If you're thinking about ending your life, or you're not safe right now, call 000 in Australia or 911 in the US. You can also call Lifeline on 13 11 14 in Australia, or call or text 988 in the US, any time. Anywhere else, findahelpline.com lists free local lines.
Behavioural activation
The behavioural activation hierarchy
A behavioural activation hierarchy is a list of activities ranked by how hard each one feels to you right now. You start near the bottom and move up as the easier ones get done. The NHS suggests starting with the easier ones and building up from there.
How to rank activities
- List 10 to 15 activities you'd like to do, from several areas of life.
- Score each one from 0 to 10 for how hard it feels today. 0 is easy, 10 is the hardest you can picture.
- Sort the list from the lowest score to the highest.
- Pick one or two from the bottom and plan them for set times this week.
For ideas, see the list of 142 activities, grouped by area and by how long each takes.
An example ladder
These scores are for a made-up person. Yours will be different.
| How hard (0 to 10) | Activity | Area |
|---|---|---|
| 1 | Open the curtains or blinds | Body |
| 2 | Make a nice cup of tea or coffee | Enjoyment |
| 2 | Text someone you've been meaning to reach out to | Connection |
| 3 | Wash the dishes | Achievement |
| 4 | Go for a walk | Body |
| 5 | Do a load of laundry | Achievement |
| 6 | Tidy one room | Achievement |
| 7 | Call a friend | Connection |
| 8 | Meet someone for coffee | Connection |
| 9 | Take a group fitness class | Connection |
When to move up a step
Move up when an activity near the bottom feels manageable most times you plan it. If the next step feels too big, put a smaller one in between, such as a five-minute walk before a longer one. How hard an activity feels can change from week to week, so score the list again now and then.
How it differs from graded exposure
Graded exposure is a different method that also uses a ladder. There, each step is a situation you fear, faced on purpose. A behavioural activation hierarchy ranks activities by how hard they feel, and the aim is to do more of the activities that matter to you. If you want help with a fear, ask a psychologist.
What the research says
A 2020 Cochrane review brought together 53 studies of behavioural activation for depression in adults, with about 5,500 people. Five of those studies, with 601 people, compared it with CBT. The review found no clear difference between the two in the short term, up to six months after treatment, and rated that evidence as moderate certainty.
Behavioural activation is a recommended psychological approach for depression (RANZCP 2020; NICE NG222).
These studies tested behavioural activation with a therapist or trained mental health worker. They didn't test Bloom, and Bloom isn't therapy.
Behavioural activation step by step sets out the whole method, and activity scheduling shows how to plan a week.
When to get more help
Has it lasted more than two weeks? Is it getting in the way of work, study or the people around you? Then talk to your GP. In Australia, your GP can refer you to a psychologist under a Mental Health Treatment Plan.
Beyond Blue is on 1300 22 4636 in Australia. If you're not safe, call 000 in Australia or 911 in the US. Lifeline is on 13 11 14, and in the US you can call or text 988. Anywhere else, see findahelpline.com.
Bloom does this with you
Bloom lets you filter activities to Low effort or 5 min or less, so you can start with the easiest.
Sources
- NHS Every Mind Matters. Low mood and depression. Accessed 17 October 2026. www.nhs.uk/every-mind-matters/mental-health-issues/low-mood/
- Lejuez CW and others (2011). Ten year revision of the brief behavioral activation treatment for depression: revised treatment manual. Behavior Modification 35: 111–161. doi.org/10.1177/0145445510390929
- Kanter JW and others (2010). What is behavioral activation? Clinical Psychology Review 30: 608–620. doi.org/10.1016/j.cpr.2010.04.001
- Uphoff E and others (2020). Behavioural activation therapy for depression in adults. Cochrane Database of Systematic Reviews. doi.org/10.1002/14651858.CD013305.pub2
- NICE (2022). Depression in adults: treatment and management (NG222). www.nice.org.uk/guidance/ng222
- Malhi GS and others (2021). The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders. Australian and New Zealand Journal of Psychiatry 55: 7–117. www.ranzcp.org/getmedia/a8c79505-c0b5-46b4-9f27-67f79e047674/RANZCP-mood-disorders-clinical-practice-guideline-2020.pdf