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Avapl v ba for ptsd

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Unformatted text preview: Behavioral Activation Strategies for the Treatment of PTSD Treatment Acknowledgments Acknowledgments Amy Wagner, PhD Amy Portland VAMC Portland Sona Dimidjian, PhD, Sona MIRECC fellow, Seattle VAMC MIRECC Lisa Roberts, PhD Former MIRECC fellow, Viterion, inc. Christopher Martell, PhD University of Washington Private Practice Origins of Behavioral Activation Activation BA as an application of reinforcement theory to the BA treatment of depression (e.g., Lewinsohn, 1974) treatment The behavioral component of cognitive therapy treatment for The depression (Beck, 1976) depression BA is an independently effective intervention for depression BA (e.g., Dimidjian et al., 2006; Jacobson et al., 1996) (e.g., BA has evolved into a stand-alone behavioral treatment for BA Major Depressive Disorder (see Martell, Addis and Jacobson, 2001) Jacobson, What is Behavioral Activation? What Structured, brief psychosocial approach Based on premise that problems in vulnerable Based individuals' lives and behavioral responses reduce ability to experience positive reward from their environments to Aims to systematically increase activation such that Aims patients may experience greater contact with sources of reward in their lives and solve life problems reward solve Focuses directly on activation and on processes that Focuses inhibit activation, such as escape and avoidance behaviors and ruminative thinking behaviors Key Elements of BA Key Behavioral case conceptualization Functional analysis Activity monitoring and scheduling Emphasis on avoidance patterns Emphasis on routine regulation Behavioral strategies for targeting worry or Behavioral rumination rumination Goals are specific to the individual (not Goals necessarily pleasant events) necessarily Course of BA Course Orient to treatment Treatment rationale, including conceptualization of Treatment psychological distress and primary treatment strategies strategies Role of therapist/patient Develop treatment goals Behavioral analyses Repeated application of activation and Repeated engagement strategies engagement Troubleshooting Treatment review and relapse prevention Structure of Sessions Structure Set collaborative agenda Set collaborative Review homework Review weekly activities Troubleshoot problem behaviors Assign new homework Assign Ask for feedback Presentation of Treatment Rationale Rationale Emphasize relationships between environment, Emphasize mood (or anxiety) and activity mood Highlight vicious cycle that can develop between Highlight depressed mood, withdrawal/avoidance, and worsened mood (or anxiety) worsened Suggest activation as a tool to break...
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