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Background <p>Patients may be vulnerable to relapse in the period immediately following discharge from intensive psychiatric care.</p> Methods <p>We investigated whether (1) feeling positive after using a therapy skill and (2) frequency of using specific skills predict continued recovery after discharge. Participants were patients discharging from a partial hospital program who reported their use of therapeutic skills and their affect 5–6 times a day for two weeks. Using a predictive modeling approach, we assessed how individual differences in therapeutic skills use and their affective responses to skills use influenced recovery. Predictors included within-person correlations between positive affect and the use of any cognitive behavioral or dialectical behavioral skill, respectively, as well as the frequency of each skill independently (i.e., behavioral activation, cognitive restructuring, etc.).</p> Results <p>The final model retained five predictors and achieved acceptable discriminative ability (AUC = .74). Higher frequency of behavioral activation predicted improvement (OR = 1.24). A within-person increase in positive affect following the use of any CBT skill predicted non-improvement (OR = .84).</p> Conclusions <p>When participants experienced an increase in positive affect after using any CBT skill, they were less likely to see continued improvement, possibly suggesting that feeling positive after using a skill might indicate less effective implementation of this skill or less effective skill selection. However, when frequency of behavioral activation was summed independently of other skills, more use of this skill predicted improvement.</p>

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What Happens After Intensive Treatment? Post-Discharge Skill Use and Affect as Predictors of Depression Outcomes

  • 期刊论文

  • 发表日期：

    2026年3月12日

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  • Shaan F. McGhie,
  • Marie Forgeard,
  • Kailyn Fan,
  • Richard J. McNally,
  • Courtney Beard

摘要

Background

Patients may be vulnerable to relapse in the period immediately following discharge from intensive psychiatric care.

Methods

We investigated whether (1) feeling positive after using a therapy skill and (2) frequency of using specific skills predict continued recovery after discharge. Participants were patients discharging from a partial hospital program who reported their use of therapeutic skills and their affect 5–6 times a day for two weeks. Using a predictive modeling approach, we assessed how individual differences in therapeutic skills use and their affective responses to skills use influenced recovery. Predictors included within-person correlations between positive affect and the use of any cognitive behavioral or dialectical behavioral skill, respectively, as well as the frequency of each skill independently (i.e., behavioral activation, cognitive restructuring, etc.).

Results

The final model retained five predictors and achieved acceptable discriminative ability (AUC = .74). Higher frequency of behavioral activation predicted improvement (OR = 1.24). A within-person increase in positive affect following the use of any CBT skill predicted non-improvement (OR = .84).

Conclusions

When participants experienced an increase in positive affect after using any CBT skill, they were less likely to see continued improvement, possibly suggesting that feeling positive after using a skill might indicate less effective implementation of this skill or less effective skill selection. However, when frequency of behavioral activation was summed independently of other skills, more use of this skill predicted improvement.