How to Do Activity Scheduling: 6 Templates & Worksheets

How to Do Activity Scheduling: 6 Templates & Worksheets – The activities we engage in influence how we feel. And yet, when depressed, clients often find themselves unable to do those things that bring enjoyment and meaning to their lives (Behavioral Activation for Depression, n.d.).

Behavioral activation is a crucial aspect of Cognitive-Behavioral Therapy, helping shed light on how the client’s behaviors influence their emotions (Beck, 2011; Farmer & Chapman, 2016).

Once understood, activities can be scheduled that improve the client’s mood and lessen their experience of emotional distress or depression.

This article explores activity scheduling as part of behavioral activation while introducing tools and worksheets for use in treatment.

What Is Activity Scheduling in CBT and Therapy?

Clients with depression entering treatment may have stopped engaging in activities that previously gave them a sense of enjoyment or achievement and increased other unhelpful behaviors, such as staying in bed or watching excessive TV (Beck, 2011).

However, such inactivity reduces the opportunity to gain mastery and control over their lives or experience pleasure, increasing negative thinking and a downward spiral of triggers, negative emotions, and behavior (Beck, 2011).

Behavioral activation can help clients become more active and increase engagement in their lives through the following (Behavioral Activation for Depression, n.d.):

• Understanding the negative thinking cycles of depression
• Tracking daily activities
• Identifying and defining goals and values
• Encouraging motivation and energy through mastery and pleasure
• Purposefully scheduling enjoyable and engaging activities
• Using problem-solving to overcome obstacles to activity
• Reducing avoidance behavior
• Promoting gradual and sustained change
• Using between-session homework

The process of behavioral activation typically begins with activity monitoring. The client identifies what they are doing throughout each day and its effect on their mood. This knowledge increases their understanding of which behaviors lead to positive and negative emotions and which activities maintain or worsen their depression (Behavioral Activation for Depression, n.d.).

The client and therapist can then work together to create activity schedules for the days ahead, taking care not to overwhelm the client by creating a too-busy plan.

The therapist “builds in short periods of activity with longer periods of leisure activity or rest” and encourages them to give themselves credit every time they follow the schedule (Beck, 2011, p. 93).

At the next session, the therapist asks the client how it went. Did the activity scheduling help, or were they too tired to participate in the activities? The review process can help motivate the client to find new ways to increase engagement in pleasurable and productive activities (Beck, 2011).

2 Real-Life Examples of Activity Scheduling

Activity assessment and scheduling are vital aspects of CBT and other treatments, especially when a client is presenting with symptoms of depression and withdrawing from prior activities, such as the two real-life examples below.

Sally reviews her schedule and starts activity scheduling

Beck (2011) discusses her client Sally’s daily schedule of activities to understand what has changed for her and what she may be doing too little of.

Therapist: Sally, do you notice anything different about your daily activities from say, a year ago?

Sally: Yes, I spend more of my time in bed.

Therapist: Does staying in bed make you feel better? Do you get out feeling refreshed and ready to go?

Sally: No, I still feel sleepy and down.

Therapist: I believe you used to spend time exercising, is that right?

Sally: Yes, I used to run or swim most mornings, but I’ve felt tired and didn’t think I’d enjoy it.

Therapist: Would you like to plan some exercise, perhaps going for a short run or swim three times a week?

Sally: Yes, I could commit to that.

Therapist: You could also give yourself credit for when you do such things.

Whether written down or verbal, the client makes a commitment to take part in an activity they find enjoyable.

Diane’s level of activity is impacted by her worsening mood

Farmer and Chapman (2016) introduce Diane, a 42-year-old recently divorced woman, referred because of a progressive worsening of her mood. Following marital difficulties, her depressed mood has affected her performance at work and as a mother to her two children.

Diane completed a self-monitoring exercise where she captured her activities and associated moods. Reviewing the form, it became clear that her mood changed with the activities she performed. For example, drinking wine late at night and watching the news channel accompanied a lowered mood.

The therapist suggested that Diane may benefit from scheduling more pleasurable activities. Together, they created an activity schedule that included activities like going to the movies with her friend.

Activity scheduling can replace activities that appear to lower a client’s mood with new ones associated with pleasurable emotions. Clients can track their feelings to see whether the changes are associated with better coping and more positive feelings (Farmer & Chapman, 2016).

Does It Work? 4 Proven Benefits

Activity scheduling has proven effective at reducing symptoms in various mental health conditions, including anxiety and eating disorders, and is an essential element of behavioral activation commonly found in CBT treatments (Beck, 2011; Farmer & Chapman, 2016).

Its use has seen positive results elsewhere, including promoting motor functioning in Parkinson’s disease, where clients experience associated fears of falling and disease progression (Koychev & Okai, 2017).

Does it help with depression?

Activity scheduling is an effective behavioral intervention in clients with depression. A 2008 study of an inpatient depression program found that planning and performing activities associated with positive moods increased engagement in their lives and improved their chances of recovery (Iqbal & Bassett, 2008).

How to Do Activity Scheduling: 6 Tips

Participation in social and other pleasurable activities is “strongly associated with positive moods” and can be encouraged through planning, goal setting, and the use of activity schedules (Farmer & Chapman, 2016, p. 241).

The following six tips are helpful when working with clients to schedule and carry out activities. Ask the client to consider each of the following (modified from Farmer & Chapman, 2016):

1. Identify the activities to participate in
   Be clear on what you want and plan to do. What do you no longer do that previously you found pleasant? Create a list, including how, where, and when you will do it.
2. Make a commitment
   Schedule specific times during the week that are wholly dedicated to doing those activities identified as pleasurable, including social ones such as meeting up with others.
3. Create a clear plan or arrangement
   Are there any obstacles that might get in the way of the activities? Plan for them and seek help where needed, for example, childcare or making a reservation.
4. Stick to the plan
   A plan is worth nothing if it is not implemented. Following it through to the end will ensure that you gain control over your life, dictating its direction and meeting your needs.
5. Reflect on the outcome
   Once completed, whether entirely successful or not, reflect on the activity. Was it pleasurable? How did it impact your mood? Do you wish to schedule it again or replace it with something else?
6. Increase social support
   Too often we respond to emotional distress through social withdrawal. Plan activities to strengthen existing or form new relationships.

Activity scheduling is ultimately a behavioral experiment. With help from the therapist, the client learns what improves their mood and increases the frequency of pleasant activities.

6 Best Templates & Worksheets

The following templates and worksheets are helpful for working with clients in session or as homework.

Will Behavioral Activation Be Helpful?

Behavioral activation and the use of activity scheduling, in particular, can be highly effective for clients.

Use the Will Behavioral Activation Be Helpful? worksheet with your client to understand whether scheduling pleasurable activities is likely to be beneficial.

Ask the client to reflect on a series of questions, including:

• Do you typically have a sense of what is triggering the lowering of your mood or increasing your anxiety?
• Do you find yourself opting to do very little, with limited pleasure or meaning attached?
• Do you know when or why you feel better?
• Do you find yourself feeling better when you perform certain activities?
• Do you have a hard time knowing what you enjoy or find meaning in?

Answering ‘yes’ to several of the questions suggests that activity scheduling could be helpful.

Understanding Vicious Cycles

Behavioral activation research suggests that depression can create a vicious cycle of events, emotions, and behavior (Behavioral Activation for Depression, n.d.).

Use the Understanding Vicious Cycles worksheet to explore the events that trigger depression, the emotions that arise, and the client’s behavior.

Ask the client to think of some recent events that they believe may have triggered or maintained their depression.

Understanding the triggers linked to depression and the emotions that lead to specific behaviors can help create a treatment plan.

Tracking Activities and Mood

Tracking activities and accompanying moods is a valuable part of the process of behavioral activation and is often used in CBT treatments (Beck, 2011).

Use the Tracking Activities and Mood worksheet to capture the activities that the client has engaged in and how they felt over seven days.

While tracking activities will not cure the client’s depression, it can help to know what activities made them feel better (Beck, 2011).

Up and Down Activities

Having tracked at least a week’s worth of activities, it is now possible to recognize trends in what is causing the client’s moods to improve or worsen.

Use the Up and Down Activities worksheet to summarize the patterns and relationships between activities and feelings.

The ‘up’ activities should then be scheduled for the client to ensure that they form a regular part of their life, leading to a more positive sense of well-being.

Behavioral Activity Motivation

Even when an activity has been identified as positive in the client’s past and likely to increase their mood, they may find it difficult to initiate or maintain the behavior.

Use the Behavioral Activity Motivation worksheet to reflect on an activity the client has planned or is thinking of scheduling.

Ask the client to visualize what it might be like preparing for and taking part in the activity, and consider negative thoughts or obstacles that may get in their way.

Activity Scheduling

Activity scheduling allows the client to set and commit to valuable activities they find pleasurable and that improve their mood.

Use the Activity Scheduling worksheet to plan times to perform each mood-enhancing activity. After completing each one, they can mark it as complete and capture their mood.