Although behavior therapy has a long history and data support its use for depression, the strategy of increasing pleasurable activities and decreasing unpleasurable ones has struck many therapists as simplistic. Over decades, especially in the United States, behavioral therapy withered as an independent modality and was incorporated into cognitive behavior therapy, which uses behaviors mainly to test the validity of underlying automatic, irrational thoughts. That is, behaviors were subordinated to cognitions. In 1996, however, Jacobson and colleagues (1) dismantled cognitive behavior therapy in a randomized, controlled three-cell trial of 150 patients with DSM-III-R major depression. They found that behavioral activation, a purely behavioral intervention, worked as efficaciously as full cognitive behavior therapy—without addressing negative cognitions. A study is now comparing behavioral activation, cognitive behavior therapy, paroxetine, and placebo (S. Hollon, personal communication, Jan. 2003).