Guideline SupportedCBT lineageBehavioural

Behavioural Activation(BA)

Last evidence review: January 20268 printable resources

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Overview

Behavioural Activation is a structured psychological therapy that focuses on increasing engagement in meaningful activities to improve mood. It is grounded in behavioural models of depression and emphasises action before motivation — the principle that waiting to feel better before doing things keeps people stuck.

What this therapy focuses on

BA targets avoidance and withdrawal, helping people reconnect with activities linked to pleasure, meaning, and accomplishment. Rather than working primarily with thoughts (as in full CBT), BA works directly with what people do and how that affects how they feel.

What sessions are usually like

Session length: 30–60 minutes

Frequency: Weekly

Time-limited: Yes (commonly 8–16 sessions)

Between-session work: Activity planning, monitoring, and tracking mood alongside activities

Session profile

Duration: 30–60 minutes
Frequency: Weekly
Typical course: 8–16 sessions
Between sessions: Activity monitoring, scheduling, and mood tracking

Common uses and suitability

What problems it is commonly used for

DepressionLow mood associated with chronic illnessPost-depressive relapse preventionWithdrawal and inactivity linked to grief or loss

Who this therapy may suit best

  • People feeling stuck or withdrawn
  • Those who find cognitive approaches overwhelming or unhelpful
  • Individuals preferring action-based, practical therapy
  • People early in treatment who need momentum

When it may need adapting or may not be suitable

  • Severe anhedonia may require additional scaffolding
  • Active suicidality requires integrated risk management
  • Physical health limitations may require adapted activity planning

Where this therapy may not be enough

BA may not be sufficient for complex depression with significant cognitive distortions, personality difficulties, or relational trauma. It does not directly address thought content or relational patterns.

What happens in therapy

Activity Monitoring

Tracking what you do each day and how it affects your mood, so you can see patterns.

Values-Based Activity Scheduling

Planning activities based on what matters to you, not just what feels easy.

Graded Task Assignment

Breaking larger tasks into smaller, manageable steps so you can build momentum gradually.

TRAP/TRAC

Noticing when you are stuck in a pattern of avoidance (TRAP) and choosing an alternative coping response (TRAC).

Evidence Base

Guideline support

Strong. BA is recommended by NICE (NG222) for depression. The COBRA trial (Richards et al., 2016) demonstrated that BA delivered by junior mental health workers was non-inferior to CBT delivered by more experienced therapists, supporting both its effectiveness and cost-effectiveness.

Strength of evidence

Strong for depression. Multiple RCTs and meta-analyses demonstrate effectiveness comparable to full CBT for depression.

Limitations

Evidence is strongest for depression; less evidence for anxiety disorders as a standalone treatment. The simplicity of BA may be insufficient for complex presentations requiring cognitive or relational work.

Evidence claims by condition

DepressionGuideline SupportedAdults

BA is a recommended talking therapy for depression that helps by increasing activities that improve mood.

Resources & Printables

Practitioner & Training Notes

Typical professional background

Mental health professionals including psychological wellbeing practitioners, therapists, and psychologists.

Recognised training routes

Often embedded within CBT training programmes. Standalone BA training available. The COBRA trial demonstrated effective delivery by junior staff with appropriate supervision.

Registration considerations

Typically held within broader CBT or mental health registrations.

Source Registry

Depression in adults: treatment and management (NG222)
NICEGuidelineUKChecked: 2026-01-28

Link and cite; do not reproduce large sections verbatim.

Last evidence review: January 2026. All sources are verified and checked on a scheduled cadence.