Behavioral activation lesson 2: what matters to you

In lesson 1, you kept a diary of what you did and how you felt. This lesson asks a new question: what do you want your days to be about? Your answers are your values. They will guide which activities you add back into your life.

Behavioral activation (BA) is a therapy for depression that works by changing what you do. One well-known version uses values to choose which activities to try.^1,2 This lesson walks you through that step.

Why this step matters

When depression takes hold, many people stop doing things that once gave them good moments. That means fewer chances to enjoy something, feel capable or spend time with others. Mood often sinks further as a result.² BA tries to bring those good moments back on purpose. The National Institute of Mental Health also suggests doing things you used to enjoy, even when you do not feel like it.⁴

But "just do more" is not the whole idea. In the brief version of BA, values are used to guide which activities you pick.² Activities tied to what you care about can feel more worth the effort, and they give you a reason to act when motivation is missing.

Values are a helper, not magic. A review of 26 BA trials found that versions with an added values step did not work better than simpler ones.⁶ The heart of BA is doing more of what gives you a lift.

Values, goals and activities: what is the difference?

These three words get mixed up, so here is a simple way to tell them apart.

In BA, you work mostly with activities, because they are small enough to do today.

The idea of values in BA came partly from another therapy, acceptance and commitment therapy (ACT).¹ If you want to go deeper on values, see ACT lesson 1: finding your values.

The life areas

A revised BA manual from 2011 organized this step around life areas, values and activities.¹ Here are common areas, with questions to help you think. You do not need an answer for every one.

Purpose may matter for more than mood. In a U.S. study of nearly 7,000 adults over 50, people with the strongest sense of purpose were less likely to die over about four years than those with the weakest. The study cannot prove cause.⁷ See purpose, meaning and well-being.

Three kinds of helpful activities

When you turn values into activities, aim for a mix. Depression often cuts people off from three kinds of rewards: pleasant experiences, time with others, and the feeling of having done something well.²

Don't skip the "boring" tasks. Avoided chores, like a stack of mail, can weigh on your mood. England's national depression guideline describes BA as linking activities to mood and making practical changes that cut down on avoidance.³

Steps: build your values and activities list

1. Look back at your lesson 1 diary. Circle activities that lifted your mood even a little. Note what is missing compared with how your life used to be.
2. Pick three or four life areas from the table above that feel most important right now. Leave the rest for later.
3. Write one value for each area. Use a short phrase that starts with "Being..." or "Caring for...". For example, "Being a good friend" or "Caring for my health."
4. List three to five activities for each value. Make each one specific and small enough to do in one day. Include at least one very easy one.
5. Rate each activity. Mark it E (easy), M (medium) or H (hard). Also mark whether it brings pleasure (P), accomplishment (A) or connection (C).
6. Check the list against your health and energy. If an activity is too hard right now, write a smaller version next to it. "Walk 30 minutes" can become "walk to the mailbox."
7. Choose two easy activities to try before next week. You will plan the rest in lesson 3.

Later life, health limits and caregiving

Values often stay the same as we age, even when the ways we live them change. If you can no longer garden in a large yard, a pot of herbs on the windowsill may still honor that value.

In a U.K. program of phone-based BA for people 65 and older with long-term health conditions, people returned to old hobbies, took up new ones, joined group outings and finished small tasks at home. ⁸ A U.S. BA approach for late-life depression called Engage also centers on getting people back into rewarding activities. In a small study of 48 older adults, gains in activity were followed by drops in depression.⁹

If you are a family caregiver, your own values count too. Pick at least one activity that is just for you. See caregiver stress and burnout.

If you care for a person living with dementia, pleasant activities can still lift mood and give a sense of success. A checklist called the Pleasant Events Schedule-AD helps families find activities the person enjoys.¹⁰ See meaningful activities in dementia and apathy and depression in dementia.

Common problems

I can't think of any values.

That is common in depression, which can make everything feel flat. Think of a time you felt proud or at peace. What were you doing, and who were you with? Start with just one area.

My values feel out of reach because of my health.

Look for a smaller way to act on the same value. If you value helping others but cannot volunteer in person, you might make calls for a group from home. Check with your doctor before starting new exercise. See chronic pain and mood.

Is it selfish to put fun on my list?

No. Pleasure is part of how BA works. Enjoyable moments help rebuild mood, and they give you energy for the harder tasks.²

Should I use this list instead of seeing a doctor?

Self-help is a good start, but it does not replace care when depression is moderate or severe. The American Psychological Association recommends behavioral therapy for adult depression, usually with a trained therapist.¹¹ See treatment for depression and starting therapy. If you take medicine for depression, keep taking it. Talk with your doctor or pharmacist before changing anything.

When to get help

Next: Lesson 3: scheduling and troubleshooting. Or go back to the behavioral activation overview.

Education only. This page is general information written from the sources listed. It is not medical, legal or financial advice and does not replace a doctor, therapist or lawyer who knows your situation. How we write and check pages.