A Randomized Controlled Trial of a Behavioral Activation Intervention to Increase Engagement with Life and Well-Being in Older Adults

Introduction: Engagement with life is central to aging well. There is currently a lack of flexible programs for promoting engagement that tailor to the unique interests, capacities, and life circumstances of individuals. We designed and evaluated a new program for promoting engagement with later life based on principles of behavioral activation. 

Methods: A total of 135 adults aged 65 years and older who scored at or below the median on the Life Engagement Test were randomly assigned to either a 6-week behavioral activation program (n = 69) or a 6-week well-being program based on brief positive psychology interventions (the active control; n = 66). Participants completed assessments at baseline, 1-week follow-up, and 3-month follow-up. The primary outcome was engagement with life, and secondary outcome measures included social network characteristics, measures of mental health, well-being, and psychological and self-regulatory resources. 

Results: Participants in both conditions showed improvements in engagement with life post-intervention that were sustained at 3 months. Post-intervention improvements in both conditions were observed across most secondary outcomes; however, for several outcomes, participants with more limited functional and cognitive resources benefitted from participation in the positive psychology (active control) condition, but not the treatment condition. 

Conclusion: Similar levels of improvement in engagement with life and well-being were evident for participants who completed a behavioral activation-focused intervention, compared with participants who completed a positive psychology-focused intervention. The positive psychology approach may confer greater benefits for emotional well-being among those with poorer functional and cognitive abilities.