Behavioral Activation of Religious Behaviors (BARB): Randomized Trial With Depressed College Students

Although spiritual or religious behaviors are sometimes targeted within behavior activation therapy (Hopko & Lejuez, 2007; Lejuez, Hopko, & Hopko, 2001) the efficacy of a protocol that ideographically assesses and develops a religiously based behavioral repertoire has not been investigated. This randomized study investigated the efficacy of a single-session behavioral activation of religious behaviors (BARB) protocol relative to supportive therapy (ST) among mild to moderately depressed undergraduate students (n = 50). Clinical outcomes assessed depression, anxiety, environmental reward, and quality of life. Results indicated that BARB successfully increased religious behaviors, attitudes, and coping skills at posttreatment. Hierarchical linear modeling indicated that the BARB group also had significantly greater decreases in depression and anxiety, and increased quality of life at posttreatment. At 1-month follow-up, these treatment gains were maintained and 84% or BARB participants reported continued religious activation. Finally, mediation analysis indicated that religious behaviors and attitudes were significant mediators of the relation between treatment condition and attenuation of depression. This study provides encouraging preliminary support for the efficacy of a parsimonious religious-based behavioral activation intervention for depression in college students.