Jacobson, N. S., Dobson, K. S., Truax, P. A., Addis, M. E., Koerner, K., Gollan, J. K., Gortner, E., & Prince, S. E. (1996). A component analysis of cognitive-behavioral treatment for depression. Journal of Consulting and Clinical Psychology, 64(2), 295–304. https://doi.org/10.1037/0022-006X.64.2.295

Type of Study: Randomized controlled trial
Number of Participants: 152

Population:

• Age — BA Group: Mean=36.6 years; AT Group: Mean=38.3 years; CT Group: Mean=39.2 years
• Race/Ethnicity — BA Group: 93% Caucasian, 4% Hispanic, 2% African American, and 2% Native American; AT Group: 91% Caucasian, 5% Native American, 2% Hispanic, and 2% Asian; CT Group: 76% Caucasian, 6% African American, 6% Native American, and 4% Asian
• Gender — 72% Female
• Status — Participants were patients referred by their HMO or recruited through public service announcements.

Location/Institution: Washington State

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to test the efficacy of Behavioral Activation [now called Behavioral Activation Treatment for Depression (BATD)]. Participants were randomly assigned to one of three intervention conditions: Behavioral Activation alone (BA), BA and the teaching skills to modify automatic thoughts (AT), or full Cognitive Behavioral Therapy treatment (CT). Measures utilized include the Longitudinal Interval Follow-up Evaluation (LIFE), the Hamilton Rating Scale for Depression (HRSD), and the Beck Depression Inventory (BDI). Results indicate that all treatment conditions showed approximately the same rates of improvement and recovery for participants with about 70% showing improved depression scores and 57% showing recovery. Limitations include lack of comparison group and length of follow-up.

Length of controlled postintervention follow-up: 6 months.

Hopko, D. R., Lejuez, C. W., LePage, J. P., Hopko, S. D., & McNeil, D. W. (2003). A brief Behavioral Activation Treatment for Depression: A randomized pilot trial within an inpatient psychiatric hospital. Behavior Modification, 27(4), 458–469. https://doi.org/10.1177/0145445503255489

Type of Study: Randomized controlled trial
Number of Participants: 25

Population:

• Age — Mean=30.5 years
• Race/Ethnicity — 96% Caucasian
• Gender — 64% Male
• Status — Participants were patients being treated in an acute- to medium-care psychiatric facility.

Location/Institution: West Virginia

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to test the efficacy of the Brief Behavioral Activation Treatment for Depression (BATD) [now called Behavioral Activation Treatment for Depression (BATD)]. Participants were randomly assigned to receive either 14 days of BATD treatment or an equivalent period of Supportive Psychotherapy (SP). Measures utilized include the Beck Depression Inventory (BDI). Results indicate that patients in the BATD condition showed a decrease in their BDI scores from baseline levels and this decrease was significantly greater than that found in the SP group. Limitations include use of a single assessment, small sample size, and lack of follow-up.

Length of controlled postintervention follow-up: None.

Dimidjian, S., Hollon, S. D., Dobson, K. S., Schmaling, K. B., Kohlenberg, R. J., Addis, M. E., Gallop, R., McGlinchey, J. B., Markley, D. K., Gollan, J. K., Atkins, D. C., Dunner, D. L., & Jacobson, N. S. (2006). Randomized trial of Behavioral Activation, Cognitive Therapy, and antidepressant medication in the acute treatment of adults with major depression. Journal of Consulting and Clinical Psychology, 74(4), 658–670. https://doi.org/10.1037/0022-006X.74.4.658

Type of Study: Randomized controlled trial
Number of Participants: 241

Population:

• Age — 18–60 years
• Race/Ethnicity — 82% White
• Gender — 66% Female
• Status — Participants were recruited by referral or through the media.

Location/Institution: Washington State

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to test the efficacy of the Brief Behavioral Activation Treatment for Depression (BATD) [now called Behavioral Activation Treatment for Depression (BATD)]. Participants were randomly assigned to receive BATD, Cognitive Therapy (CT), the antidepressant medication paroxetine (ADM), or a placebo (PLA). Measures utilized include the Beck Depression Inventory (BDI) and the Hamilton Rating Scale for Depression (HRSD). Results indicate that, among more severely depressed patients, BATD performed as well as the ADM treatment. These two treatments also performed significantly better than the CT treatment. Limitations include high attrition rate and lack of follow-up results.

Length of controlled postintervention follow-up: None.

Gawrysiak, M., Nicholas, C., & Hopko, D. R. (2009). Behavioral Activation for moderately depressed university students: Randomized controlled trial. Journal of Counseling Psychology, 56(3), 468–475. https://doi.org/10.1037/a0016383

Type of Study: Randomized controlled trial
Number of Participants: 30

Population:

• Age — Mean=18.4 years
• Race/Ethnicity — 70% Caucasian, 13% African American, 7% Asian American, 7% Latino, and 3% Other
• Gender — 80% Female
• Status — Participants were students recruited from introductory psychology classes at a Southeastern University.

Location/Institution: Public Southeastern U.S. University

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to test the efficacy of the Behavioral Activation Treatment for Depression (BATD). Participants were randomly assigned to the BATD group or a no-treatment control group. Measures utilized include the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), the Environmental Reward Observation Scale (EROS), and the Multidimensional Scale of Perceived Social Support. Results indicate that at posttest the BATD group showed significantly greater reductions in depression scores and improvements in scores and social support. Limitations include small sample size and lack of long-term follow-up.

Length of controlled postintervention follow-up: 2 weeks.

MacPherson, L., Tull, M. T., Matusiewicz, A. K., Rodman, S., Strong, D. R., Kahler, C. W., Hopko, D. R., Zvolensky, M. J., Brown, R. A., & Lejuez, C. W. (2010). Randomized controlled trial of behavioral activation smoking cessation treatment for smokers with elevated depressive symptoms. Journal of Consulting and Clinical Psychology, 78(1), 55–61. https://doi.org/10.1037/a0017939

Type of Study: Randomized controlled trial
Number of Participants: 68

Population:

• Age — Mean=43.8 years
• Race/Ethnicity — 74% African American
• Gender — 49% Female
• Status — Participants were recruited through the media for a study on smoking cessation.

Location/Institution: Not specified

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to test the efficacy of the Behavioral Activation Treatment for Depression (BATD). Participants were randomly assigned to 8 weeks of standard treatment or to the BATD intervention. Measures utilized include the Beck Depression Inventory (BDI) and the Environmental Reward Observation Scale (EROS). Results indicate that participants in the BATD condition were more successful in maintaining smoking cessation and also showed lower levels of depression and higher enjoyment scores. Limitations include small sample size and length of follow-up.

Length of controlled postintervention follow-up: 22 weeks.

Hopko, D. R., Armento, M. E. A., Robertson, S. M. C., Ryba, M. M., Carvalho, J. P., Colman, L. K., Mullane, C., Gawrysiak, M., Bell, J. L., McNulty, J. K., & Lejuez, C. W. (2011). Brief behavioral activation and problem-solving therapy for depressed breast cancer patients: Randomized trial. Journal of Consulting and Clinical Psychology, 79(6), 834–849. https://doi.org/10.1037/a0025450

Type of Study: Randomized controlled trial
Number of Participants: 80

Population:

• Age — Mean=55.4 years
• Race/Ethnicity — 93% Caucasian and 7% African American
• Gender — 100% Female
• Status — Participants were women diagnosed with breast cancer and major depression.

Location/Institution: University of Tennessee Medical Center's Cancer Institute (Knoxville, TN)

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to test the efficacy of an 8-session version of Behavioral Activation Treatment for Depression (BATD) compared to Problem-Solving Therapy. Participants were randomly assigned to one of the two interventions. Measures utilized include the Beck Depression Inventory, Hamilton Rating Scale for Depression, and the Environmental Reward Observation Scale. Results indicate that both treatments had significant pretest-posttest treatment gains across all outcome measures. Approximately three-quarters of patients exhibited clinically significant improvement. No significant group differences were found at posttreatment. Treatment gains were maintained at 12-month follow-up, with some support for stronger maintenance of gains in the BATD group. Limitations include concerns regarding generalizability to other populations, limited assessment of anxiety, and the lack of a no treatment control group.

Length of controlled postintervention follow-up: 12 months.

Hopko, D. R., Funderburk, J. S., Shorey, R. C., McIndoo, C. C., Ryba, M. M., File, A. A., Benson, K., & Vitulano, M. (2013). Behavioral activation and problem-solving therapy for depressed breast cancer patients: Preliminary support for decreased suicidal ideation. Behavior Modification, 37(6), 747–767. https://doi.org/10.1177/0145445513501512

Type of Study: Randomized controlled trial
Number of Participants: 80

Population:

• Age — Mean=55.4 years
• Race/Ethnicity — 93% Caucasian and 7% African American
• Gender — 100% Female
• Status — Participants were women diagnosed with breast cancer and major depression.

Location/Institution: University of Tennessee Medical Center's Cancer Institute (Knoxville, TN)

Summary: (To include basic study design, measures, results, and notable limitations)
The study used the same sample as Hopko et al. (2011). The purpose of the study was to compare the efficacy of Behavioral Activation Treatment for Depression (BATD) and Problem-Solving Therapy (PST) in reducing depression and suicidal ideation, as well as increasing hopefulness in breast cancer patients with Major Depressive Disorder (MDD). Participants were randomly assigned to BATD or PST. Measures utilized include the Hamilton Rating Scale for Depression, the Beck Depression Inventory–II (BDI–II), and Center for Epidemiological Studies of Depression Scale (CES-D). Results indicate that across both treatments analyses revealed decreased depression and suicidal ideation and increased hopefulness at posttreatment. Additionally, follow-up patient contact at approximately 2 years posttreatment yielded no indication of completed suicide. Limitations include the largely Caucasian sample, limited measures of suicidal ideation, and lack of no treatment control group.

Length of controlled postintervention follow-up: 3, 6, 9, and 12 months.

Ryba, M. M., Lejuez, C. W., & Hopko, D. R. (2014). Behavioral Activation for depressed breast cancer patients: The impact of therapeutic compliance and quantity of activities completed on symptom reduction. Journal of Consulting and Clinical Psychology, 82(2), 325–335. https://doi.org/10.1037/a0035363

Type of Study: Other quasi-experimental
Number of Participants: 23

Population:

• Age — Mean=57 years
• Race/Ethnicity — 100% Female
• Gender — 91% White, and 9% African American
• Status — Participants were women with breast cancer diagnosed with depression.

Location/Institution: University of Tennessee Medical Center's Cancer Institute

Summary: (To include basic study design, measures, results, and notable limitations)
The study used a subset of the same sample as Hopko et al. (2011). The purpose of the study was to examine the relationships among the quantity of activities completed, proportion of activities completed (i.e., therapeutic compliance), environmental reward, and depression in breast cancer patients treated with Behavior Activation Treatment for Depression (BATD). Participants were grouped to 8-week (one-on-one) sessions of BATD and were assigned monitoring logs to complete and return. Measures utilized include the Anxiety Disorders Interview Schedule-IV (ADIS-IV), the Beck Depression Inventory–II (BDI–II), and the Environmental Reward Observation Scale (the EROS). Results indicate that therapeutic compliance with assigned activities was related to depression reduction, but the specific quantity of completed activities was not systematically related. Analyses indicated that for patients completing all assigned activities, treatment response and remission were achieved for all patients. Neither therapeutic compliance nor the quantity of completed activities was directly associated with self-reported environmental reward during the behavioral activation interval, and environmental reward did not mediate the relation between activation and depression. Limitations include reliance on self-report measures of reinforcement, lack of follow-up, and small sample size.

Length of controlled postintervention follow-up: None.

Collado, A., Castillo, S. D., Maero, F., Lejuez, C. W., & MacPherson, L. (2014). Pilot of the brief Behavioral Activation Treatment for Depression in Latinos with limited English proficiency: Preliminary evaluation of efficacy and acceptability. Behavior Therapy, 45(1), 102–115. https://doi.org/10.1016/j.beth.2013.10.001

Type of Study: One-group pretest–posttest study
Number of Participants: 10

Population:

• Age — Mean=41.45 years
• Race/Ethnicity — 100% Latino
• Gender — 70% Female
• Status — Participants were Latinos with limited English proficiency and depressive symptomatology recruited through flyers and referrals provided by two different community centers serving Latinos.

Location/Institution: Maryland

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to evaluate Behavioral Activation Treatment for Depression (BATD) in individuals with limited English proficiency. Participants were grouped into a 10 session BATD intervention. Measures utilized include the Structured Clinical Interview for DSM-IV (SCID-IV), the Beck Depression Inventory-II (BDI-II), Behavioral Activation for Depression Scale (BADS), Reward Probability Index (RPI), Multidimensional Acculturative Stress Inventory (MASI), The Therapeutic Alliance With Clinician Questionnaire (TAC), and a standard demographics questionnaire. Results indicate that depressive symptomatology decreased, while both activation and environmental reward increased over the course of BATD. Increases in activation corresponded concurrently with decreases in depression, while environmental reward preceded decreases in depressive symptomatology. Limitations include the small sample size, lack of control or comparison group, and lack of generalizability to other ethnic populations.

Length of controlled postintervention follow-up: 1 month.

Collado, A., Calderon, M., MacPherson, L., & Lejuez, C. (2016). The efficacy of behavioral activation treatment among depressed Spanish-speaking Latinos. Journal of Consulting And Clinical Psychology, 84(7), 651–657. https://doi.org/10.1037/ccp0000103

Type of Study: Randomized controlled trial
Number of Participants: 46

Population:

• Age — Mean=35.91 years
• Race/Ethnicity — 100% Latino
• Gender — 86% Female
• Status — Participants were Latinos with limited English proficiency and depressive symptomatology recruited through flyers and referrals provided by two different community centers serving Latinos

Location/Institution: Washington, DC

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to evaluate the efficacy of Behavioral Activation Treatment for Depression (BATD) compared to supportive counseling in Spanish-speaking Latinos. Participants were randomly assigned to either BATD group or supportive counseling comparison group. Measures utilized include the Beck Depression Inventory-II (BDI-II), Behavioral Activation for Depression Scale (BADS), Reward Probability Index (RPI), Multidimensional Acculturative Stress Inventory (MASI), The Therapeutic Alliance With Clinician Questionnaire (TAC), and a standard demographics questionnaire. Results indicate that relative to supportive counseling, BATD led to greater decreases in depressive symptoms over time and greater MDD remission at the end of treatment. Activity level and environmental reward showed greater increases over time among those who received BATD compared to supportive counseling. Limitations include the small sample size, lack of generalizability to other ethnic populations, and length of follow-up.

Length of controlled postintervention follow-up: 1 month.