The remarkable growth of the Latino population in the United States can no longer be ignored. Many challenges face this group and contribute to high rates of depression, including the stress associated with the migration experience, low levels of acculturation, inadequate housing, financial burdens, unemployment, low educational attainment, discrimination, and the language barrier. Recently, a promising psychotherapeutic treatment for depression, Behavioral Activation (BA), has performed well in a large randomized trial, suggesting it is as effective as anti-depressant medication for moderate-to-severe depression. BA is a simple, pragmatic approach that activates patients to achieve environmental change and thus may be well suited to Latino depression. Thus, the primary purpose of this exploratory research project is to increase scientific knowledge on the development and delivery of a culturally and linguistically adapted version of BA for depressed Latinos. Some initial work on BA-Latino has already been completed including the completion of an initial manual and a small pilot study. The specific aims of the current project are to: 1) Continue the process of developing the treatment manual for BA-Latinos with focus groups and additional pilot cases, and 2) Compare BA-Latino to treatment-as-usual with a randomized clinical trial in a Latino community clinic. The project will continue the development of an empirically-supported approach to Latino depression that potentially has strengths at retaining patients in treatment and targeting the specific environmental variables that influence depression in this population. This project also will lead to further evaluations of BA-Latino compared to CBT rather than TAU, larger effectiveness studies that allow for more powerful analyses of relapse and remission, attempts to study the dissemination of the BA-Latino training methods to additional community clinics, and creation of a model for the adaptation of BA for other minority populations, including African Americans, Native Americans and Asian Americans. PUBLIC HEALTH RELEVANCE: This project will develop and evaluate a culturally and linguistically adapted version of Behavioral Activation (BA) for Latinos with depression. BA is a simple, pragmatic approach that activates patients to achieve environmental change and thus may be well suited to Latino depression, which often is characterized by seemingly overwhelming environmental obstacles. This project will lead to further evaluations of BA-Latino, larger effectiveness studies that explore depression relapse and remission, attempts to study the dissemination of the BA-Latino training methods to additional community clinics, and creation of a model for the adaptation of BA for other minority populations, including African Americans, Native Americans and Asian Americans.