Table 2.

Key Strategies for Practitioners

Theme	Key Strategies for Practitioners
Established habits and commitments kept me engaged.	Probe for long-standing habits that incorporate prearranged activities or commitments because these may be a strategy to facilitate continued engagement during the depressive episode.
	Reinforce activity engagement by prearranging commitments and encouraging follow through with the client or family and friends.
Some activities were still gratifying.	Encourage continued involvement in activities that remain pleasurable or incite a sense of accomplishment.
Family and friends nudged me into action.	Coach family and friends to facilitate participation in activities and suggest ways to do so. For some people, grandchildren provide a specific source of activity prompting.
I gotta keep going.	Reinforce positive outcomes of activity engagement with the client and family and friends while pointing out negative consequences of inactivity.
Distraction and escape took me away from my situation.	Probe for and support activities that promote constructive use of time while providing an outlet to redirect thinking away from the client’s less-than-optimal situation.
I’m hiding my depression from other people.	Educate family and friends about depressive symptoms, the need to remain vigilant to recognize early signs of depression, and benefits of early communication with health care providers to initiate intervention.
The activity is not meaningful to me now.	Identify activities that are meaningful to the client and encourage participation, recognizing that activities may vary at given time points.
	Recommend adapted strategies for completion of activities that, if forfeited, would likely be detrimental to the client.
I no longer had the physical or cognitive energy to do it.	Encourage the client to weigh activity options, and when insufficient reserve capacity prevents completion of all activities, select the most meaningful activity for engagement.
It’s too physically painful.	Identify activities the client can realistically carry out in the usual way, or suggest modifications to the method used to allow successful engagement.
I constricted my social space.	Probe for meaningful activities that match the client’s current capacity for social interaction.