It’s a well-supported treatment for depression, but like any approach, it’s not a silver bullet.
While it works well for many people, it can have some potential issues:
- May feel too hard at first
Even basic tasks like getting out of bed can feel overwhelming when someone is deeply depressed.
BA promotes people to do things despite not wanting to. For some, that can feel like too big a leap too soon.
If expectations aren’t paced well, it can backfire and increase frustration.
Risk: Pushing too hard, too fast, can worsen desperation if someone repeatedly feels like they’re failing.
- Doesn’t directly address thoughts
Unlike CBT, BA doesn’t focus on challenging negative thinking patterns.
That can be a downside for people whose depression is driven by cognitive distortions, low self-worth, or intrusive thoughts.
For some, thoughts like “I’m worthless” or “nothing will ever change” need to be addressed before they can engage in important activities.
Limitation: It might not work as well for people with strong cognitive symptoms unless combined with other therapies.
- Not ideal for all types of depression
BA is most effective for behavioral avoidance-based depression, where people stop doing things they once enjoyed.
It may be less effective for:
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- Melancholic depression (with more biological symptoms like early morning waking or appetite loss).
- Atypical depression.
- Depression with psychotic features or bipolar disorder, where more complex treatment is often needed.
Limitation: BA works best when avoidance and lack of engagement are core symptoms.
- Can feel superficial
Some clients may feel like BA is too simplistic or “surface-level.”
If they’re looking for emotional insight or want to work through trauma or existential issues, they might feel BA doesn’t go deep enough.
Risk: Clients might disengage or drop out if it’s not paired with more intense therapy when needed.
- Requires time and consistency
Behavioral change takes time. BA is a process, and it often requires:
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- Regular check-ins.
- Tracking progress.
- Support (from a therapist or workbook).
If someone is expecting immediate relief, they might feel discouraged when results don’t come fast enough.
Limitation: It’s not a quick fix. The benefits often come with consistent practice over weeks or months.
- Assumes capacity for planning
BA involves scheduling activities, setting goals, and reflecting on what feels rewarding.
People with executive dysfunctions, such as ADHD, trauma, or very severe depression, might struggle with these tasks without serious support.
Risk: The process can feel too mentally demanding without structure or external help.
- Risk of misalignment with values
One of BA’s strengths is reconnecting people with values-based activities.
But if the endeavors chosen feel meaningless or externally imposed (e.g., “go for a walk” when someone doesn’t enjoy nature or physical activity), it may feel pointless or even patronizing.
Tip: Activities should feel important to you personally, not just generically “healthy.”
- Doesn’t work well alone for complex cases
BA might not be enough on its own in moderate to severe cases or when comorbidities (like trauma, personality disorders, anxiety, or substance use) are present.
It regularly needs to be combined with other therapies or medication.
Limitation: It’s not a standalone cure for all forms of depression.
