Table Of ContentBehavioral activation
for Depression
B
ehavioral
a
ctivation for
D
epression
A Clinician’s Guide
christopher r. Martell
sona DiMiDjian
ruth herMan-Dunn
Foreword by Peter M. Lewinsohn
the GuilforD press
new York london
© 2010 The Guilford Press
A Division of Guilford Publications, Inc.
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www.guilford.com
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Except as indicated, no part of this book may be reproduced,
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Last digit is print number: 9 8 7 6 5 4 3 2 1
LIMITED PHOTOCOPY LICENSE
These materials are intended for use only by qualified mental health professionals.
The Publisher grants to individual purchasers of this book nonassignable permission to reproduce
all materials for which photocopying permission is specifically granted in a footnote. This license
is limited to you, the individual purchaser, for personal use or use with individual clients. This
license does not grant the right to reproduce these materials for resale, redistribution, electronic
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Library of Congress Cataloging-in-Publication Data
Martell, Christopher R.
Behavioral activation for depression : a clinician’s guide / Christopher R. Martell,
Sona Dimidjian, and Ruth Herman-Dunn.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-60623-515-7 (hard cover : alk. paper)
1. Depression, Mental—Treatment. 2. Behavior therapy. I. Dimidjian, Sona. II.
Herman-Dunn, Ruth. III. Title.
[DNLM: 1. Depressive Disorder—therapy. 2. Cognitive Therapy—methods.
WM 171 M376b 2010]
RC537.M3737 2010
616.85′27—dc22
2009040847
This book is dedicated to the late Neil S. Jacobson,
our friend, colleague, and behavioral activation mentor.
We are forever indebted to his initial vision for this work.
Neil’s memory influences us in all our research,
writing, and clinical work.
about the authors
Christopher R. Martell, PhD, ABPP, is Clinical Associate Professor in
the Department of Psychiatry and Behavioral Sciences and in the Depart-
ment of Psychology at the University of Washington in Seattle, where he
also has a private practice. He is board certified in both clinical psychol-
ogy and behavioral psychology through the American Board of Profes-
sional Psychology and is a founding fellow of the Academy of Cognitive
Therapy. The coauthor of four books, Dr. Martell has published widely
on behavioral treatments for depression and other areas of application
of cognitive-behavioral therapy, including cognitive-behavioral therapy
with lesbian, gay, and bisexual clients. He is an international workshop
leader and lecturer, and was the recipient of the Washington State Psy-
chological Association’s Distinguished Psychologist Award in 2004.
Sona Dimidjian, PhD, is Assistant Professor of Psychology at the Uni-
versity of Colorado at Boulder. Her research addresses the treatment
and prevention of depression, including a particular focus on the mental
health of women during pregnancy and postpartum. Dr. Dimidjian is a
leading expert in cognitive and behavioral approaches to treating and
preventing depression. She is one of a core group of experts in behav-
ioral activation (BA) treatment for depression and has published widely
in this area. Dr. Dimidjian is also an expert in the clinical application
of contemplative practices, such as mindfulness meditation, and is an
international workshop leader and lecturer.
vii
viii about the authors
Ruth Herman-Dunn, PhD, is in private practice in Seattle and supervises
graduate students in her position as Clinical Instructor in the Depart-
ment of Psychology at the University of Washington. She has been a
research therapist on several large randomized clinical trials for behav-
ioral treatments, including BA and dialectical behavior therapy, and has
led workshops on these treatments throughout the United States and
Canada. Dr. Herman-Dunn provides consultation on treatment dis-
semination studies and collaborates with a core group of BA experts on
research, training, and treatment development.
acknowledgments
there are a number of people who have generously given time and
attention to this project to whom we wish to extend our gratitude.
The University of Washington Treatments for Depression Study, in
Seattle, was the birthplace of our conceptualization of behavioral activa-
tion (BA), and the people involved in that study have been instrumen-
tal in guiding our thinking over the past decade. We thank the study’s
participants and all the clients with whom we have worked since then
whose dedication and efforts have inspired and shaped our work. We
are grateful to the investigators on the BA study, our dear friends and
colleagues Robert J. Kohlenberg, PhD, Steven D. Hollon, PhD, Keith S.
Dobson, PhD, Karen B. Schmaling, PhD, Michael E. Addis, PhD, and
David L. Dunner, MD. Robert Gallop, PhD, is a statistical genius and
an invaluable collaborator as well. Finally, Marsha M. Linehan, PhD,
has been an inspiration and guide in many ways. Whether consulting
on specific clients or talking about behavior therapy over dinner at her
home, she offered keen insights into theory and technique, graciously
challenged us to refine our thinking, and shared her enthusiasm for the
ongoing importance of this work.
Many conversations over the years with colleagues and friends have
also sharpened our thinking and understanding. In particular, Virginia
Rutter, PhD, has been an ongoing source of support, friendship, and
wisdom. Chris Dunn, PhD, David Markley, PhD, Linda Dimeff, PhD,
Sarah Landes, PhD, and Sandra Coffman, PhD, engaged us in stimu-
lating discussions about theory and technique and helped to shape the
book without necessarily knowing at the time the valuable contribution
they were making. Eric Woodcock, BS, had the original idea for the
ix
Description:From leading experts in behavioral activation research and clinical practice, this volume presents an empirically tested approach for helping clients overcome depression by becoming active and engaged in their own lives. Behavioral activation is a stand-alone treatment whose principles can be integr
