Values assessment in Behavioural Activation

1. Values assessment in Behavioural Activation Dean McMillan, September 2012

2. Values • What’s important to a person, what gives life meaning • Very individual • No right or wrong values • Crucially for BA: • Values can be linked to behaviours • “Value consistent behaviours”

3. Values • What’s important to a person, what gives life meaning • Very individual • No right or wrong values • Crucially for BA: • Values can be linked to behaviours • “Value-consistent behaviours”

4. Values and BA theory Low levels of +ve reinforcement Narrowed behavioural repertoires Sadness, loss of energy, biological symptoms Life events Attempt to cope with symptoms Stay home, miss work, avoid friends, ruminate Depression

5. Values and BA theory Low levels of +ve reinforcement Narrowed behavioural repertoires Sadness, loss of energy, biological symptoms Life events Attempt to cope with symptoms Stay home, miss work, avoid friends, ruminate Depression • Negative reinforcement: If a behaviour is followed by an unpleasant thing stopping (or not occurring or reducing), then the behaviour will increase • Short-term gain: Reduction or avoidance of unpleasant thoughts and feelings • Long-term loss: May stop behaving in a way that allows the person to access +ve reinforcement

6. Values and BA theory Low levels of +ve reinforcement Narrowed behavioural repertoires Sadness, loss of energy, biological symptoms Life events Attempt to cope with symptoms Stay home, miss work, avoid friends, ruminate Depression • Values assessment can help identify behaviours that are likely to be positively reinforced, because meaningful and important to the person • If behaviours are linked to values, then person may be more likely to persist in these behaviours even in the face of initial unpleasant thoughts and feelings

7. Introducing values • Give a rationale • “Depression can mean we do things in the short-term that make us feel a bit better, but in the long-run keep depression going” • “Thinking about values can help identify behaviours that when done in the long-run protect against depression” • Discuss values areas • Introduce different values areas (e.g., work, family, spirituality) • Make it clear that perhaps not all will be relevant • Other important points • Emphasise that no right or wrong values • Sensitivity to avoid person beating him or herself up

8. Doing a values assessment • Spirituality values: • Importance: • Goals /actions: • Thoughts and emotions that are /might /could prevent you from living your values: • Write a short paragraph about what it would mean to you to live the value and what it would mean if you didn’t:

9. Doing a values assessment • Spirituality values: • Importance: • Goals /actions: • Thoughts and emotions that are /might /could prevent you from living your values: • Write a short paragraph about what it would mean to you to live the value and what it would mean if you didn’t: It’s the person’s values, not what you think the person’s values should be Cannot make assumptions that it will be important to all

10. Doing a values assessment • Spirituality values: • Importance: • Goals /actions: • Thoughts and emotions that are /might /could prevent you from living your values: • Write a short paragraph about what it would mean to you to live the value and what it would mean if you didn’t: Important to link values to behaviours “In an ideal world in which you were living your live in keeping with that value, what would you be doing?”

11. Doing a values assessment • Spirituality values: • Importance: • Goals /actions: • Thoughts and emotions that are /might /could prevent you from living your values: • Write a short paragraph about what it would mean to you to live the value and what it would mean if you didn’t: Sensitivity needed here What was once easy is now very difficult – common in depression