A study examining Behavioural Activation (BA)

Banares, Sabah Aliya (2024) A study examining Behavioural Activation (BA). Doctoral thesis (PhD), Manchester Metropolitan University.

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Abstract

Purpose – Behavioural Activation (BA) is a short-term and risk-free programme designed to provide minimal guidance to individuals allowing them to challenge their behaviours, facilitating self-governance. Research has primarily focused on the investigation of BA with individuals experiencing depressive symptoms usually in a face-to-face environment. This method has shown to be productive for this group but there is limited research surrounding those experiencing low mood; reduced well-being or those who are unable to attend face-to-face sessions. As such, the focus of this paper was to firstly conduct a review encompassing research around BA in relation to psychological distress i.e., depression and anxiety followed by a reflective methodological piece exploring the methodological choices and actions. This is then followed by an empirical paper examining a single session online BA (SSBA) programme using a randomised controlled trial (RCT) which is finally followed by a reflexive statement. Methods – A systematic literature review was conducted using the Preferred Register of Systematic Reviews and Meta-analyses (PRISMA) guidelines alongside the Critical Appraisal Skills Programme (CASP) to examine studies that had explored BA with psychological distress. From this review eighteen RCTs met the inclusion criteria. An empirical study was conducted using an RCT to examine the effectiveness of a SSBA programme online in reducing low mood and increasing well-being. Twenty participants were recruited with ten participants randomly allocated in each condition i.e., either the SSBA programme or the mindfulness control group. Many of the participants were academics and completed a pre- and post-assessment which was assessed using a Moods and Feelings questionnaire (MFQ – Angold & Costello (1987) and the Quality-of-Life questionnaire (QoL – Endicott et al, 1993) (Appendix 1). Results – Within the systematic review the eighteen RCTs indicated an improvement in psychological distress symptoms with the majority reducing the depressive symptoms significantly more than the control or comparative group. In addition to this, online and face-to-face BA study results indicated no significant differences suggesting the application of BA can be just as effective online as it is face-to-face. Even though the empirical paper findings suggest that group statistical analyses did not reveal statistically significant results, independently, 50% of the participants in the SSBA condition presented with low mood and an increase in well-being. Conclusions – Despite the studies in the review indicating promising results it may have been useful to consider how the findings would have been if the research was conducted over a longer period and with different populations i.e., gender and age groups. This was also indicative in the empirical paper as many of the participants were academics and the results may have differed if different populations were also involved. Therefore, there is a need to establish more rigour to establish the effectiveness of an SSBA programme in increasing wellbeing. Future studies should include larger sample sizes, longer follow-up periods and stronger methodological designs.