Treating Anxiety and Depression
What is Depression?
One in four people experience at least one episode of depression in their lifetime, but even though depression is common, it is still not completely understood. Often depression is described and treated as an illness. We call this an internal explanation for depression-that is something that exists inside a person. It is most common to believe that depression is biological, like a chemical imbalance or psychological, like a pattern of negative thoughts. The biological component to depression can be treated with medication prescribed by a doctor. The psychological component to depression can be treated by talking with a therapist or other professional and dealing with the feelings and thoughts around depression.
There is another component to depression-the behavioral component- that is often ignored and is considered the external explanation for depression. The behavioral component of depression suggests that depression is not only a problem inside a person, but a problem with how a person interacts in their world.
Depression is not only a problem inside of you, but a mismatch between you and how you interact in the world.
For someone who is depressed and who may be seeing only the bad in themselves, a behavioral approach to depression can be freeing. If you believe that the problem is inside of you, it may make you feel worse about yourself and could feel impossible to change. But, if you also understand that the problem could be outside of you in your environment, you can begin to see that there is hope to change the things around you to decrease your depression.
So, Is Depression and Illness?
Depression is recognized as an illness by the American Psychiatric Association and by healthcare professionals and insurance companies. This can make it easier to understand depression and feel less self-blame about your depression diagnosis, but there are also some limitations involved in understanding depression as a disease.
First of all, thinking of depression as a disease means that you have a list of symptoms, but you don’t know how those symptoms started or what to do to get them to stop. Secondly, thinking of depression as a disease defines it as a strictly a physical problem, but research shows that depression involves biology, psychology, and environmental factors. Third, using a medical model of depression means that the focus is on only medical solutions, and while medical advice and solutions should always be a part of treating depression, there are many other options to consider, including behavioral activation.
The Depression Cycle
Depression is often described as a vicious cycle. If you are experiencing depression, you probably understand this cycle. The symptoms of depression often include low energy, lack of motivation and a feeling of not getting pleasure from things you used to enjoy. A lack of enjoyment and energy leads you to withdraw, isolate yourself, and stop doing things, which leads to even lower energy and lack of motivation.
Depression often begins with a specific event that triggers the symptoms and feelings of depression. This could be a new event, like losing a job or the memory of a previous event, like losing a loved-one. The experience of that event causes feelings of sadness, anxiety, or despair. Those emotions lead to behaviors of inactivity and isolation, like staying inside, avoiding friend phone calls, and cancelling plans to do things that are enjoyable. Avoidance and isolation create another series of events, like friends stop calling and texting because you never want to go out anymore or your work piles up because you are avoiding it or you don’t have interesting things to do anymore. This leads to greater isolation as you feel guilty that you aren’t meeting your responsibilities or lonely because friends aren’t calling or boring because you aren’t doing things that are fun and satisfying. This loop can continue indefinitely if you don’t take steps to interrupt the loop.
Behavioral Activation as Treatment for Depression
Behavioral Activation (BA) is a therapeutic treatment that can be used to disrupt the depression cycle. With the help of a trained therapist, you will be guided to understand your triggers for depression and the behaviors that you choose when you are depressed and then coached to create a plan that will help you create new behaviors that are more effective. This process is called activation and will help you to systematically stop the depression cycle, as you learn new ways of setting up your environment for success.
Learn about the step by step process of activation
Apointments and Fees
To begin therapy, we will meet for an intake session to understand your concerns, assess your needs, and agree upon a plan for treatment. This appointment typically lasts 50 minutes and is provided free of charge. During this appointment, we can answer any questions you might have about behavioral activation therapy and ensure that behavioral activation meets your needs. To schedule an intake appointment, you can call 940-222-8556 Ext. 700 or email at email@example.com.
Our philosophy of treatment includes clearly defined treatment goals that can make meaningful changes in your life in a relatively short period of time. Behavioral activation therapy is often completed in 20-25 session, although this varies from person to person. Along with your therapist, you will agree to a course of treatment that will help you to meet your goals and make lasting changes that will continue after therapy.
We accept cash, check, and credit card for payment, and payment is due on the day that the services are received. We do not currently accept insurance, but will provide a detailed receipt so that you can seek reimbursement from your insurance if you desire. We are considered an out of network provider for reimbursement purposes. We are also able to accept payments from health savings accounts or flexible spending accounts.
Our hourly rate is $105 per hour.
For more information about rates, sessions, and scheduling, visit our Patient Portal to download our policies and practices
Meet Your Therapist
Jessica Bowers is a Board Certified Behavior Analyst and a Licensed Behavior Analyst with 3 years’ experience in the clinical treatment of depression and anxiety. She received her master’s degree from Ball State University. Having personally experience anxiety and depression, Jessica has a passion for helping others to navigate through their anxiety and depression to make meaningful and long lasting life changes. She uses her training in Applied Behavior Analysis (ABA) and Behavioral Activation (BA) to provide practical, interactive and solution-focused treatment. You can contact Jessica directly at firstname.lastname@example.org
To learn more about behavioral activation, visit Jessica’s therapy blog
The BA Difference
How is BA different from other therapies?
There are three components of depression that should be considered for a complete treatment plan: biological, cognitive (thinking) and behavioral. The behavioral component, or how you are acting in your environment, is the most ignored component of treatment. This component is best addressed using a treatment package known as Behavioral Activation (BA).
BA is a treatment for anxiety and depression that is based on a principle that, as individuals become depressed, they tend to engage in avoidance, isolation, and other ineffective coping skills, which serve to maintain or worsen their symptoms. In other words, you feel depressed or anxious which leads to not wanting to do anything which makes you more depressed. Read more about the depression loop (link)
The goal of BA therapy is to coach you to gradually decrease your avoidance and isolation and increase positive behaviors that have been shown to increase mood. Behavioral Activation differs from traditional “talk therapy” in that it is focused more on action and activity, rather than thoughts and feelings. BA is considered an “outside-in” approach in which you identify elements in your daily life that can be changed to impact how you feel about yourself, rather than an “inside-out” approach which you target your thoughts and feelings in an effort to change how you interact in your world.
The principles used to guide this process are based in the science known as Applied Behavior Analysis (ABA). ABA is a scientific discipline that uses data collection to drive decision making for each individual’s behavior change. ABA therapists create programs to target behaviors that the client has indicated are important, and use data to determine if progress is occurring so that the program can be finely tuned for the best outcomes.
Your BA therapist will guide you to make meaningful changes in your life that match your goals and values. The therapist serves as your coach and encourager as you make these changes helps you identify changes that are successful and ways that you can be more successful in the future. While the therapist facilitates this process, I you will learn to use these techniques on your own. You will be a very active participant in your treatment, including keeping records, completing homework, and other tasks to further your progress, so that when treatment is complete, you feel confident in the changes that you have made.
Will Behavioral Activation Work for Me?
Maybe. We hope it will and the research tells us that behavioral activation works just as well as medication, but with more longevity and durability. That means that you can have high expectations that behavioral activation can make a meaningful difference in your life and that it will be long lasting, even as you encounter other life difficulties.
Nothing in the treatment of depression and anxiety is certain, but there are some things about BA treatment that make it more predictable. First of all, rather than focusing on subjective things like thoughts and feelings, BA is centered on actions. These are things we can define and measure and that makes it easier to track the progress. Along the way, we will be taking data so that we can have a clear picture of what is happening in treatment and using that data to make changes to optimize your success.
You should consider BA therapy if:
- You have tried traditional therapy or medication and you don’t feel like you made enough progress
- You like action-based therapy solutions
- You like the idea of having objective evidence for your progress
- You would like to learn a skill set that will help you avoid becoming depressed or anxious in the future
- You are already involved in cognitive therapy and/or you are using medication for depression and you would like a well-rounded approach
- You feel comfortable with a predictable, step-by-step approach to treatment
Your Role in Behavioral Activation Therapy
Behavioral Activation is personalized process in which you “activate” areas of your life to break the cycle of depression. During activation, you will identify goals that you want to achieve based on your personal values and create an action plan for how you will achieve these goals. As you participate in your action nd action helps to support your values and then alter your plan to get you closer to your goals. During therapy, you will collect data on your progress, complete homework assignments, and take an active role in directing your progress.
The Role of the Therapist
Behavioral Activation is meant to be a self-guided process, but when you are depressed, it can be very hard to motivate yourself to do anything, let alone make meaningful life changes. Having someone to direct your process is vital. Your therapy is guided by a Board Certified Behavior Analyst who will use the principles of Applied Behavior Analysis to direct your treatment progress. Your therapist will take the role of mentor and coach to create a partnership with you to make meaningful changes in your life that will allow you to access greater happiness and contentment. Through the process, the therapist will help you identify the areas of your life where your goals and values do not align with your activity and collaborate with you to create a plan to make changes that will help you to arrange your behavior to match your goals and values. The therapist will guide you to analyze your progress and make changes so that you can get the most out of your treatment.
Our Step by Step Approach
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