Self-Directed Affiliation and Autonomy Across Acute and Continuation Phase Cognitive Therapy for RecurreAFFILIATIONn ANVDI ATUTETNOGNLO,M CYLA AtRCKR,O JASSR CROE TGTNITIVE TDHERAPY epression

Using Benjamin’s (2000) Structural Analysis of Social Behavior, we evaluated change in “self-directed” affiliation and autonomy and prediction of treatment response and relapse/recurrence among adult outpatients with recurrent major depressive disorder consenting to acute phase cognitive therapy (A–CT; Beck, Rush, Shaw, & Emery, 1979; N = 156); A–CT responders randomized (N = 84) to 8 months of continuation phase cognitive therapy (C–CT; Jarrett, 1989; Jarrett et al., 1998; Jarrett&Kraft, 1997) or assessment-only control; and C–CT and control patients entering a 16-month, assessment-only follow-up (N = 74). Self-directed affiliation and autonomy increased after A–CT, and C–CT further increased affiliation and autonomy. Affiliation and autonomy did not predict A–CT response, but lower affiliation and higher autonomy pre-A–CT predicted relapse/recurrence post-A–CT.We discuss potential clinical implications of these results and present case examples to illustrate patterns of change.