The Effectiveness of Behavioral Activation Therapy on Reducing Hopelessness and Suicidal Ideation in Adolescents with Major Depressive Disorder: A Quasi-Experimental Study with a Two-Month Follow-Up

Bigham Lalabadi, Elahe; Mikaeili, Niloofar; Atadokht, Akbar; Basharpoor, Sajad; Molavi, Parviz

doi:10.22054/jcps.2026.89506.3308

The Effectiveness of Behavioral Activation Therapy on Reducing Hopelessness and Suicidal Ideation in Adolescents with Major Depressive Disorder: A Quasi-Experimental Study with a Two-Month Follow-Up

Document Type : Research Paper

Authors

¹ 1. Ph.D. Student of Psychology, Psychology Department, School of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.

² Professor, Psychology Departmen, School of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.

³ 5. M.D. professor of psychiatry,Ardabil University of Medical Science psychiatrist, Subspeciality in Child & Adolescent Psychiatry, Ardabil, Iran.

10.22054/jcps.2026.89506.3308

Abstract

Abstract
Objective The present study aimed to investigate the effectiveness of Group Behavioral Activation Therapy (BA) on reducing hopelessness and suicidal ideation in adolescents diagnosed with Major Depressive Disorder (MDD).
Research Methodology: This quasi-experimental study utilized a pre-test, post-test, and two-month follow-up design with a control group. The sample (N=40) consisted of adolescents aged 12 to 19 in Kermanshah, diagnosed with MDD, who were selected via purposive sampling and randomly assigned to the experimental (n=20) or control (n=20) group. The mean age of participants was approximately 14.4 years. The experimental group received ten 90-minute weekly group sessions of BA, while the control group received no intervention. Research instruments included the Hopelessness Scale for Children (HSC) and the Beck Scale for Suicide Ideation (BSSI). Data were analyzed using Mixed-Design Analysis of Variance (Mixed ANOVA).
Findings: The results indicated a statistically significant Group × Time interaction for both variables, confirming the effectiveness of the BA intervention. BA significantly reduced levels of hopelessness (F=11.18,p<0.001,η2=0.22) and suicidal ideation (F=29.92,p<0.001,η2=0.37) compared to the control group. Furthermore, post-hoc analysis confirmed that the therapeutic gains achieved were maintained at the two-month follow-up. The intervention had a stronger effect on reducing suicidal ideation (η2=0.37) than on hopelessness (η2=0.22).
Conclusion: The findings suggest that Behavioral Activation is an effective, evidence-based, and cost-effective intervention for reducing the core symptoms of depression and exerting a profound therapeutic impact on high-risk constructs like hopelessness and suicidal ideation in adolescents. The study underscores the importance of implementing BA in clinical and educational settings.
Keywords:
Adolescents;Behavioral Activation; Hopelessness; Major Depressive Disorder; Suicidal Ideation

Keywords