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| New Advances in Behavioral Activation for Depression with Ethnic Minorities |
| Sunday, May 25, 2008 |
| 2:30 PM–3:50 PM |
| Boulevard B |
| Area: CBM; Domain: Service Delivery |
| Chair: Rachel Manos (University of Wisconsin, Milwaukee) |
| Discussant: Jonathan W. Kanter (University of Wisconsin, Milwaukee) |
| Abstract: Behavioral Activation (BA) began with Lewinsohn’s notion of activating clients to produce response-contingent positive reinforcement. After Jacobson and colleagues (Gortner, Gollan, Dobson, & Jacobson, 1998; Jacobson et al., 1996) conducted a component analysis that found the BA component of Cognitive Therapy (CT) to produce equivalent outcomes to the full CT package, there has been a resurgence of interest in this treatment. This symposium will present new research on Behavioral Activation (BA), focusing on applications of BA with ethnic minorities. First, Dr. Jonathan Kanter will present the background of BA and why BA is a particularly appropriate treatment for ethnic minority individuals with depression. Then, Andrew Busch will present on validating a clinical measure of activation, the Behavioral Activation for Depression Scale (BADS), for use with ethnic minorities. Finally, Laura Rusch will present recent data on outcomes of BA as a treatment for Latino depression and as an intervention to reduce stigma of depression in African Americans. |
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| The Application of Behavioral Activation Theory to Ethnic Minorities. |
| JONATHAN W. KANTER (University of Wisconsin, Milwaukee), Laura C. Rusch (University of Wisconsin, Milwaukee), Rachel Manos (University of Wisconsin, Milwaukee), Azara Santiago-Rivera (University of Wisconsin, Milwaukee), Paul West (16th Street Community Health Clinic) |
| Abstract: Behavioral Activation (BA; Martell, Addis, & Jacobson, 2001) is based on a model of depression that focuses on environmental factors that lead to losses or chronically low levels of positive reinforcement. Therefore, treatment involves activating clients to take active steps toward solving the environmental problems that precipitated depression, and includes monitoring daily activities, scheduling daily activities, and assigning increasingly difficult tasks related to client goals. BA clients are taught to recognize avoidance patterns and to activate themselves specifically in the difficult and stressful situations that evoke avoidance. BA may be particularly appropriate for treating depression in ethnic minorities, as it specifically targets the complex environmental stressors experienced by ethnic minorities, such as employment problems and discrimination. BA offers a simple, pragmatic approach that emphasizes empowerment and perseverance in the face of these seemingly overwhelming environmental difficulties. Furthermore, BA is more cost effective and easier to train and learn than many other mainstream therapies (e.g., cognitive therapy), which is especially important in communities with very limited resources. This paper will present further support for applying BA to ethnic minorities, as well as adaptations that may further strengthen this treatment for specific application to minority clients. |
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| Measuring Avoidance: Data on Applying the Behavioral Activation for Depression Scale (BADS) to Ethnic Minorities. |
| ANDREW BUSCH (University of Wisconsin, Milwaukee), Laura C. Rusch (University of Wisconsin, Milwaukee), Jonathan W. Kanter (University of Wisconsin, Milwaukee), Alex Czarnecki (University of Wisconsin, Milwaukee), Cristal E. Weeks (University of Wisconsin, Milwaukee), Jesus Calvillo (University of Wisconsin, Milwaukee) |
| Abstract: Recently, the psychotherapy research community has devoted a considerable amount of attention to the use of Behavioral Activation (BA) as a treatment for depression and two randomized controlled trials have supported its efficacy. This presents an obvious need for a system for measuring the degree of activation in clients over the course of BA as a way for clinicians to assess treatment progress and for researchers to examine mechanisms of change. This paper presents new data on the BADS, a self-report scale developed previously for that purpose. The BADS has four empirically derived subscales: activation, avoidance/rumination, social impairment, and work/school impairment that attempt to assess the behavioral function as well as the form of these constructs. Previously this scale has been validated with an undergraduate sample and a depressed community sample. We present additional data on the psychometric properties of the BADS with an African American sample and a Latino sample. Implications of validating this measure with minority groups will be explored. |
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| Clinical Outcomes and Implications for the Application of BA for Ethnic Minorities. |
| LAURA C. RUSCH (University of Wisconsin, Milwaukee), Andrew Busch (University of Wisconsin, Milwaukee), Jonathan W. Kanter (University of Wisconsin, Milwaukee), Rachel Manos (University of Wisconsin, Milwaukee), William Reyes (University of Wisconsin, Milwaukee), Azara Santiago-Rivera (University of Wisconsin, Milwaukee) |
| Abstract: Little formal research on the treatment of depression in ethnic minorities exists. This presentation will present data on applications of Behavioral Activation for Latinos and African Americans. First, a pilot version of BA for Latino depression was compared to treatment-as-usual in a Latino community clinic (n = 20). Results in terms of both treatment retention and treatment outcome were encouraging and will be presented. Second, based on previous research with a Caucasian sample, the BA model of depression was compared to a biological model of depression to reduce stigma associated with depression in African Americans (n = 37). Results of this study also will be presented. Implications for future development of BA for ethnic minorities will be discussed. |
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