Table 1. Comparison of BATD provided in both a standard and motivation-based framework at key treatment junctures.

Standard BATD	Motivation-focused BATD (MBATD)
A. First contact
Present the components of BATD Provide general overview of depression. Encourage patient to put aside concerns about the thoughts and feelings that are holding back progress and “act” with the expectation that motivation will follow.	Build motivation to overcome depression by: evoking impact of depression on life evoking vision of life without depression Build commitment to overcome depression Once commitment is built, present information about BATD how BATD treats depression components of BATD
B. Introducing homework
Introduces homework forms and strongly emphasizes the importance of completing the forms. Anticipate barriers to completing homework and lead a discussion with patient to generate list of barriers and strategies to deal with each that can be tried by the patient.	Avoid use of term homework in order to facilitate a more collaborative and egalitarian relationship between provider and patient. Obtain permission from patient to explain the role of between-session activities in BATD and the ways it is useful to many patients. Proceed after permission is granted Stress that it is the patient's decision whether to complete the between-session activities. Evoke from patient how between-session activities may help them overcome their depression and how they might best motivate and remind themselves to complete homework exercises Use reflections to selectively reinforce change talk regarding completing between-session activities Offer patient the opportunity to personalize monitoring forms to make activity monitoring more useful and meaningful to them
C. Motivating patients to complete activities
Mildly push patient to reconsider that action has to precede motivation. Review treatment rationale and role of completing activities in BATD Lead a discussion of how the patient might benefit from completing activities.	Evoke from patient how they might feel after completing an activity and how this might help them overcome the depression Use reflections to selectively reinforce change talk regarding completing homework When reviewing homework completion, evoke and explore how patient felt after completing the homework, selectively reflecting change talk. Further reinforce motivation by offering a summary of the change talk patient offered regarding benefits of completing homework.
D. Addressing non-adherence with forms or activities
Non-completion of activities: Remind patient about the value of completing activities even if they are not feeling motivated. Encourages discussion of possible reasons/barriers and help the patient generate solutions to address those barriers. Have the patient complete a support contract in session as a role play and then assigns one contract for the patient to complete with a friend or family member. Non-adherence with forms: The first few times homework isn't completed the therapist lists possible reasons and ask the patient to what extent each contributed to the forms not being completed. Model completing forms with the patient in session Assess barriers to form non-completion. Mildly challenge patient regarding their commitment to the treatment when homework repeatedly isn't completed May indicate to the patient that BATD is not a viable treatment option if homework is not completed.	Affirm patient for occasions when they completed the homework forms or activities Evoke what help them complete homework forms or activities on those occasions and affirm patient characteristics that contribute to success Evoke how patient felt after completing forms/activities how they were useful in lessening the depression Selectively reflect patient's change talk about completing forms or activities to reinforce their experience of the usefulness of the homework Explore the patient's interest in improving homework completion. Once commitment to doing so is obtained, explore how patient might use the approaches they used successfully more regularly Problem-solve other obstacles; evoke possible solutions from patient before offering suggestions Present option of incorporating contracts (supports) and evoke from patient how this may be helpful in their treatment.