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Published on: January 7, 2019
Behavioral activation for depression: A comprehensive systematic review and meta-analysis
Pim Cuijpers1, Marketa Ciharova2, Lingyao Tong2
1Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands; Babeș-Bolyai University, International Institute for Psychotherapy, Cluj-Napoca, Romania.
Clinical Psychology Review
|July 23, 2026
Summary
Behavioral activation (BA) is an effective depression treatment for adults, with benefits lasting up to 12 months. Self-guided and institutional BA also show significant positive effects.
Area of Science:
- Psychiatry
- Clinical Psychology
- Behavioral Science
Background:
- Depression is a leading cause of disability worldwide.
- Behavioral activation (BA) is a key psychotherapeutic intervention for depression.
- A comprehensive meta-analysis of randomized controlled trials (RCTs) on BA for depression is lacking.
Purpose of the Study:
- To conduct a comprehensive meta-analysis of RCTs evaluating the efficacy of Behavioral Activation (BA) for depression.
- To synthesize evidence on BA's effectiveness across different formats and settings.
- To assess the durability of BA's effects on depression symptoms.
Main Methods:
- Systematic review and meta-analysis of RCTs on BA for depression.
- Inclusion of trials across all age groups, settings, and comparators.
- Analysis of 105 trials involving 13,933 patients, with 40 trials assessed as low risk of bias.
Main Results:
- BA demonstrated a significant effect (SMD=0.67) for adult outpatients compared to control conditions, with high heterogeneity.
- Effects remained significant up to 12 months post-randomization.
- Self-guided BA (SMD=0.36) and BA in institutional settings (SMD=0.36) also showed significant efficacy.
Conclusions:
- Behavioral Activation (BA) is an efficacious treatment for depression in adults.
- The positive effects of BA persist for at least 12 months.
- BA is effective in self-guided formats and institutional settings, though effects may be smaller.
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