Treating depressive symptoms among veterans in primary care: A multi-site RCT of brief behavioral activation

Jennifer S. Funderburk, Wilfred R. Pigeon, Robyn L. Shepardson, Michael Wade, John Acker, Hayley Fivecoat, Laura O. Wray, Stephen A. Maisto

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Background: Behavioral activation is ideal for embedded behavioral health providers (BHPs) working in primary care settings treating patients reporting a range of depressive symptoms. The current study tested whether a brief version of Behavioral Activation (two 30-minute appointments, 2 boosters) designed for primary care (BA-PC) was more effective than primary care behavioral health treatment-as-usual (TAU) in reducing depressive symptoms and improving quality of life and functioning. Methods: Parallel-arm, multi-site randomized controlled trial. 140 Veterans were randomized to BA-PC or TAU and completed assessments at baseline, 6 weeks, 12 weeks, and 24 weeks. Results: Reductions in depressive symptoms were observed in both groups between baseline and 3-weeks prior to any treatment, with continued reductions among those in the BA-PC condition through 12-weeks. However, there was no significant condition X time interaction at 12-weeks. Quality of life and mental health functioning were significantly improved for those in the BA-PC condition, compared to TAU, at 12 weeks. Limitations: Generalizability to a broader population may be limited as this sample consisted of veterans. Although engagement in TAU matched other prior work, it was lower than engagement in BA-PC, which also may compromise results. Conclusions: Although this study found that both TAU and BA-PC participants showed a decline in depressive symptoms, improvements in functioning and quality of life within those assigned to BA-PC, strong treatment retention and feasibility of BA-PC, and significant reductions in depressive symptoms among those with more severe baseline depressive symptoms are encouraging and support continued research on BA-PC. This trial was registered in as Improving Mood in Veterans in Primary Care (NCT02276807).

Original languageEnglish (US)
Pages (from-to)11-19
Number of pages9
JournalJournal of Affective Disorders
StatePublished - Mar 15 2021


  • Behavioral Activation
  • Depression
  • Intervention
  • Primary Care
  • RCT
  • Veterans

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


Dive into the research topics of 'Treating depressive symptoms among veterans in primary care: A multi-site RCT of brief behavioral activation'. Together they form a unique fingerprint.

Cite this