The Benefits of Using Psychotherapy Skills Following Treatment for Depression: An Examination of “Afterwork” and a Test of the Skills Hypothesis in Older Adults

It has long been assumed that one of the reasons clients maintain improvement after psychotherapy is that they learn skills during the course of therapy and continue to apply them once therapy has ended. While research on homework completion and psychotherapy outcome provides support for this assumption, there has been no direct examination of “afterwork,” the use of skills learned in therapy after therapy has ended, or how those posttherapy skills differ across different theoretical approaches. The purpose of this study is to test a skills hypothesis of long-term psychotherapeutic benefit in a sample of 90 older adults who have completed psychotherapy for depression. Helpfulness of the techniques learned in therapy was negatively associated with depressive symptoms up to 2 years after treatment. The number of techniques used was positively correlated with depressive symptoms within 6 months of treatment once helpfulness was controlled, indicating that skills learned in therapy are used when symptoms return. There were also between-group differences in which skills were reported to be covered and used by patients after therapy ended. These findings support the expectation that the benefits of therapy are extended by continuing to use helpful skills learned in therapy.