Behavioural Activation Model of Depression
Lewinsohn (1976) · Depression
Written by Tarun Vermani, Trainee Clinical Psychologist Last reviewed
The behavioural activation model of depression (Lewinsohn, 1976; Martell and colleagues, 2001) explains low mood as a loss of reward: withdrawal relieves in the short term while removing the very activity that lifts mood.
Behavioural Activation Model of 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.
Understanding the model
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.
Questions therapists ask about this model.
Frequently asked questions
What maintains depression in this model?
A change that strips away everyday reward and routine — a loss, illness, redundancy, a major upheaval — lowers mood and energy. Pulling back then feels natural and brings relief, but it removes the very things that lift mood: enjoyment, a sense of achievement, time with other people. Meanwhile the problems being avoided quietly pile up, so less reward is left than before, and withdrawing pulls harder still.
How does it differ from Beck's cognitive model?
It works at the level of behaviour and its consequences rather than at the level of belief: what maintains the depression is the loss of reward that follows withdrawal, not the content of thought. Beck's model (1979) adds the developmental layer and places negative automatic thoughts at the centre. Both cover depression, which NICE NG222 addresses, and each is a different entry into the same picture.
How did the behavioural model of depression develop?
Lewinsohn and Graf (1973) linked mood with how often people took part in pleasant activities, and Lewinsohn, Biglan and Zeiss (1976) built that into a behavioural account of depression centred on lost reward. Martell, Addis and Jacobson (2001) and Jacobson, Martell and Dimidjian (2001) later developed modern behavioural activation from those roots, giving more weight to avoidance and to the context of the client's life.
Worksheets and reading for this model
Using this model in session — for therapists
How to introduce the model, guided-discovery questions, treatment targets and a behavioural experiment are available to signed-in therapists.
References
- Lewinsohn, P. M., Biglan, A., & Zeiss, A. M. (1976). Behavioral treatment of depression. In P. O. Davidson (Ed.), The behavioral management of anxiety, depression and pain (pp. 91–146). Brunner/Mazel.
- Lewinsohn, P. M., & Graf, M. (1973). Pleasant activities and depression. Journal of Consulting and Clinical Psychology, 41(2), 261–268.
- Martell, C. R., Addis, M. E., & Jacobson, N. S. (2001). Depression in context: Strategies for guided action. W. W. Norton.
- Jacobson, N. S., Martell, C. R., & Dimidjian, S. (2001). Behavioral activation treatment for depression: Returning to contextual roots. Clinical Psychology: Science and Practice, 8(3), 255–270.
This diagram is a reconstruction of the published model for clinical and educational use, grounded in the sources above.
Cite this page (APA 7)
Vermani, T. (2026). Behavioural Activation Model of Depression. Formulate. https://formulatetools.co.uk/tools/formulation/behavioural-activation-depression
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