PROBLEMS WITH HOMEWORK IN CBT: RARE EXCEPTION OR RATHER FREQUENT?

Abstract

Homework assignments are an essential part of cognitive-behavioural therapy, and are included in the majority of therapy manuals and frequently used in therapeutic practice. Despite this, little is known about problems with homework completion or possible influences on homework compliance. The aim of the present practitioner survey was to provide data on problems related to homework use and compliance. Furthermore, the relationships between different variables and homework compliance were examined. Data were collected by asking 77 cognitive-behavioural therapists to recall two individual patients. Therapists described homework tasks assigned to these patients and procedures of assignment as well as problems that arose during assignment and completion. The results suggested that problems during the assignation of a task as well as during completion regularly occur. Homework compliance was positively associated both with patients' motivation for therapy, outcome at a later stage of therapy, and the provision of a written note or homework sheets on the task. Regression analyses pointed to patient variables as most crucial for homework compliance. Implications for effective homework use in clinical practice are discussed.