The integration of behavioral activation therapy (a form of psychotherapy that supports environmental positive reinforcement for individuals through goal setting and the scheduling of positive reinforcement between-session activities) into Transcranial Magnetic Stimulation (TMS) has been shown to be a feasible, well-tolerated, and has led to a significant reduction in the symptoms of major depressive disorder, according to a study published in the Journal of Affective Disorders.
Six of the eleven outpatients with major depressive disorder who received treatment with behavioral activation therapy +TMS protocol met the study criteria for response following treatment: overall symptom improvement as shown by a ≥50% change in baseline to end point scores on the Inventory of Depressive Symptoms and the 9-item Patient Health Questionnaire. Participants also demonstrated a 77% average behavioral activation therapy goal completion rate. The primary study limitation was its inability to compare the behavioral activation therapy +TMS protocol with the efficacy of TMS alone.
Reference: Russo, G, B, Tirrell, E, Busch, A, Carpenter, L L. (2018). Behavioral activation therapy during transcranial magnetic stimulation for major depressive disorder. J Affect Disord. doi: 10.1016/j.jad.2018.04.108