Abstract/Summary

Objectives: Anhedonia, the loss of interest and pleasure, is a core symptom of depression and is associated with deficits in reward processing. Behavioural Activation for depression may address this symptom due to its focus on identifying and increasing intrinsically rewarding activities. Design: This was a qualitative study employing reflexive Thematic Analysis (TA) to analyse data from semi-structured interviews with young people after treatment. Methods: Participants were eight treatment-seeking adolescents with a recent primary diagnosis of depression who had received eight sessions of Brief Behavioural Activation. Qualitative semi-structured interviews were conducted after treatment was completed. Results: Three main themes emerged: 1) Connecting, reviewing and taking action: ‘focus on getting better rather than what you’re feeling;’ 2) Struggles, restrictors and motivators: ‘it seemed really unachievable;’ and 3) Feeling, acting or seeing things differently: ‘looking forwards in a more healthy way.’ Conclusions: Specific Brief Behavioural Activation strategies (e.g. connecting with values) and more generic therapeutic strategies (e.g. self-monitoring) may both be helpful in treating the symptom of anhedonia in adolescents with depression. Motivational aspects of anhedonia, as well as anxiety, fatigue and academic pressures act as potential barriers to recovery. This highlights the need for psychological treatments for adolescent depression to include explicit and targeted strategies to enhance motivation.