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

Abstract Background. Patients may be vulnerable to relapse in the period immediately following discharge from intensive psychiatric care. Additional attention to factors that support continued recovery after discharge is therefore warranted. Methods. This study examined whether patterns of therapeutic skills use and affect during the acute post-discharge period predicted continued improvement in depression symptoms of patients who completed a partial hospital program. Using ecological momentary assessment and a predictive modeling approach, we assessed how individual differences in therapeutic skills use and their affective responses to skills use influenced recovery. Results.The final model retained five predictors and achieved acceptable discriminative ability (AUC = .74). Total use of behavioral activation predicted improvement (OR = 1.24). A within-person increase in positive affect following CBT skill use predicted non-improvement (OR = .84). Conclusions. These findings suggest that behavioral activation is an effective skill for sustaining depression symptom improvement in the weeks after discharging from a partial hospital program.