Behavioral Activation for Treatment-resistant Depression: Theoretical Model and Intervention Protocol (BA-TRD)

Background: Treatment-resistant depression (TRD) is a severe public health problem and a condition uncommonly addressed by psychological therapies. This paper presents a theoretical model, grounded in established learning principles and in the perspective of behavioral activation (BA), to explain it...

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Main Authors: Michel A. Reyes-Ortega, Jorge Barraca, Jessica Zapata-Téllez, Alejandra M. Castellanos-Espinosa, Joanna Jiménez-Pavón
Format: Article
Language:English
Published: Colegio Oficial de Psicólogos de Madrid 2024-11-01
Series:Clínica y Salud. Investigación Empírica en Psicología
Subjects:
Online Access: https://journals.copmadrid.org/clysa/art/clysa2024a17
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author Michel A. Reyes-Ortega
Jorge Barraca
Jessica Zapata-Téllez
Alejandra M. Castellanos-Espinosa
Joanna Jiménez-Pavón
author_facet Michel A. Reyes-Ortega
Jorge Barraca
Jessica Zapata-Téllez
Alejandra M. Castellanos-Espinosa
Joanna Jiménez-Pavón
author_sort Michel A. Reyes-Ortega
collection DOAJ
description Background: Treatment-resistant depression (TRD) is a severe public health problem and a condition uncommonly addressed by psychological therapies. This paper presents a theoretical model, grounded in established learning principles and in the perspective of behavioral activation (BA), to explain its constitution and development. Method: A review of theoretical models and empirical research on TRD was conducted in major databases. Results: The model reflects how patients with TRD are more susceptible to becoming trapped in their condition by seeking to avoid discomfort through avoidance and escape behaviors, which increasingly drives them away from sources of positive reinforcement. Based on this model, a BA-based intervention protocol is suggested for the treatment of TRD. Through six phases (in a total of thirteen sessions), the protocol guides the intervention towards the reestablishment of personalized routines to increase the probability of reinforcement and reduce avoidance behaviors. Conclusions: Although the model holds significant potential to become an effective intervention in TRD, future research will allow the evaluation of the efficacy of the protocol as a standalone intervention.
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issn 1130-5274
2174-0550
language English
publishDate 2024-11-01
publisher Colegio Oficial de Psicólogos de Madrid
record_format Article
series Clínica y Salud. Investigación Empírica en Psicología
spelling doaj-art-373aec054fc64980b1d95e0a680e09d62025-08-20T02:11:00ZengColegio Oficial de Psicólogos de MadridClínica y Salud. Investigación Empírica en Psicología1130-52742174-05502024-11-0135313514010.5093/clysa2024a1711320559Behavioral Activation for Treatment-resistant Depression: Theoretical Model and Intervention Protocol (BA-TRD)Michel A. Reyes-Ortega0Jorge Barraca1Jessica Zapata-Téllez2Alejandra M. Castellanos-Espinosa3Joanna Jiménez-Pavón4Instituto de Terapia y Análisis de la Conducta, Ciudad de México , México, Instituto de Terapia y Análisis de la Conducta, Ciudad de México, México;Universidad Camilo José Cela, Facultad HM de Ciencias de la Salud, Madrid , Spain, Facultad HM de Ciencias de la Salud de la Universidad Camilo José Cela, Madrid, Spain;Consejo Nacional de Ciencia y Tecnología, Instituto Nacional de Psiquiatría “Ramón de la Fuente Muñiz”, Ciudad de México , México, Consejo Nacional de Ciencia y Tecnología, Instituto Nacional de Psiquiatría “Ramón de la Fuente Muñiz”, Ciudad de México, México;Instituto de Terapia y Análisis de la Conducta, Ciudad de México , México, Instituto de Terapia y Análisis de la Conducta, Ciudad de México, México;Clínica de Trastornos Afectivos, Instituto Nacional de Psiquiatría “Ramón de la Fuente Muñiz”, Ciudad de México , México, Clínica de Trastornos Afectivos, Instituto Nacional de Psiquiatría “Ramón de la Fuente Muñiz”, Ciudad de México, MéxicoBackground: Treatment-resistant depression (TRD) is a severe public health problem and a condition uncommonly addressed by psychological therapies. This paper presents a theoretical model, grounded in established learning principles and in the perspective of behavioral activation (BA), to explain its constitution and development. Method: A review of theoretical models and empirical research on TRD was conducted in major databases. Results: The model reflects how patients with TRD are more susceptible to becoming trapped in their condition by seeking to avoid discomfort through avoidance and escape behaviors, which increasingly drives them away from sources of positive reinforcement. Based on this model, a BA-based intervention protocol is suggested for the treatment of TRD. Through six phases (in a total of thirteen sessions), the protocol guides the intervention towards the reestablishment of personalized routines to increase the probability of reinforcement and reduce avoidance behaviors. Conclusions: Although the model holds significant potential to become an effective intervention in TRD, future research will allow the evaluation of the efficacy of the protocol as a standalone intervention. https://journals.copmadrid.org/clysa/art/clysa2024a17 behavioral activationtreatment-resistant depressiontreatment protocolmajor depressive disordertreatment-resistant depression theory
spellingShingle Michel A. Reyes-Ortega
Jorge Barraca
Jessica Zapata-Téllez
Alejandra M. Castellanos-Espinosa
Joanna Jiménez-Pavón
Behavioral Activation for Treatment-resistant Depression: Theoretical Model and Intervention Protocol (BA-TRD)
Clínica y Salud. Investigación Empírica en Psicología
behavioral activation
treatment-resistant depression
treatment protocol
major depressive disorder
treatment-resistant depression theory
title Behavioral Activation for Treatment-resistant Depression: Theoretical Model and Intervention Protocol (BA-TRD)
title_full Behavioral Activation for Treatment-resistant Depression: Theoretical Model and Intervention Protocol (BA-TRD)
title_fullStr Behavioral Activation for Treatment-resistant Depression: Theoretical Model and Intervention Protocol (BA-TRD)
title_full_unstemmed Behavioral Activation for Treatment-resistant Depression: Theoretical Model and Intervention Protocol (BA-TRD)
title_short Behavioral Activation for Treatment-resistant Depression: Theoretical Model and Intervention Protocol (BA-TRD)
title_sort behavioral activation for treatment resistant depression theoretical model and intervention protocol ba trd
topic behavioral activation
treatment-resistant depression
treatment protocol
major depressive disorder
treatment-resistant depression theory
url https://journals.copmadrid.org/clysa/art/clysa2024a17
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