Self-Guided Behavioral Activation Using an Online Single-Session Intervention: Content and Lexical Analyses of Activity Scheduling

The Common Elements Toolbox (COMET) is a self-guided online single-session intervention (SSI) containing cognitive-behavioral elements, including behavioral activation (BA). Little is known about the process of activity scheduling in BA. Using data from an 8-week randomized controlled trial of COMET with 409 online workers with a history of psychopathology, two raters coded the types of activities individuals scheduled during the intervention. Additionally, we compared the activities to a BA dictionary developed from therapist-led psychotherapy. We explored baseline clinical and demographic variables that were predictive of the activity category scheduled and explored the scheduled activity category as a predictor of depression, anxiety, and well-being post-intervention. Results yielded 9 different activity types, most commonly sedentary hobbies (41%), physical activity (29%), and active hobbies (18%). We found a small overlap (17%) between the self-guided BA activities in our COMET sample and those in the existing BA dictionary. Demographic variables were predictive of activity category, but clinical variables were not. The type of activity scheduled was not predictive of post-intervention outcomes. In self-guided BA, individuals, particularly men, less educated participants, and racial-ethnic minorities, tend to pick sedentary activities. Findings underscore the need for adaptive and personalized interventions.