Kökenleri Eski Amacı Yeni Bir Terapi Modeli: Davranışsal Aktivasyon Terapisi

Year 2023, Volume: 1 Issue: 2, 46 - 68, 29.10.2023

Yavuz Koşan

Abstract

Davranışsal aktivasyon terapisi depresif bozukluklara müdahalede kullanılan davranışçı bir terapi modelidir. Lewinsohn ve Ferster gibi öncüllerin çalışmalarına dayanan davranışsal aktivasyon terapisi, temelde depresyonun bireylerin yaşamlarında ödüllendirici olan davranışları azalttığını yani aktivasyon düzeylerinin düşürdüğünü bununla birlikte erteleme ve sosyal çekinme gibi kaçınma davranışlarını ise arttırdığını savunmaktadır. Dolayısıyla müdahale genellikle bireylerin aktivasyon düzeylerini arttırmaya, kaçınma davranışlarını ise azaltmaya yönelik stratejiler kullanılarak yürütülmeye çalışılır. Davranışsal aktivasyon terapisi depresyona müdahalede kanıta dayalı bir müdahale olarak kabul edilmekle birlikte son zamanlarda çeşitli kaygı bozuklukları ve travma sonrası stres bozukluğu gibi psikolojik sorunlara yönelikte kullanılmaya başlanmıştır. Mevcut çalışmada davranışsal aktivasyon terapisinin genel özellikleri, tarihsel gelişimi ve kullanım alanları ve kullanılan tekniklere yer verilmiştir. Derleme çalışma sonucunda davranışsal aktivasyon terapisinin depresyon, kaygı bozuklukları ve travma sonrası stres bozukluğu müdahalede etkili olduğu özellikle alan uzmanları için pratik bir terapi modeli sunduğu söylenebilir.

Keywords

Davranışsal aktivasyon terapisi, davranışsal aktivasyon, depresyon, kaçınma, aktivasyon

References

• Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. Guilford.
• Beheshtian, E., Toozandehjani, H., & Saffarian Tousi, M. (2020). Comparison of modular cognitive-behavioral therapy and behavioral activation on the intolerance of uncertainty in students with generalized anxiety disorder. Journal of Nursing and Midwifery Sciences, 7(1), 30. https://doi.org/10.4103/JNMS.JNMS_29_19
• Carvalho, J. P., & Hopko, D. R. (2011). Behavioral theory of depression: Reinforcement as a mediating variable between avoidance and depression. Journal of Behavior Therapy and Experimental Psychiatry, 42, 154–162. https://doi.org/10.1016/j.jbtep.2010.10.001
• Coto, R., Fernández, C., & González, S. (2020). Activación Conductual en formato grupal para ansiedad y depresión. Una revisión sistemática. Terapia Psicológica, 38(1), 63–84.
• Dahne, J., Collado, A., Lejuez, C. W., Risco, C., Diaz, V. A., Kustanowitz, J., Zvolensky, M., & Carpenter, M. J. (2019). ¡Aptívate!: A Spanish-language behavioral activation mobile application for delivery via primary care. In Psychological Services (Vol. 16, Issue 2, pp. 271–275). Educational Publishing Foundation. https://doi.org/10.1037/ser0000304
• Dahne, J., Kustanowitz, J., & Lejuez, C. W. (2018). Development and Preliminary Feasibility Study of a Brief Behavioral Activation Mobile Application (Behavioral Apptivation) to Be Used in Conjunction With Ongoing Therapy. Cognitive and Behavioral Practice, 25(1), 44–56. https://doi.org/10.1016/j.cbpra.2017.05.004
• Dimidjian, S., Barrera, M., Martell, C., Muñoz, R. F., & Lewinsohn, P. M. (2011). The origins and current status of behavioral activation treatments for depression. Annual Review of Clinical Psychology, 7, 1–38. https://doi.org/10.1146/annurev-clinpsy-032210-104535
• Dimidjian, S., Goodman, S. H., Sherwood, N. E., Simon, G. E., Ludman, E., Gallop, R., Welch, S. S., Boggs, J. M., Metcalf, C. A., Hubley, S., Powers, J. D., & Beck, A. (2017). A pragmatic randomized clinical trial of behavioral activation for depressed pregnant women. In Journal of Consulting and Clinical Psychology (Vol. 85, Issue 1, pp. 26–36). American Psychological Association. https://doi.org/10.1037/ccp0000151
• Ekers, D., Webster, L., Van Straten, A., Cuijpers, P., Richards, D., & Gilbody, S. (2014). Behavioural activation for depression; An update of meta-analysis of effectiveness and sub group analysis. PLoS ONE, 9(6). https://doi.org/10.1371/journal.pone.0100100
• Ellis, A. (1962). Reason and emotion in psychotherapy. In Reason and emotion in psychotherapy. Lyle Stuart.
• Etherton, J. L., & Farley, R. (2022). Behavioral Activation for PTSD: A Meta-Analysis. Psychological Trauma: Theory, Research, Practice, and Policy, 14(5), 894–901. https://doi.org/10.1037/TRA0000566
• Fernández-Rodríguez, C., González-Fernández, S., Coto-Lesmes, R., & Pedrosa, I. (2020). Behavioral Activation and Acceptance and Commitment Therapy in the Treatment of Anxiety and Depression in Cancer Survivors: A Randomized Clinical Trial: Https://Doi.Org/10.1177/0145445520916441, 45(5), 822–859. https://doi.org/10.1177/0145445520916441
• Ferster, C. B. (1974). “A functional analysis of depression”: Reply. American Psychologist, 29(5), 361–362. https://doi.org/10.1037/H0038144
• Gortner, E. T., Gollan, J. K., Dobson, K. S., & Jacobson, N. S. (1998). Cognitive–behavioral treatment for depression: Relapse prevention. Journal of Consulting and Clinical Psychology, 66(2), 377–384. https://doi.org/10.1037/0022-006X.66.2.377
• Herrnstein, R. J. (1974). FORMAL PROPERTIES OF THE MATCHING LAW 1. Journal of the Experimental Analysis of Behavior, 21(1), 159–164. https://doi.org/10.1901/jeab.1974.21-159
• Hershenberg, R., & Glass, O. M. (2022). Implementing Behavioral Activation in Geriatric Depression: A Primer. Clinical Psychology and Special Education, 11(2), 81–96. https://doi.org/10.17759/cpse.2022110205
• Hopko, D. R., Lejuez, C. W., Lepage, J. P., Hopko, S. D., & McNeil, D. W. (2003). A Brief Behavioral Activation Treatment for Depression. Behavior Modification, 27(4), 458–469. https://doi.org/10.1177/0145445503255489
• Hopko, D. R., Lejuez, C. W., Ruggiero, K. J., & Eifert, G. H. (2003). Contemporary behavioral activation treatments for depression: Procedures, principles, and progress. Clinical Psychology Review, 23(5), 699–717. https://doi.org/10.1016/S0272-7358(03)00070-9
• 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
• Kanter, J. W., Busch, A. M., & Rusch, L. C. (2010). The distinctive practical features of behavioral activation. In W. Dryden (Ed.), Behavioral Activation. Routledge. https://doi.org/10.1002/9781118470886.ch9
• Kanter, J. W., Manos, R. C., Bowe, W. M., Baruch, D. E., Busch, A. M., & Rusch, L. C. (2010). What is behavioral activation?. A review of the empirical literature. Clinical Psychology Review, 30(6), 608–620. https://doi.org/10.1016/j.cpr.2010.04.001
• Koşan, Y. (2023). Davranışsal aktivasyon terapisinin depresif belirtileri olan bireylerde sigarayı bırakmaya yönelik olarak kullanılması. In E. Çetinkaya (Ed.), 17. Uluslararası Bilimsel Araştırmalar Kongresi (pp. 29–30). Asos Yayınları.
• Koşan, Y., & Kaya, M. S. (2023). Psychometric Properties and Factor Structure of the Turkish Version of the Short Form of Behavioural Activation for Depression Scale (BADS-SF) in Non-Clinical Adults. E-International Journal of Educational Research, 61(1), 20–32. https://doi.org/10.19160/e-ijer.1227934
• Koşan, Y., & Seçer, İ. (2021). Depresyon belirtilerini azaltmaya yönelik davranışsal aktivasyon terapisi uygulaması. In İ. Seçer & Z. Topal (Eds.), Okul ruh sağlığı sorunları (pp. 347–357). Vizetek Yayıncılık.
• Koşan, Y., & Seçer, İ. (2022). Adaptation of Adolescent Behavioral Activation Program and Investigation of Its Effectiveness by Mixed Method. Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry, 14(Ek 1), 293–307. https://doi.org/10.18863/pgy.1188941
• Lejuez, C. W., Hopko, D. R., Acierno, R., Daughters, S. B., & Pagoto, S. L. (2011). Ten year revision of the brief behavioral activation treatment for depression: Revised treatment manual. Behavior Modification, 35(2), 111–161. https://doi.org/10.1177/0145445510390929
• Lejuez, C. W., Hopko, D. R., & Hopko, S. D. (2001). A Brief Behavioral Activation Treatment for Depression. Behavior Modification, 25(2), 255–286. https://doi.org/10.1177/0145445501252005
• Lejuez, C. W., Hopko, D. R., & Hopko, S. D. (2002). The brief Behavioral Activation Treatment for Depression (BATD): A comprehensive patient guide. Pearson Custom Publishing.
• Lejuez, C. W., Hopko, D. R., LePage, J. P., Hopko, S. D., & McNeil, D. W. (2001). A brief behavioral activation treatment for depression. Cognitive and Behavioral Practice, 8(2), 164–175. https://doi.org/10.1016/S1077-7229(01)80022-5
• Lewinsohn, P. M. (1974). A behavioral approach to depression. - PsycNET. https://psycnet.apa.org/record/1975-07556-006
• Lewinsohn, P. M., Biglan, A., & Zeiss, A. M. (1976). Behavioral treatment of depression. In P. O. Davidson (Ed.), The behavioral management of anxiety, depression and pain.
• Lewinsohn, P. M., & Libet, J. (1972). Pleasant events, activity schedules, and depressions. Journal of Abnormal Psychology, 79(3), 291–295. https://doi.org/10.1037/h0033207
• Macphillamy, D. J., & Lewinshon, P. M. (1971). Pleasant Events Schedule. October, 124–135.
• Martell, C. R., Addis, M. E., & Jacobson, N. S. (2001). Depression in context: Strategies for guided action. W W Norton & Co. https://psycnet.apa.org/record/2001-06573-000
• Martell, C. R., Dimidjian, S., & Herman-Dunn, R. (2010). Behavioral activation for Depression A Clinician’s Guide. The Guilford Press.
• Martell, C. R., Dimidjian, S., & Herman-Dunn, R. (2022). Behavioral Activation for Depression (2nd ed.). The Guilford Press.
• Mazzucchelli, T. G., Kanter, J. W., & Martell, C. R. (2016). A clinician’s quick guide of evidence-based approaches: Behavioural activation. Clinical Psychologist, 20(1), 54–55. https://doi.org/10.1111/cp.12086
• McCauley, E., Gudmundsen, G., Schloredt, K., Martell, C., Rhew, I., Hubley, S., & Dimidjian, S. (2016). The Adolescent Behavioral Activation Program: Adapting Behavioral Activation as a Treatment for Depression in Adolescence. Journal of Clinical Child & Adolescent Psychology, 45(3), 291–304. https://doi.org/10.1080/15374416.2014.979933
• McCauley, E., Schloredt, K. A., Gudmundsen, G. R., Martell, C. R., & Dimidjian, S. (2016). Behavioral activation with adolescents: A clinician’s guide. Guilford Press. https://psycnet.apa.org/record/2016-06086-000
• Pass, L., Lejuez, C. W., & Reynolds, S. (2018). Brief Behavioural Activation (Brief BA) for Adolescent Depression: A Pilot Study. Behavioural and Cognitive Psychotherapy, 46(2), 182–194. https://doi.org/10.1017/S1352465817000443
• Raines, A. M., Thomas, E. A., Tock, J. L., Hallinan, T. M., Hartley, S., MacKenna, H., Constans, J. I., & Franklin, C. L. (2020). Examining the Effectiveness of a Group-Based Behavioral Activation Treatment for Depression among Veterans. Journal of Psychopathology and Behavioral Assessment, 42(2), 306–313. https://doi.org/10.1007/S10862-019-09778-3/TABLES/2
• Sánchez Angulo, J. G., Mairal, J. B., Pérez Padilla, J. R., Thirion, I. I., Ríos, J. M., Cruz Morales, S. E., & Gómez, L. G. (2021). A preliminary study on the application of Behavioral Activation in the treatment of smoking in women. Psychology, Society and Education, 13(2), 35–47. https://doi.org/10.25115/psye.v13i2.3511
• Schwartzman, J. M., & Bonner, H. R. (2023). Behavioral and Social Activation in Autism and Associations with Youth Depressive Symptoms from Youth and Caregiver Perspectives. Journal of Autism and Developmental Disorders, 1–12. https://doi.org/10.1007/S10803-023-06039-X/TABLES/5
• Skinner, B. F. (1953). Science and human behavior. Simon and Schuste.
• Sugiyama, C., Koseki, S., Niikawa, Y., Ito, D., Takahashi, F., & Ishikawa, R. (2021). Applied Improvisation Enhances the Effects of Behavioral Activation on Symptoms of Depression and PTSD in High School Students Affected by the Great East Japan Earthquake. Frontiers in Psychology, 12, 3746. https://doi.org/10.3389/FPSYG.2021.687906/BIBTEX
• Suh, J.-W., Lee, E.-B., Han, Y., Lee, M.-G., & Choi, K.-H. (2021). The effects of brief behavioral activation (BA) on children with physical disabilities: A randomized controlled trial. In American Journal of Orthopsychiatry (Vol. 91, Issue 1, pp. 86–95). Educational Publishing Foundation. https://doi.org/10.1037/ort0000517
• Takagaki, K., Jinnin, R., Yokoyama, S., Mori, A., Kambara, K., Okamoto, Y., Miyake, Y., Kagawa, F., & Okamoto, Y. (2021). Relations Among Clinical Factors After Behavioral Activation for Subthreshold Depression. International Journal of Cognitive Therapy, 14, 612–622. https://doi.org/10.1007/s41811-021-00108-8
• Veale, D. (2008). Behavioural activation for depression. Advances in Psychiatric Treatment, 14(1), 29–36. https://doi.org/10.1192/apt.bp.107.004051
• Wagener, A., Baeyens, C., & Blairy, S. (2016). Depressive symptomatology and the influence of the behavioral avoidance and activation: A gender-specific investigation. Journal of Affective Disorders, 193, 123–129. https://doi.org/10.1016/j.jad.2015.12.040
• Zeiss, A. M., Lewinsohn, P. M., & Muñoz, R. F. (1979). Nonspecific improvement effects in depression using interpersonal skills training, pleasant activity schedules, or cognitive training. Journal of Consulting and Clinical Psychology, 47(3), 427–439. https://doi.org/10.1037/0022-006X.47.3.427