-disabled individuals with comorbid pain and depression. Trial registration ClinicalTrials.gov: NCT0517442. Retrospectively registered.

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“…Numerous investigations have supported the use of behavioral activation as an effective treatment for depression [26]. There are also indications that behavioral activation might improve return to work outcomes in individuals with chronic depression [27]. The behavioral activation component of the treatment program focused on goal setting, structuring and scheduling activities, increasing success and achievement experiences, and problemsolving.…”

Section: Methods Participantsmentioning

confidence: 99%

Risk-Targeted Behavioral Activation for the Management of Work-Disability Associated with Co-Morbid Pain and Depression: A Feasibility Study

Sullivan

Wideman

Gauthier³

et al. 2022

Preprint

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Purpose The purpose of the present study was to conduct a preliminary evaluation the feasibility and impact of a risk-targeted behavioral activation intervention for work-disabled individuals with co-morbid pain and depression. Methods The design of the study was a single arm non-randomized trial. The sample consisted of 66 work-disabled individuals with co-morbid pain and depression. The treatment program consisted of a 10-week standardized behavioral activation intervention supplemented by techniques to target two psychosocial risk-factors for delayed recovery, namely, catastrophic thinking and perceptions of injustice. Measures of pain severity, depression, catastrophic thinking, perceived injustice and self-reported disability were completed pre-, mid-, and post-treatment. Satisfaction with treatment was assessed at post-treatment. Return to work was assessed at 6-month follow-up. Results The drop-out rate was 18%. At treatment termination, 91% of participants indicated that they were ‘very’ or ‘completely’ satisfied with their involvement in the treatment program. Significant reductions in pain (d = .71), depression (d = .86), catastrophic thinking (d = 1.1) and perceived injustice (d = 1.0) were observed through the course of treatment. In multivariate analyses, treatment-related reductions in depression, catastrophic thinking, perceived injustice, but not pain, contributed significant unique variance to the prediction of return-to-work outcomes. Conclusions Risk-targeted behavioral activation was found to be an acceptable and effective intervention for work-disabled individuals with co-morbid pain and depression. The findings suggest that interventions targeting psychosocial risk factors for pain and depression might contribute to more positive recovery outcomes in work-disabled individuals with co-morbid pain and depression.

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Behavioral activation therapy for return to work in medication-responsive chronic depression with persistent psychosocial dysfunction

Cited by 20 publications

References 48 publications

Reward Network Modulation as a Mechanism of Change in Behavioral Activation

Reward Network Modulation as a Mechanism of Change in Behavioral Activation

Risk-targeted behavioral activation for the management of work disability associated with comorbid pain and depression: a feasibility study

Risk-Targeted Behavioral Activation for the Management of Work-Disability Associated with Co-Morbid Pain and Depression: A Feasibility Study

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