Effect on avoidance patterns in the treatment of depression: behavioral activation by graded task assignment. A comparative nursing intervention research.

From recent research, there is increasing interest in avoidance in the
behavioral activation therapy for depression. Avoidance is the most important
factor in sustaining depression. Avoidance may cause the patient to not achieve
their treatment goals. Graded task assignment (treatment goals divided into
small weekly increments) ensures that during treatment, patients continue to
focus on goals. Moreover, avoidance will be quickly visible, so this can
intervene. There is little research on the effect of weekly goals to the
avoidance of patients with depression. Research on goals in sport and in
education is promising.

In this study the effect of adding graded task assignment to standard treatment
with behavioral activation are examined on avoidance patterns in patients with
depression. Treatment objectives will be granted by gradual task assignment
into sub-objectives accompanied with weekly planning.

The patients will be distributed into two groups (Group A and Group B).
Intervention Group A will receive the standard treatment supplemented with
gradual task allocation. Control group B will receive the standard treatment.
Patients are randomized to groups A and B. There will be stratified on the
severity of the depression and the outpatient group where patients are treated.
A minimisation module will be used to achieve an equal distribution of
patients.

Treatment objectives will be granted by gradual task assignment into
sub-objectives with accompanying weekly plan. The patient is asked to write a
daily brief report on the progress of these agreements. These agreements are
reviewed weekly and adjusted as necessary in the nurse conversations.

The study will hardly be of a burden to the patient.