Efficacy of behavioural activation therapy (Activate) in treating depression among substance dependent individuals


Substance dependence is a chronic relapsing condition, associated with high levels of psychopathology. On entry to drug and alcohol treatment approximately 25% of heroin users and 40% of methamphetamine users meet criteria for Major Depression (MD), and this comorbidity has been linked to poorer treatment outcomes. Despite this, the development and assessment of behavioural interventions for depression among substance users has received little empirical attention. One treatment approach that has shown promise among residential rehabilitation clients in the United States is Behavioural Activation Therapy for Depression (BATD-R; Lejuez et al, 2011). BATD-R is a structured treatment that aims to activate clients in specific ways that will increase rewarding experiences in their lives. It is more time efficient and less complex than most other treatments for depression. The Activate study sought to examine the feasibility of using BATD-R among depressed opioid replacement therapy (ORT) and residential rehabilitation clients.


Cassar, J., Ross, J., Dahne, J., Ewer, P., Teesson, M., Hopko, D. & Lejuez, C.W. (2016) Therapist Tips for the Brief Behavioural Activation Therapy for Depression- Revised (BATD-R) Treatment Manual: Practical Wisdom and Clinical Nuance. Clinical Psychologist, 20, 46-53.

Ross, J., Teesson, M., Lejuez, C., Mills, K., Kaye, S., Brady, K., Dore, G., Prior, K., Larkin, X., Cassar, J., Ewer, P., Memedovic, S., Kihas, I. & Masters, S.L. (2016) The efficacy of behavioural activation treatment for co-occurring depression and substance use disorder (the activate study): a randomized controlled trial. Study protocol. BMC Psychiatry, 16, 221 DOI 10.1186/s12888-016-0943-1

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