In yesterday's post "Targeting behavioural activation better both for decreasing depression and increasing wellbeing (first post)", I suggested that there are at least three (and probably many more) interesting ways that could make behavioural activation (BA) both more targeted and potentially more effective.  I wrote about aiming BA particularly to "problem solve" triggering factors (especially interpersonal ones) that seemed to have contributed to deterioration in a subject's psychological state.  I also mentioned the recent Mazzuchelli et al paper "Behavioral activation interventions for well-being: a meta-analysis"  showing how helpful BA can also be at building wellbeing as well as treating depression.

There are a series of meta-analyses showing that "behavioural activation" (BA) is a good treatment for depression and that it is as effective as best-established approaches like full cognitive behavioural therapy - see, for example, last year's paper by Trevor and colleagues "Behavioral activation treatments for depression in adults: a meta-analysis and review".  BA involves encouraging increased engagement in enjoyable activities.  Subjects may be asked to keep a record of their daily activities and associated feelings - for example, feelings of achievement and enjoyment.  The downloadable charts and handouts further down this website's "Problem solving and behavioural activation" page illustrate this well-known approach.

Here are six recent papers on CBT treatment for a variety of disorders - for fuller details, abstracts and links, see further down this page.  Lamb et al explored the value of "Group cognitive behavioural treatment for low-back pain in primary care".  That their results were reported in the Lancet, highlights the importance of their findings.  The active treatment group received an additional assessment and then six 1.5 hour group therapy sessions (average group size, eight participants).  Therapy focused on "guided discovery, identifying and countering negative automatic thoughts, pacing, graded activity, relaxation, and other skills."   Outcomes demonstrated that "Over 1 year, the cognitive behavioural intervention had a sustained effect on troublesome subacute and chronic low-back pain at a low cost to the health-care provider."

I read a lot of research.  When I find an article of particular interest I download it to my bibliographic database - EndNote - which currently contains over 14,300 abstracts. 

I wrote yesterday about "The fourth morning: honouring my mother".  Now at home again.  Lying in bed this morning feeling happy.  Warm and content.

The last morning of the group.  I wake a bit "troubled".  This is the ebb and flow of the group.  Feelings tend to be more intense here.  As the "group river" flows its four day course, I know that I'm likely to move through a series of different emotional states.  I lie in bed for a bit sensing what I'm feeling.  What's it about.  The overall "smell/flavour" of my mood seems contributed to by a mix of things.  One factor is that I feel, what seems to me, a low key grumbling unease going on between me and one of the other people in the group.  A second factor is a discomfort I have about how another person expressed themselves for a while in the group yesterday.  A third is a concern I'm feeling about another person seeming to get too "isolated" in the group.  And there's something too about the group ending - both saying goodbye to the people and saying goodbye to this

Third morning.  It's after 7.00am.  Yesterday I wrote on "Authenticity & feedback".  The group seems to be "speeding up" now.  That's partly because I've got less time this morning.  Fairly typically at home, I try to have my light off by 10.15pm and get up by 5.15am.  Last night we were dancing till about midnight.  Brilliant.  Such great fun, but not a big encouragement to be up only a few hours later.  And partly the group feels it's speeding up because, like being away on a few days holiday, experiences start to blur together.  And partly I feel it's because the river of emotion and openness is running more strongly.  As happens so often, many of us - me included - seem more fluid, more easily touched by strong feeling, more easily "triggered" by the depth of what others express.

Yesterday in "A 3 layer view of intrapersonal & interpersonal judgement" I wrote about the first morning of this four day residential group.  Now it's the start of the second day.  What happened yesterday?  I began in that "on-my-own" familiar way - getting up quite early, washing, writing, meditating, plunging in the stream.  I tried running up the Drove Road, but slightly pulled my calf muscle again - a recurrence of a strain from earlier in the week.  I walked/hobbled back down through the fields.  Lambs, cowslips, beautiful hares, calls from the curlews. 

Nearly every year for the last twenty years I've come down to a four day Spring residential "Mixed Group" in Cumbria.  I wrote about this group last year and the year before, and I'm also involved with a similar pattern of autumn "Men's Groups".