Authors: Jonathan W. Kanter, PhD Ajeng Puspitassari, MA Maria Santos, MA Gabriela Nagy, BA
Social work is grounded in the values of service, social justice, integrity, and competence, and is committed to promoting the dignity and worth of individuals and human relationships (National Association of Social Workers, 1999; Reamer, 2006).
Given these founding principles, the profession’s primary mission is to enhance individual and family well-being by helping clients take action to meet their basic needs, with a focus on assisting those who are vulnerable and oppressed.
Consistent with acceptance and commitment therapy (ACT), social workers emphasize the role of environmental and cultural factors that cause or contribute to individuals’ problems, and promote clients’ meaningful participation in the decision-making process in practice.
As in social work practice, behavioral activation (BA) is designed to help clients effect change in their lives to meet their needs and improve well-being. BA’s basic idea is to help clients overcome depression by identifying and activating behaviors in line with their goals and values.
Throughout therapy, the social worker and the client collaborate to specify behavioral assignments for the client to complete in between sessions. These activities are discussed in detail during each session to ensure the following:
That the activity targets the client’s problems as the client defines them.
The activity is compatible with the client’s values.
It can be feasibly implemented given the client’s capabilities and resources.
A primary obstacle that is addressed in BA is avoidance. Challenges such as fatigue, anxiety, and hopelessness oftentimes overwhelm clients and make it difficult to engage in life. Clients are taught to problem solve to overcome avoidance, and mindfulness and acceptance techniques are taught to enable activation in the face of difficult environmental and personal circumstances.
BA’s underlying theory and therapeutic concepts are harmonious with the social work profession. Specifically, BA theory is consistent with the notion of the person-in-environment, which emphasizes the importance of considering the individual in context, a conceptual thread that cuts across major social work frameworks (Greene, 1999). Moreover, BA’s basic treatment ideas are compatible with the profession’s values and mission.
BA techniques are designed precisely to help clients effect change in their environments and, by extension, in society at large. This action-oriented treatment is intended to be executed collaboratively. Of particular relevance to social workers’ target populations, it accommodates flexibility and creativity in tailoring the treatment to the needs of the individual.
Society’s most vulnerable and impoverished are facing tangible obstacles that may contribute to their experiences of depression. Mindfulness in particular holds promise as an empowering technique that can allow a client to activate and remain engaged in life despite societal barriers such as discrimination and disenfranchisement, among others.
Given the congruence between BA techniques and social work’s mission, we suspect many professionals already engage in “behavioral activation.”
What does behavioral activation contribute to social work knowledge and practice?
BA for depression as an effective, efficient, easily trainable, and acceptable treatment approach for social workers and clients across diverse settings and cultures is based on three factors:
1. BA is an empirically supported approach to depression with a solid scientific basis.
2. BA works for diverse populations, including impoverished clients, minority clients, and clients with whom other forms of treatment have failed.
3. BA techniques work at the personal level, allowing social workers to use BA in their own lives to stay active in the presence of difficult obstacles and to structure and organize their days to maximize meaning and productivity.
BA provides a coherent, easy-to-use framework that organizes and consolidates activation techniques that practicing social workers likely use and that can serve to guide the implementation of the techniques.