2 Practical methodology of
behavioural activation and other
LI CBT skills
Tereza Ruzickova

Psychopharmacology and Emotion Research Lab

University of Oxford
19th May 2021
General factors
- treating each client with respect and empathy
(re
fl
ection, summarising, eye contact, facial
expressions)
- the client is the expert by experience
- treatment is decided collaboratively
- BA practitioner’s role is to validate, motivate and
encourage (kind of like a coach)
Initial assessment
1. Introduction
2. Con
fi
dentiality
3. Information gathering
4. Risk assessment
5. Information giving
1. Introduction
- introduce yourself and your role
- describe agenda (length + purpose
of meeting)
- make it clear they can ask
questions, express preference
2. Confidentiality
- record storage?
- anonymised database?
- supervision?
- research?
- conditions for breaking con
fi
dentiality?
3. Information gathering:
The funnelling method
1. Open & general: four Ws
1. Open & general: four Ws
2. Open & speci
fi
c
Can you tell me a bit more about…

Can you say a bit more about…
3. Information gathering:
The funnelling method
1. Open & general: four Ws
2. Open & speci
fi
c
3. Closed
(frequency, intensity, duration, triggers)
- How often do you feel depressed like this?

- How long does it usually last?

- On the scale from 0-10, how intense is the
feeling (of depression/guilt/grief)?

- What factors tend to trigger it?

3. Information gathering:
The funnelling method
3. Information gathering:
specific example
Describe the last time you felt
depressed like this…

- emotional symptoms

- behavioural symptoms

- cognitive symptoms

- physical symptoms
3. Information gathering:
contextual information
- triggers, onset, progress, impact on daily life
- other current mental health treatments
- previous mental health treatments
- other current physical health treatments
- employment status
- alcohol, drug, ca
ff
eine consumption
+ Routine Outcome Measures
Routine outcome measures
- completed at baseline and every week
of intervention
- checking whether our intervention is
helping you
- can always explain results
- research support
4. Risk assessment
- suicidal ideation
- intent
- plans
- action
- prevention
- ideation:
Do you ever have thoughts of taking your own life?
Have you ever felt this way in the past?
- intent:
Have you ever thought about how you would take your own life?
How often do you have thoughts of killing yourself?
How easily can you put these thoughts out of your mind?
How strongly do you believe that you would act on these
thoughts on the scale 0-10?
- plans
Have you made any plans to act on these thoughts?
Have you acted on these thoughts in the past?
- actions
Have you taken any steps towards taking your own life?
What access do you have to things that you could use?
What did you use when you attempted this in the past?
- prevention
What’s keeping you going at the moment?
Who do you turn to when you need someone to talk to?
What stopped you from taking your own life in the past?