Lewinsohn (1976) · Depression
Lewinsohn (1976)
Trigger — Loss or Life Change
A trigger that reduces everyday rewards and routine — a loss or bereavement, illness, redundancy, relationship breakdown, or a major life change.
Low Mood & Low Energy
Low mood and reduced energy — sadness, flatness, fatigue, and loss of interest and motivation.
Withdrawal & Avoidance
Withdrawal, avoidance and inactivity — staying in bed, cancelling plans, stopping rewarding activities, and putting off tasks. Understandable and relieving in the short term, but self-defeating over time.
Fewer Rewards & Mounting Problems
A drop in positive reinforcement — less pleasure, less sense of achievement, less contact with people — while avoided problems accumulate. With fewer rewards available, mood falls further and the pull to withdraw grows, completing the cycle.
The published model, shown for reference. Switch to “Blank” to see the empty template you complete with a client.
When we're low, doing things feels like too much, so we do less — and yet doing less is one of the things that keeps depression going. This model, behind behavioural activation, explains that vicious circle and points to a way out.
It often begins with a change that strips away our usual sources of reward — a loss, illness, redundancy, or a big upheaval. Mood drops and energy fades.
When everything feels flat and effortful, it's natural to pull back: to stay in bed, cancel plans, drop hobbies, and put things off. In the short term that brings relief.
But pulling back removes the very things that lift mood — enjoyment, a sense of achievement, time with people — while problems we're avoiding quietly pile up. With even fewer rewards, mood sinks further, and the pull to withdraw grows. The encouraging part: because activity drives the cycle, gradually rebuilding rewarding and meaningful activity can turn it the other way.
How to introduce the model, guided-discovery questions, treatment targets and a behavioural experiment are available to signed-in therapists.
This diagram is a reconstruction of the published model for clinical and educational use, grounded in the sources above.
Formulate provides educational CBT resources for use with a qualified therapist. They are not a substitute for professional assessment, diagnosis, or crisis care.
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