On your own or with a therapist
4 minute read
Plenty of people keep an activity record on their own, and plenty keep one as homework between therapy sessions. This covers when to get support first, what a record offers either way, and what the research on related self-help does and does not show.
When to get help first
An activity record is not the right first step for everything. Talk to a professional before you start, or alongside it, if any of these apply.
- Low mood has lasted more than a couple of weeks and is getting in the way of work, relationships, or looking after yourself.
- You are having thoughts of harming yourself, or thoughts that life is not worth living.
- Keeping the record leaves you feeling markedly worse, or turns into another way to criticize yourself.
- You have spells of unusually high energy and little need for sleep, as well as low periods.
- You are hearing or seeing things others do not, or you are relying heavily on alcohol or drugs to get through.
Nothing you write in the app or the worksheet is seen by anyone else, including us. That keeps it private, and it also means no one can notice if you are struggling or respond to what you write.
If you may be in crisis, contact your local emergency number or a crisis line now. In the United States you can call or text 988, the Suicide and Crisis Lifeline, which also offers help in Spanish. In the UK and Ireland, Samaritans answer on 116 123. Elsewhere, findahelpline.com lists free lines by country.
On your own
Kept on your own, an activity record does the same job it does anywhere. It shows how your weeks actually go, where enjoyment and achievement turn up, what tends to go with better and worse hours, and where avoidance creeps in. That is worth having for its own sake, and it gives you something concrete to bring to a program or a therapist later if you want one.
What the research on self-help shows
Studies of self-help have looked at behavioral activation programs rather than at a record kept alone. Those programs teach the whole method, including planning activities, and usually include brief support from a person who checks in, encourages you to keep going, and reviews progress. In 2018 Huguet and colleagues pooled nine randomized trials of internet-delivered behavioral activation with 2,157 adults, most recruited from the community rather than from clinics. The pooled results, for guided programs, showed less depression and anxiety than waiting lists or usual care, and about as much improvement as other behavioral approaches. The authors warn that much of the evidence was of low or very low quality and follow-up was short.
The UK's clinical guideline on depression, published by the National Institute for Health and Care Excellence in 2022, points the same way. For less severe depression it lists guided self-help first, meaning structured materials, which can include behavioral activation, with support from a trained practitioner over about six to eight sessions.
So the research supports guided self-help built on behavioral activation. It does not tell us how much a record kept alone will help.
With a therapist
In therapy the record becomes shared material. A therapist can see the week without relying on memory, notice avoidance you might not name, and, if you are doing behavioral activation, help plan activities of the right size in the steps that follow.
If you already see someone, ask whether they would like the record and in what form. Some prefer paper, and the printable sheets are made for that. The app and the worksheet both export a PDF.
What this site is
Activity Record is a tool for keeping the record and seeing it clearly. It does not diagnose, it does not give advice about your situation, and it is not therapy. It is built to be useful on its own and easy to bring into a session.
References
- Huguet, A., Miller, A., Kisely, S., Rao, S., Saadat, N., & McGrath, P. J. (2018). A systematic review and meta-analysis on the efficacy of Internet-delivered behavioral activation. Journal of Affective Disorders, 235, 27–38. doi.org/10.1016/j.jad.2018.02.073
- National Institute for Health and Care Excellence. (2022). Depression in adults: Treatment and management (NICE guideline NG222). nice.org.uk/guidance/ng222
Helpful links
- NICE guideline NG222: Depression in adults
- 988 Suicide and Crisis Lifeline
- Beck Institute: Directory of certified CBT clinicians
Educational content, not medical advice or a substitute for professional care. Ready to try it? Open the free worksheet, print a sheet, or get the app for iPhone and iPad or Android.