Originally developed in the 1970s, behavioural activation is a manualised approach based entirely on behavioural strategies [688]. Behavioural activation aims to improve mood and resilience by enabling a person to focus on their core values and increase engagement in activities that align with those values [689]. The therapy is based on the notion that problems in the lives of vulnerable people reduce their ability to experience positive reward from their environments, leading to symptoms and behaviours characteristic of depression. Behavioural activation aims to activate clients in specific ways that will increase rewarding experiences in their lives. It also focuses on processes that reduce activation, such as escape and avoidance behaviours including AOD use.
Behavioural activation has been shown to be effective at reducing the quantity and frequency of AOD use as well as depressive symptoms, among people with co-occurring depression and AOD use [690]; effective at improving abstinence from AOD use among those with single disorder AOD use [691, 692], and as effective as CBT [693] and antidepressants [694] at treating depressive symptoms among those with depression as a single disorder.