8 Behavioral Activation in the Context of “Third Wave” Therapies CHRISTOPHER R. MARTELL AND JONATHAN W. KANTER
DESCRIPTION OF THE MODEL OF PSYCHOPATHOLOGY AND TREATMENT The model of psychopathology and treatment presented by behavioral activation (BA)1 is based on a behavioral theory of depression and has its philosophical roots in functional contextualism as described by Hayes, Strosahl, & Wilson (1999). Functional contextualism, in turn, evolved from earlier writings of B. F. Skinner on radical behaviorism (e.g., Skinner, 1953). BA’s direct lineage with this traditional behavioral theory results in several key assumptions about how psychopathology is conceptualized and about the nature of the treatment techniques that follow from this conceptualization. The assumptions are simple to lay out and undoubtedly familiar to most readers. They are (a) thoughts and feelings are seen as behaviors to be explained rather than as causes of behavior; (b) an analysis of causality is not complete until the historical and contextual determinants of behavior are identified—this analysis is known as functional analysis; and (c) treatment techniques should target those determinants. Thus, in this model, thoughts and feelings are not direct causes of behavior, but can be accounted for, at least in principle, by functional analysis (Moore, 1980). The functional analyses upon which BA’s model of depression are based were initially presented by Lewinsohn (1974) and Ferster (1973, 1974). Lewinsohn suggested that depressive thoughts, feelings, and behaviors result from decreases in response contingent positive reinforcement (Lewinsohn, 1974; Martell, Dimidjian, & Lewinsohn, 2009). When positive reinforcers are decreased, operant behaviors previously maintained by those reinforcers are extinguished, and respondent emotional states, such as feeling sad, down, blue, and so forth, are elicited. Simply put, when positive reinforcement 1
There are several variants of BA. In this chapter, we largely focus on BA as described by Martell, Addis, and Jacobson (2001), because this variant of BA has received the most empirical support and the techniques included in it have the most relevance to a discussion of mindfulness and acceptance. However, other important variants of BA exist, notably those of Lejuez, D. R. Hopko, Lepage, Hopko, and McNeil (2001), and Kanter, Busch, and Rusch (2009). 193
JWBT357c08_p193-209.indd 193
10/7/10 2:40:34 PM
