Journal of Contemporary Psychotherapy

, Volume 47, Issue 4, pp 201–210 | Cite as

Behavioral Activation for a Breast Cancer Patient with Major Depression and Coexistent Personality Disorder

  • Kerry M. Cannity
  • Derek R. Hopko
Original Paper


Behavioral activation is an empirically validated treatment for depression, with recent applications toward other psychological and medical conditions. However, modification to the treatment protocol may be necessary when symptoms, environment, or personality necessitate. This feasibility study applied Behavioral Activation Treatment for Depression (BATD) in a case of a woman with recurrent major depression and obsessive–compulsive personality disorder (OCPD) undergoing breast cancer treatment. A quasi-experimental design was used, comparing supportive psychotherapy (while she received radiation therapy) followed by eight sessions of BATD. Treatment was designed in accordance with patient and therapist goals of increasing exercise, decreasing fatigue, and reducing interference due to perfectionistic behaviors. The patient exhibited resistance to initiation of BATD, related to symptoms of OCPD, which necessitated modification of treatment strategies and scheduling. Following BATD, the patient reported a significant reduction in depressive symptoms, physical problems, and role limitations—gains not observed following supportive therapy. In addition, she demonstrated less psychological rigidity and interference due to OCPD symptoms within the therapeutic relationship and other interpersonal relationships. Consistent with previous research, results indicate BATD may effectively treat individuals with complex clinical presentations that include personality disorder pathology. In addition, methods of modification to BATD are discussed, as well as future directions for research in this area.


Behavioral activation Depression OCPD Cancer Flexibility within fidelity 


Compliance with Ethical Standards

Conflict of interest

All authors declare that there are no conflicts of interest with this study.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all individual participants included in this study.

Supplementary material

10879_2017_9359_MOESM1_ESM.xlsx (16 kb)
Supplementary material 1 (XLSX 16 KB)


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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.Department of PsychologyThe University of Tennessee – KnoxvilleKnoxvilleUSA
  2. 2.KnoxvilleUSA

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