One month ago I started to build this website. I called it Do More That Matters. Although over 2300 people have visited the site no-one has asked me why. So I'll tell you anyway. The website title also links with a big life event - on Saturday morning I received copies of our new treatment manual for Brief Behavioural Activation. You might have noticed that I proudly posted a picture of this on the home page - sorry for the self promotion but I'm very excited.
Do More That Matters summarises the key concept we use in Brief Behavioural Activation to help young people clamber out of depression and overcome the many barriers that stop them getting on with their life. Some barriers are internal. They include the very symptoms of depression itself; these include lack of motivation, low energy, fatigue, feeling worthless, and hopelessness. Depression is the difficulty that just keeps on taking. Depression not only takes away important parts of your life it also interferes with your ability to benefit from treatment. Other barriers to overcoming depression are external and tangible. Often young people with depression live in challenging contexts and experience poverty, deprivation, abuse, or neglect. Sometimes their physical environments are impoverished and they lack stable, reliable care. Usually they feel powerless.
The aim of Brief Behavioural Activation is simple - to help and support depressed young people to Do More That Matters – to them. Not to anyone else. This is a powerful way to work with a young person. Identifying 'what matters' is engaging, stimulating, challenging and supportive. We use it to then identify valued activities that the young person can start to do a little more of. As we help them increase their valued activities, this provides them with rewards, the 'feel good factor' or, as we psychologists like to call it, positive reinforcement. Slowly, slowly, slowly, experiencing small doses of the 'feel good factor' helps young people to climb out of the trap of depression.
Therefore what we do in Brief Behavioural Activation for depression is based on the answer to one simple question. 'What matters to you?' I love that question. I love the fact that it seems so simple. I love the fact that when you ask me, it shows me that you are interested in me. I love the fact that it makes me think about things in a different way. I love that there are a million different answers to the question. I love that it opens up new ideas and puts me at the centre. I love that it is a great question. Psychological therapy can be more about questions than answers.
Remember when you were 15 years old? What mattered to you?
Did you know what mattered to you? Or was this a question you still needed to be asked?
Did anyone ask 'What Matters to You?" when you were 15?
Or did you ask yourself?
Adolescence is a most challenging time, a time when one of our key tasks is to figure out who we are. This is a critical task if we are to make life changing decisions. The subjects we study, the friends we make and keep, how we spend our free time, the choices we make about jobs, education, family and our future will set us on a particular direction into our future. To make all of these decisions it's helpful to have some kind of answer to "What matters to you?" In Brief BA we often describe "What Matters to You" as a compass - something to help show you the way.
When we ask young people "What matters to you?" we are asking them to think about their values. The concept of values is increasingly important in psychological therapies. We (Laura Pass and I) stumbled across and incorporated 'values' into Brief Behavioural Activation without really understanding how central it is to many therapies. And we are still learning about that. We adapted Brief Behavioural Activation from the work of Carl Lejeuz and Derek Hopko who used 'values' in their manualised treatment for adults with depression - Behavioural Activation for the Treatment of Depression BATD). As they suggested, using values to guide behavioural change means that we are more likely to incorporate new behaviours that are intrinsically rewarding, and of course link these to a broader sense of our self and who we are. It helps with day to day planning and choices, the task of growing up and becoming independent, and ultimately with making important life decisions.
Maybe this is why talking about "What Matters to You" is so powerful in therapy with a young person.
The importance of knowing What Matters to You does not diminish as we grow older. The values we develop and identify in youth, are typically the values that we take through life. How about now? What matters to you? How often are you finding time for valued activities? And what is giving you the 'feel good factor'?