what is cbt homework

Sending Homework to Clients in Therapy: The Easy Way

Successful therapy relies on using assignments outside of sessions to reinforce learning and practice newly acquired skills in real-world settings (Mausbach et al., 2010).

Up to 50% of clients don’t adhere to homework compliance, often leading to failure in CBT and other therapies (Tang & Kreindler, 2017).

In this article, we explore how to use technology to create homework, send it out, and track its completion to ensure compliance.

Before you continue, we thought you might like to download our three Positive Psychology Exercises for free . These science-based exercises will explore fundamental aspects of positive psychology including strengths, values, and self-compassion, and will give you the tools to enhance the wellbeing of your clients, students, or employees.

This Article Contains:

Is homework in therapy important, how to send homework to clients easily, homework in quenza: 5 examples of assignments, 5 counseling homework ideas and worksheets, using care pathways & quenza’s pathway builder, a take-home message.

Cognitive-Behavioral Therapy has “been shown to be as effective as medications in the treatment of a number of psychiatric illnesses” (Tang & Kreindler, 2017, p. 1).

Homework is a vital component of CBT, typically involving completing a structured and focused activity between sessions.

Practicing what was learned in therapy helps clients deal with specific symptoms and learn how to generalize them in real-life settings (Mausbach et al., 2010).

CBT practitioners use homework to help their clients, and it might include symptom logs, self-reflective journals , and specific tools for working on obsessions and compulsions. Such tasks, performed outside therapy sessions, can be divided into three types (Tang & Kreindler, 2017):

Psychoeducation Reading materials are incredibly important early on in therapy to educate clients regarding their symptoms, possible causes, and potential treatments.
Self-assessment Monitoring their moods and completing thought records can help clients recognize associations between their feelings, thoughts, and behaviors.
Modality specific Therapists may assign homework that is specific and appropriate to the problem the client is presenting. For example, a practitioner may use images of spiders for someone with arachnophobia.

Therapists strategically create homework to lessen patients’ psychopathology and encourage clients to practice skills learned during therapy sessions, but non-adherence (between 20% and 50%) remains one of the most cited reasons for CBT failure (Tang & Kreindler, 2017).

Reasons why clients might fail to complete homework include (Tang & Kreindler, 2017):

Internal factors

Lack of motivation to change what is happening when experiencing negative feelings
Being unable to identify automatic thoughts
Failing to see the importance or relevance of homework
Impatience and the wish to see immediate results

External factors

Effort required to complete pen-and-paper exercises
Inconvenience and amount of time to complete
Failing to understand the purpose of the homework, possibly due to lack of or weak instruction
Difficulties encountered during completion

Homework compliance is associated with short-term and long-term improvement of many disorders and unhealthy behaviors, including anxiety, depression, pathological behaviors, smoking, and drug dependence (Tang & Kreindler, 2017).

Greater homework adherence increases the likelihood of beneficial therapy outcomes (Mausbach et al., 2010).

With that in mind, therapy must find ways to encourage the completion of tasks set for the client. Technology may provide the answer.

The increased availability of internet-connected devices, improved software, and widespread internet access enable portable, practical tools to enhance homework compliance (Tang & Kreindler, 2017).

Clients who complete their homework assignments progress better than those who don’t (Beck, 2011).

Having an ideal platform for therapy makes it easy to send and track clients’ progress through assignments. It must be “user-friendly, accessible, reliable and secure from the perspective of both coach and client” (Ribbers & Waringa, 2015, p. 103).

In dedicated online therapy and coaching software, homework management is straightforward. The therapist creates the homework then forwards it to the client. They receive a notification and complete the work when it suits them. All this is achieved in one system, asynchronously; neither party needs to be online at the same time.

For example, in Quenza , the therapist can create a worksheet or tailor an existing one from the library as an activity that asks the client to reflect on the progress they have made or work they have completed.

The activity can either be given directly to the client or group, or included in a pathway containing other activities.

Here is an example of the activity parameters that Quenza makes possible.

A message can be attached to the activity, using either a template or a personally tailored message for the client. Here’s an example.

Once the activity is published and sent, the client receives a notification about a received assignment via their coaching app (mobile or desktop) or email.

The client can then open the Quenza software and find the new homework under their ‘To Do’ list.

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Quenza provides the ability to create your own assignments as well as a wide selection of existing ones that can be assigned to clients for completion as homework.

The following activities can be tailored to meet specific needs or used as-is. Therapists can share them with the client individually or packaged into dedicated pathways.

Such flexibility allows therapists to meet the specific needs of the client using a series of dedicated and trackable homework.

Examples of Quenza’s ready-to-use science-based activities include the following:

Wheel of Life

The Wheel of Life is a valuable tool for identifying and reflecting on a client’s satisfaction with life.

You can find the worksheet in the Positive Psychology Toolkit© , and it is also included in the Quenza library. The client scores themselves between 1 and 10 on specific life domains (the therapist can tailor the domains), including relationships, career development, and leisure time.

This is an active exercise to engage the client early on in therapy to reflect on their current and potential life. What is it like now? How could it look?

The wheel identifies where there are differences between perceived balance and reality .

The deep insights it provides can provide valuable input and prioritization for goal setting.

The Private Garden: A Visualization for Stress Reduction

While stress is a normal part of life, it can become debilitating and interfere with our everyday lives, stopping us from reaching our life goals.

We may notice stress as worry, anxiety, and tension and resort to avoidant or harmful behaviors (e.g., abusing alcohol, smoking, comfort eating) to manage these feelings.

Visualization is simple but a powerful method for reducing physical and mental stress, especially when accompanied by breathing exercises.

The audio included within this assignment helps the listener visualize a place of safety and peace and provides a temporary respite from stressful situations.

20 Guidelines for Developing a Growth Mindset

Research into neuroplasticity has confirmed the ability of the adult brain to continue to change in adulthood and the corresponding capacity for people to develop and transform their mindsets (Dweck, 2017).

The 20 guidelines (included in our Toolkit and part of the Quenza library) and accompanying video explain our ability to change mentally and develop a growth mindset that includes accepting imperfection, leaning into challenges, continuing to learn, and seeing ‘failure’ as an opportunity for growth.

Adopting a growth mindset can help clients understand that our abilities and understanding are not fixed; we can develop them in ways we want with time and effort.

Self-Contract

Committing to change is accepted as an effective way to promote behavioral change – in health and beyond. When a client makes a contract with themselves, they explicitly state their intention to deliver on plans and short- and long-term goals.

Completing and signing such a self-contract (included in our Toolkit and part of the Quenza library) online can help people act on their commitment through recognizing and living by their values.

Not only that, the contract between the client and themselves can be motivational, building momentum and self-efficacy.

The contract can be automatically personalized to include the client’s name but also manually reworded as appropriate.

The client completes the form by restating their name and committing to a defined goal by a particular date, along with their reasons for doing so.

Realizing Long-Lasting Change by Setting Process Goals

We can help clients realize their goals by building supportive habits. Process goals – for example, eating healthily and exercising – require ongoing actions to be performed regularly.

Process goals (unlike end-state goals, such as saving up for a vacation) require long-lasting and continuous change that involves monitoring standards.

This tool (included in our Toolkit and part of the Quenza library) can help clients identify positive actions (rather than things to avoid) that they must carry out repeatedly to realize change.

We have many activities that can be used to help clients attending therapy for a wide variety of issues.

In this section, we consider homework ideas that can be used in couples therapy, family therapy, and supporting clients with depression and anxiety.

Couples therapy homework

Conflict is inevitable in most long-term relationships. Everyone has their idiosyncrasies and individual set of needs. The Marital Conflicts worksheet captures a list of situations in which conflicts arise, when they happen, and how clients feel when they are (un)resolved.

Family therapy homework

Families, like individuals, are susceptible to times of stress and disruptions because of life changes such as illness, caring for others, and job and financial insecurity.

Mind the Gap is a family therapy worksheet where a family makes decisions together to align with goals they aspire to. Mind the gap is a short exercise to align with values and improve engagement.

How holistic therapist Jelisa Glanton uses Quenza

Homework ideas for depression and anxiety: 3 Exercises

The following exercises are all valuable for helping clients with the effects of anxiety and depression.

Activity Schedule is a template assisting a client with scheduling and managing normal daily activities, especially important for those battling with depression.

Activity Menu is a related worksheet, allowing someone with depression to select from a range of normal activities and ideas, and add these to a schedule as goals for improvement.

The Pleasurable Activity Journal focus on activities the client used to find enjoyable. Feelings regarding these activities are journaled, to track recovery progress.

Practicing mindfulness is helpful for those experiencing depression (Shapiro, 2020). A regular gratitude practice can develop new neural pathways and create a more grateful, mindful disposition (Shapiro, 2020).

Each activity can be tailored to the client’s needs; shared as standalone exercises, worksheets, or questionnaires; or included within a care pathway.

A pathway is an automated and scheduled series of activities that can take the client through several stages of growth, including psychoeducation , assessment, and action to produce a behavioral change in a single journey.

How to build pathways

The creator can add two pathway titles. The second title is not necessary, but if entered, it is seen by the client in place of the first.

Once named, a series of steps can be created and reordered at any time, each containing an activity. Activities can be built from scratch, modified from existing ones in the library, or inserted as-is.

New activities can be created and used solely in this pathway or made available for others. They can contain various features, including long- and short-answer boxes, text boxes, multiple choice boxes, pictures, diagrams, and audio and video files.

Quenza can automatically deliver each step or activity in the pathway to the client following the previous one or after a certain number of days. Such timing is beneficial when the client needs to reflect on something before completing the next step.

Practitioners can also designate steps as required or optional before the client continues to the next one.

Practitioners can also add helpful notes not visible to the client. These comments can contain practical reminders of future changes or references to associated literature that the client does not need to see.

It is also possible to choose who can see client responses: the client and you, the client only, or the client decides.

Tags help categorize the pathway (e.g., by function, intended audience, or suggested timing within therapy) and can be used to filter what is displayed on the therapist’s pathway screen.

Once designed, the pathway can be saved as a draft or published and sent to the client. The client receives the notification of the new assignment either via email or the coaching app on their phone, tablet, or desktop.

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Success in therapy is heavily reliant on homework completion. The greater the compliance, the more likely the client is to have a better treatment outcome (Mausbach et al., 2010).

To improve the likelihood that clients engage with and complete the assignments provided, homework must be appropriate to their needs, have a sound rationale, and do the job intended (Beck, 2011).

Technology such as Quenza can make homework readily available on any device, anytime, from any location, and ensure it contains clear and concise psychoeducation and instructions for completion.

The therapist can easily create, copy, and tailor homework and, if necessary, combine multiple activities into single pathways. These are then shared with the click of a button. The client is immediately notified but can complete it at a time appropriate to them.

Quenza can also send automatic reminders about incomplete assignments to the client and highlight their status to the therapist. Not only that, but any resulting questions can be delivered securely to the therapist with no risk of getting lost in a busy email inbox.

Why not try the Quenza application? Try using some of the existing science-based activities or create your own. It offers an impressive array of functionality that will not only help you scale your business, but also ensure proactive, regular communication with your existing clients.

We hope you enjoyed reading this article. Don’t forget to download our three Positive Psychology Exercises for free .

Beck, J. S. (2011). Cognitive behavior therapy: Basics and beyond . Guilford Press.
Dweck, C. S. (2017). Mindset: The new psychology of success. Robinson.
Mausbach, B. T., Moore, R., Roesch, S., Cardenas, V., & Patterson, T. L. (2010). The relationship between homework compliance and therapy outcomes: An updated meta-analysis. Cognitive Therapy and Research , 34 (5), 429–438.
Ribbers, A., & Waringa, A. (2015). E-coaching: Theory and practice for a new online approach to coaching . Routledge.
Shapiro, S. L. (2020). Rewire your mind: Discover the science and practice of mindfulness. Aster.
Tang, W., & Kreindler, D. (2017). Supporting homework compliance in cognitive behavioural therapy: Essential features of mobile apps. JMIR Mental Health , 4 (2).

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What Is Therapy Homework?

Sanjana is a health writer and editor. Her work spans various health-related topics, including mental health, fitness, nutrition, and wellness.

Dr. Sabrina Romanoff, PsyD, is a licensed clinical psychologist and a professor at Yeshiva University’s clinical psychology doctoral program.

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Types of Therapy That Involve Homework

If you’ve recently started going to therapy , you may find yourself being assigned therapy homework. You may wonder what exactly it entails and what purpose it serves. Therapy homework comprises tasks or assignments that your therapist asks you to complete between sessions, says Nicole Erkfitz , DSW, LCSW, a licensed clinical social worker and executive director at AMFM Healthcare, Virginia.

Homework can be given in any form of therapy, and it may come as a worksheet, a task to complete, or a thought/piece of knowledge you are requested to keep with you throughout the week, Dr. Erkfitz explains.

This article explores the role of homework in certain forms of therapy, the benefits therapy homework can offer, and some tips to help you comply with your homework assignments.

Therapy homework can be assigned as part of any type of therapy. However, some therapists and forms of therapy may utilize it more than others.

For instance, a 2019-study notes that therapy homework is an integral part of cognitive-behavioral therapy (CBT) . According to Dr. Erkfitz, therapy homework is built into the protocol and framework of CBT, as well as dialectical behavior therapy (DBT) , which is a sub-type of CBT.

Therefore, if you’re seeing a therapist who practices CBT or DBT, chances are you’ll regularly have homework to do.

On the other hand, an example of a type of therapy that doesn’t generally involve homework is eye movement desensitization and reprocessing (EMDR) therapy. EMDR is a type of therapy that generally relies on the relationship between the therapist and client during sessions and is a modality that specifically doesn’t rely on homework, says Dr. Erkfitz.

However, she explains that if the client is feeling rejuvenated and well after their processing session, for instance, their therapist may ask them to write down a list of times that their positive cognition came up for them over the next week.

"Regardless of the type of therapy, the best kind of homework is when you don’t even realize you were assigned homework," says Erkfitz.

Benefits of Therapy Homework

Below, Dr. Erkfitz explains the benefits of therapy homework.

It Helps Your Therapist Review Your Progress

The most important part of therapy homework is the follow-up discussion at the next session. The time you spend reviewing with your therapist how the past week went, if you completed your homework, or if you didn’t and why, gives your therapist valuable feedback on your progress and insight on how they can better support you.

It Gives Your Therapist More Insight

Therapy can be tricky because by the time you are committed to showing up and putting in the work, you are already bringing a better and stronger version of yourself than what you have been experiencing in your day-to-day life that led you to seek therapy.

Homework gives your therapist an inside look into your day-to-day life, which can sometimes be hard to recap in a session. Certain homework assignments keep you thinking throughout the week about what you want to share during your sessions, giving your therapist historical data to review and address.

It Helps Empower You

The sense of empowerment you can gain from utilizing your new skills, setting new boundaries , and redirecting your own cognitive distortions is something a therapist can’t give you in the therapy session. This is something you give yourself. Therapy homework is how you come to the realization that you got this and that you can do it.

"The main benefit of therapy homework is that it builds your skills as well as the understanding that you can do this on your own," says Erkfitz.

Tips for Your Therapy Homework

Below, Dr. Erkfitz shares some tips that can help with therapy homework:

Set aside time for your homework: Create a designated time to complete your therapy homework. The aim of therapy homework is to keep you thinking and working on your goals between sessions. Use your designated time as a sacred space to invest in yourself and pour your thoughts and emotions into your homework, just as you would in a therapy session .
Be honest: As therapists, we are not looking for you to write down what you think we want to read or what you think you should write down. It’s important to be honest with us, and yourself, about what you are truly feeling and thinking.
Practice your skills: Completing the worksheet or log are important, but you also have to be willing to put your skills and learnings into practice. Allow yourself to be vulnerable and open to trying new things so that you can report back to your therapist about whether what you’re trying is working for you or not.
Remember that it’s intended to help you: Therapy homework helps you maximize the benefits of therapy and get the most value out of the process. A 2013-study notes that better homework compliance is linked to better treatment outcomes.
Talk to your therapist if you’re struggling: Therapy homework shouldn’t feel like work. If you find that you’re doing homework as a monotonous task, talk to your therapist and let them know that your heart isn’t in it and that you’re not finding it beneficial. They can explain the importance of the tasks to you, tailor your assignments to your preferences, or change their course of treatment if need be.

"When the therapy homework starts 'hitting home' for you, that’s when you know you’re on the right track and doing the work you need to be doing," says Erkfitz.

A Word From Verywell

Similar to how school involves classwork and homework, therapy can also involve in-person sessions and homework assignments.

If your therapist has assigned you homework, try to make time to do it. Completing it honestly can help you and your therapist gain insights into your emotional processes and overall progress. Most importantly, it can help you develop coping skills and practice them, which can boost your confidence, empower you, and make your therapeutic process more effective.

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Conklin LR, Strunk DR, Cooper AA. Therapist behaviors as predictors of immediate homework engagement in cognitive therapy for depression . Cognit Ther Res . 2018;42(1):16-23. doi:10.1007/s10608-017-9873-6

Lebeau RT, Davies CD, Culver NC, Craske MG. Homework compliance counts in cognitive-behavioral therapy . Cogn Behav Ther . 2013;42(3):171-179. doi:10.1080/16506073.2013.763286

By Sanjana Gupta Sanjana is a health writer and editor. Her work spans various health-related topics, including mental health, fitness, nutrition, and wellness.

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Homework in Cognitive Behavioral Supervision: Theoretical Background and Clinical Application

1 Department of Psychiatry, University Hospital Olomouc, Faculty of Medicine, Palacky University in Olomouc, Olomouc, The Czech Republic

2 Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, The Slovak Republic

3 Department of Psychotherapy, Institute for Postgraduate Training in Health Care, Prague, The Czech Republic

4 Jessenia Inc. - Rehabilitation Hospital Beroun, Akeso Holding, Beroun, The Czech Republic

Ilona Krone

5 Riga`s Stradins University, Riga, Latvia

Julius Burkauskas

6 Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania

Jakub Vanek

Marija abeltina.

7 University of Latvia, Latvian Association of CBT, Riga, Latvia

Alicja Juskiene

Tomas sollar, milos slepecky, marie ociskova.

The homework aims to generalize the patient’s knowledge and encourage practicing skills learned during therapy sessions. Encouraging and facilitating homework is an important part of supervisees in their supervision, and problems with using homework in therapy are a common supervision agenda. Supervisees are encouraged to conceptualize the patient’s lack of homework and promote awareness of their own beliefs and responses to non-cooperation. The supervision focuses on homework twice – first as a part of the supervised therapy and second as a part of the supervision itself. Homework assigned in supervision usually deals with mapping problems, monitoring certain behaviors (mostly communication with the patient), or implementing new behaviors in therapy.

Introduction

The development of competent clinical supervision is crucial to effectively training new CBT therapists and supervisors and maintaining high therapy standards throughout their careers. 1 Clinical supervision is a basis for CBT training, but there are only a few empirical evaluations on the effect of supervision on therapists’ competencies. Wilson et al 2 in their systematic review and meta-analysis, synthesized the experience and impact of supervision for trainee therapists from 15 qualitative studies. Although supervision leads to feelings of distress and self-doubts, it can effectively support supervisees in personal and professional development. It could similarly harm supervisees’ well-being, clinical work and clients’ experiences. Alfonsson et al 3 published a study to evaluate the effects of standardized supervision on rater-assessed competency in six CBT therapists under protocol-based clinical supervision. This is one of the first investigations showing that supervision affects cognitive behavioral competencies. Although several works have studied the effectiveness of supervision on the therapist’s competence and for the therapist’s work with patients in qualitative studies, 3–7 there is still a lack of studies that dealt with the importance of homework in supervision.

Homework is a vital element of cognitive behavioral therapy (CBT) which distinguishes it from many other psychotherapeutic approaches. 8–10 Patients usually participate in therapy by completing homework assignments and taking responsibility for their course.

Assigning and discussing homework is one of the basic competencies of a cognitive-behavioral therapist and a supervisor in the context of counselling, psychology, therapy, and social work. The manuscript aims to refer to homework in several settings: homework in therapy, supervision of homework in therapy, using the homework by the supervisor for the supervisee, and homework in the training of supervisors.

Homework in Therapy

While specific recommendations for the practical usage of homework have been clearly articulated since the early days of CBT, 11 , 12 practitioners state that they do not follow these recommendations. 13–15 For example, many physicians admit that they forget homework or do not focus on standard specifications when, where, how often, and how long the task should last. Often reported non-cooperation in homework assignments may be due to the practice recommendations being too strict or because students think the amount of homework they can assign is limited. 16

The Sense of Homework in the Therapy

Patients verify methods and skills they learned during the session in real situations and the natural environment. 9 , 17 Through homework, patients also test hypotheses that emerged during the session with the therapist (for example, “If I went out on the street alone, I would be so weak that I would pass out or lose control completely”). Homework help that the important part of the therapy takes place between sessions and allows the patients to become independent and manage their problems even after the end of therapy. 10 , 18 Patients learn how to raise hypotheses and test them in real-life situations. Through completing homework persistently during the therapy, patients gain skills on how to plan their activities and gain new skills, and they also collect a rich source of therapeutic diaries. The investigations advocate that adding homework to CBT increases its efficacy and that patients who constantly complete homework have better outcomes. The outcomes of four meta-analyses highlight the value of homework in CBT:

Kazantzis et al 10 inspected 14 studies that compared results for patients allocated to CBT without or with homework. The average patient in the homework group reported better results than about 70% of controls.
Outcomes from 16 studies 17 and an updated analysis of 23 studies 19 discovered that higher compliance led to better treatment results among patients who received homework projects during therapy.
Kazantzis et al 20 studied the relationships between quantity (15 studies) and quality (3 studies) of the homework to treatment results. The effect sizes were medium to large, and these effects remained fairly constant in a 12-month follow-up.

Therapists strategically create homework to reduce patients’ psychopathology and encourage them to practice skills learned during therapy sessions; nevertheless, non-adherence (between 20% and 50%) remains one of the most cited reasons for decreased CBT efficacy. 21 Several reasons for non-adherence to homework might be pointed out –the therapist does not regularly discuss homework with the patient, the patient no longer considers it important and stop doing it. 9 , 22 Discussing homework also allows the therapist to strengthen the patient’s belief in their ability to achieve certain goals. 23 The fact that the patient has completed the assignment must be properly acknowledged, and then therapists discuss the quality of homework separately. 24 Good questions might be, “How did you do your homework? Were there any difficulties in fulfilling them? What kind?” Furthermore: “How can you handle these problems next time? What did you learn while completing your homework? Can it help you cope with other issues?”

How to Increase the Effectiveness of Homework in the Therapy

Homework is the most effective, and it is most likely to succeed if: 19 , 25

Follows logically from the topics discussed during the session and uses the methods that the patient learned during the session;
they are clearly and concretely defined, so it is easy to determine whether or to what extent the patient has been successful in fulfilling them (eg, “Leaving the house alone for at least 30 minutes every day”, not “Starting to go out alone”);
the patient clearly understands their meaning (“To verify your belief that you will faint on the street” or “See for yourself whether your anxiety will continue to rise, remain the same or subside after a certain time”), and they believe they can achieve the goals;
homework is formulated so that failure is impossible because, in any case, the patient will learn something useful that will help them in therapy;
the therapist anticipates and discusses obstacles that could hinder the fulfilment of homework and plans procedures to overcome them.

An important aspect of CBT is the patient’s independence. 10 , 18 Homework is typically determined by consensus. To increase the likelihood that the patient will complete the homework, the patient and the therapist should document their assignments in writing. Additionally, it is very convenient for the patient to record the homework, typically pre-prepared. 24 These records serve as a basis for discussing homework in the next session and also allow the therapist to assess the changes achieved during therapy (“A month ago, you were able to go out alone for only half an hour and your anxiety level previously reached level ‘9’, while now you were alone outside for more than an hour and your anxiety do not exceed ‘5’ rated subjectively”).

Because the goal of therapy is to help the patient experience success, the patient’s assigned homework must be feasible. 18 , 26 On the other hand, patients should improve their ability to cope with problems and unpleasant conditions during therapy, they need to exert significant effort to overcome certain unpleasant feelings and emotions. 19 , 20

Even if therapists follow all these rules, they will unavoidably find that sometimes the patient does not complete assigned homework. 20 , 23 In this case, it is required to find out why this happened:

whether the patient understood what the task was and what it meant
whether mastering this exercise is important and motivated
whether unforeseen circumstances prevented them from fulfilling it
whether the assigned exercise was not very demanding for them in their current mental state

Therefore, therapists do not consider the non-fulfilment of homework a priori as a manifestation of resistance or lack of moral qualities on the patient’s part, then as a problem that must be solved together.

However, if, despite a thorough discussion of homework and agreement on its completion, the patient repeatedly does not even attempt to complete it, does not bring records and fails to justify non-compliance, it is necessary to return to the problem analysis and goal-setting. We need to clarify with the patient whether the problem they are currently dealing with in therapy is really the most important for them, whether the goal they seek to achieve is sufficiently desirable, and whether the therapist offers to achieve is acceptable. 9 , 20

Most practicing CBT therapists report that they use homework and consider homework important for many problems 14 and believe in the role of homework in improving therapeutic outcomes. 24 , 27 Encouraging and facilitating homework is a basic skill of a CBT therapist; therefore, it is an important part of supervision. 19 , 20 , 26 Homework needs to be carefully assigned and discussed ( Box 1 ).

Case Vignette – Discussion About Not Completing Homework with an Anxious Patient

Kazantzis et al 28 advise examining the therapeutic relationship, which significantly impacts therapy adherence, to better comprehend non-cooperation with homework assignments. Data illustrating the therapist’s homework competence and the therapy outcome 29 , 30 show that the therapist is primarily responsible for their patients’ adhering to or failing to do homework. CBT therapists exhibit many interrelated automatic thoughts, assumptions, and behaviors during sessions that affect homework use in therapy. 8 , 15 In training, common negative attitudes for therapists include: “Homework will make patients feel like school and resent!” “They will feel too controlled and limited!”; “Homework will increase some ps’ sense of vulnerability!”; or “Homework will be even more stressful for stressed patients!” Another widespread belief is that the “structure” of CBT, whose homework is important, reduces spontaneity and worsens the therapeutic relationship. 15

In addition, there is some scientific support for these views of therapists’ attitudes toward homework concerning the therapeutic process. 31 The result of these attitudes is either a complete avoidance of homework assignments in a way that is not effective and consequently maintains these beliefs. 8 For example, common behaviors require supervision, such as rapidly discussing directions at the end of a session, neglecting to repeat homework, or failing to justify while designing homework. 9 The CBT Homework Project proposed a practice model 29 that emphasizes the importance of therapist beliefs, therapist empowerment, cognitive conceptualization, and the therapeutic relationship in enhancing homework practice. 23

Theoretical and empirical support for homework assignments in CBT leads most practicing CBT therapists to at least accept in principle that regular and systematic homework assignments will benefit their patients. 8 As a result, CBT therapists favour assigning homework in therapy. However, many beginning therapists encounter problems when they start designing homework (ie, selecting tasks and discussing them with the patient), assigning homework (ie, collaborating on practical aspects of completing homework), and repeating homework in sessions. 32 Incorporating homework into therapy is often superficial, hasty, poorly done, or forgotten. 16 Therefore, problems with using homework in therapy are a common supervision agenda of practicing CBT therapists.

Personal Training and Self-Reflection of the Therapist as a Supervision Intervention

CBT training students are encouraged to conceptualize the patient’s lack of homework and promote awareness of their own beliefs and responses to non-cooperation in the CBT conceptual framework. 8 Suppose the therapist fails to develop this awareness. In that case, errors in clinical judgment may occur, adversely affecting the therapeutic relationship and course of therapy. 33 Self-exercise (practicing CBT techniques and interventions as a therapist) and self-reflection (ie, process reflection) are concepts developed by Bennett-Levy et al, 34 to operationalize a useful understanding of own processes in working with patients. CBT training students are asked to become accustomed to using self-exercise and self-reflection. In a few qualitative studies, self-exercise and self-reflection have proven to improve the therapist’s self-concept, ie, self-confidence, perceived competence in one’s abilities and belief in the effectiveness of the CBT model. 34–36 Calvert et al 37 study checked the use of meta-communication in supervision from supervisees’ perspectives using the Metacommunication in Supervision Questionnaire (MSQ). There were differences in the reported frequency with which the different types of meta-communication were used. It appears that meta-communication around difficult or uncomfortable feelings in the supervisory relationship occurs less often than other components of meta-communication. 1

Below are examples of self-exercise and self-reflective exercises. The following self-assessment is developed to shape thinking before a preliminary meeting with a supervisor. Earlier knowledge has shown that supervisees and supervisors do not always share common ideas about supervision. Therefore, the supervisee could finish this self-assessment as a homework exercise before supervision. A supervisee might want to identify conversation matters that may enable a supervisor to better comprehend their requirements and needs.

Before Starting

Questions regarding previous and desired experience in supervision.

What background information do you think your supervisor requires to understand you at the start? (This may include a curriculum vitae noting appropriate previous experience). What would be the best method to convey these details? Is there any distinction between what you desire from this placement and what you feel you need? What background details about this placement and this supervisor do you have? How does this make you feel? Exists any more information that you need? What do you want and expect your supervisor to concentrate on during supervision? What roles do you want your supervisor to play with respect to you and your work? What supervisory media do you want to experience (for example, taped, “live”, or reported)? What do you intend to do about your feelings? Consider how you feel about your supervisor evaluating your work at the end of the positioning process.

Reflection on the Strengths

What are the top three strengths you want your supervisor to uncover as you enter this supervisory relationship?

List 3 points for your development that may or might not be obvious to your supervisor.

Reflection on Difficulties

Therapists regularly discover face-to-face contact with people labelled by society as coming from a specific sub-group.

Which sub-groups make you feel uneasy for whatever reason? Do you want to address this during supervision? 38

Examples of Self-Assessment in the Supervision Process

Exploring sources of stress from clinical work.

Check all that resonate for you. 39

❑ Perfectionism ❑ Fear of failure ❑ Self-doubt ❑ Need for approval ❑ Emotional depletion ❑ Unhealthy lifestyle

Which of them seems to have the greatest impact on your stress levels?

What supervisor has most regularly identified as weak points in your clinical work?

Processing Mistakes

When mistakes are processed in ways that lead to reflection, flexibility, and adjustments in how you function, it can result in learning and growth.

Consider a patient you are now working with (or have recently worked with) with whom you have experienced a therapeutic failure.

Answer the following questions while keeping this experience in mind:

What are the signs of a therapeutic failure? How can you be certain that what you are doing is not beneficial on some level? What benefits might your patient derive from failure? When did things begin to deteriorate? Which initiatives have been most effective so far, and which have been least effective? How have you been careless?
Examine your intervention choices as well as how they were carried out:
What concerns or considerations did you overlook? What is impeding your ability to be more effective? How has your empathy and compassion for this individual been harmed? How can you use this experience to help you grow?

Reflection of Therapeutics Mastery Skills

Favorite techniques.

Explain three things you have put off in your career or life because they appear risky—you have something to lose and gain.
Which therapeutic strategies or interventions stimulate you the most?
What would you call your “hidden weapon”?
What kind of patients or presenting difficulties interest you the most?
What would it take to incorporate more of the pleasure and satisfaction you receive when applying the strategies mentioned earlier into other aspects of your work? 39

The following examples from clinical supervision demonstrate how self-exercise and self-reflection can help participants understand their belief system’s impact on homework in CBT.

Supervision of Homework in Therapy

Supervision is classically mandatory for students in cognitive behavioral training and plays a crucial part in therapist development. 2 The typical structure of continuous supervision of one patient includes discussing questionnaires or scales used to measure the severity of the problem (like the Beck depression inventory), homework, events in therapy since the last session, and then discussing the agenda of the current supervision meeting (what will be done in the session, which problem will be addressed), work on a selected issue or problems, homework assignment, session summary and its evaluation by the supervisor. The supervision focuses on homework twice – first as a part of the supervised therapy and second as a part of the supervision itself ( Box 2 ).

Case Vignette – Discussion About Patient´s Homework During Supervision

Whether and how the patient completes homework is a common supervisory issue ( Box 3 ). The therapist often complains that the patient refuses to do homework or rarely does it. 8 , 16

Recording of Paul’s Automatic Thoughts

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The picture describes the vicious circle of countertransference reaction, where automatic thoughts lead to developing negative emotions, bodily reactions and behaviors. Any vicious circle components can alert the therapists that their countertransference reaction is taking place.

Case Vignette –Discussion of Setting Homework During Supervision

Homework in Supervision

Homework assignments are a common part of supervisory work. These may involve the patient’s management (eg noticing on their recording how often the therapist strengthens the patient and how and if it is rare to clarify where reinforcement would be appropriate), working on oneself (eg clarifying experiences and attitudes that lead to countertransference in a particular patient, awareness of which other patients may also occur) and theoretical study (the supervisor may advise the therapist to read a professional text that can help better understand and work with the patient). 40

The supervisor helps define a specific engagement, discusses specific therapeutic methods, touches on what methods the therapist has used and what else they may consider the role, for the most part, the implementation of strategies whose ability to use in therapy under supervision will be planned, as part of homework.

Homework assigned in supervision usually deals with mapping problems (supplementing the conceptualization of the case, evaluation, vicious circle of the problem with the patient, etc.), monitoring certain behaviors (mostly communication with the patient), or implementing new, behaviors in therapy (usually using therapeutic strategies). 12 Homework teaches the supervisee to work on self-reflection outside the supervision meetings. 41 Discussing the homework properly at the beginning of the session is important. The mentioned home exercises usually concern the work with the supervised case report of the patient. The basic questions concern homework results, discussing the obstacles in solving them and what the supervisee learned in homework. 8 The discussion gives the supervisor case management information and can point to important practice moments.

Homework Assignment

Before the end of the session, the supervisor and the supervisee agree on a homework assignment. It is optimal when homework arises from a problem addressed in the session’s main part. 8 At the beginning of supervision, proposals for homework assignments usually come from the supervisor and are discussed and recorded in writing. 40 During supervision, the supervisee creates homework assignments, and the content is discussed with the supervisee.

The Meaning of Homework

Homework must make sense for the supervisee; otherwise, he will have no motivation to do it. However, it is also important to make sense of the patient or patients and develop the therapist’s skills and competencies. It is desirable to discuss the meaning of homework in supervision.

Possible Difficulties When Completing Homework

It is advantageous to discuss the anticipated difficulties in completing homework. This has the advantage that the supervisee can prepare for possible difficulties, consider overcoming them and consult with the supervisor. Discussing difficulties helps the supervisee model and later develops the skill to discuss the patient’s homework difficulties.

The Impact of the Therapist’s Belief System

In some therapists, there can be reasons for a more complex level of conceptualization. 42 That is important when the therapist repeats certain mistakes even though they have repeatedly discussed them with the supervisor. At a directly accessible level, the situation with the patient can be described using a vicious circle. The deeper “hidden” level refers to the core beliefs and conditional rules activated in a specific situation with the patient. 40 , 43 A supervisor can use the “falling arrow” technique to map core beliefs and conditional assumptions. 43

One such way is the Therapeutic Belief System (TBS). 44 TBS is a theoretical model useful for understanding the specific beliefs, assumptions, and behaviors that therapists and patients commonly experience that could potentially affect the course of therapy. In line with the cognitive model, TBS provides a framework for identifying therapists’ and patients’ beliefs about themselves, each other, the treatment process, the emotions these beliefs can evoke, and typical behavioral reactions. For example, a therapist may see a patient as an “aggressor”, a “helpless victim”, or a “collaborator”. The participant’s own beliefs may supplement these beliefs about himself, such as “victim”, “co-worker”, “carer”, or “rescuer”. Homework assignments may be perceived by both the therapist and the patient as “hopeless”, “productive”, or simply maintaining the status quo and lead to a different emotional and behavioral response. 8 Thus, TBS can be introduced into supervision to guide the supervisee to consider whether he or she identifies with any of the therapists’ typical beliefs and behaviors outlined in the model. A simple awareness of such patterns can be a useful orientation when considering the role of attitudes and beliefs in integrating homework ( Box 4 ).

Case Vignette – Discussion About Supervisee Homework

The scheme broadly refers to mental structures that integrate and give meaning to events. 45 Schemes can be positive, negative or neutral. In CBT as a treatment for psychological disorders, we focus on dysfunctional patterns often associated with specific diagnostic presentations (for example, emotional vulnerability patterns are common in anxiety disorders). Schema is generally defined as a ubiquitous topic of cognitive functions, emotions, physiological feelings about oneself, and relations with others. 33

Therapists’ schemes run in specific therapies and do not usually signal mental health problems. 8 Therapists’ schemes are influenced by the following factors: training experiences, such as supervision and training phase, therapy model, peer group, clinical experience, and personal experience. 13 , 40 Once identified, the therapist’s scheme can be used in supervision as a starting point to discuss some of the practitioner’s views that may interfere with therapy. 8 Completing structured questionnaires can identify participants’ schemes, basic beliefs, and assumptions. Some examples of useful questionnaires are the Dysfunctional Attitudes Scale, 46 the Personal Faith Questionnaire, 47 the Young Schema Questionnaire 48 and the Therapists’ Schema Questionnaire. 49 Leahy’s Therapists’ Scheme Questionnaire is a relatively straightforward screening technique for identifying therapeutic patterns that could affect a therapeutic relationship. It consists of 46 assumptions related to the 14 most common therapeutic regimens.

Certain schemes are particularly common in CBT supervisees. These include “demanding standards”, “excessive self-sacrifice”, and “special superior person”. 49 Training therapists who identify with the “demanding standards” scheme have a somewhat obsessive, perfectionist, and controlling approach to therapy. These therapists usually have high expectations for keeping a patient’s homework and may not realize that non-compliance with homework is often part of the learning process. Therapists may expect that there is a “right” way to complete a homework assignment, leading to feelings of frustration when assignments produce different results. This may signify insecurity and a notion that if things break from the planned structure, the therapist will be exposed as “incompetent”. Many therapists identify with the “excessive self-sacrifice” pattern, the most commonly observed pattern in both novice and experienced therapists. 33 Leahy 49 proposes that these therapists overstate the importance of their patient relationships. They may fear leaving or feel guilty that they are or feel better than the patient. As a result, the therapist may engage in therapy-defeating behaviors, such as making the homework assignment to the patient’s various needs, having difficulty with appropriate assertiveness in discussing persistent patient non-cooperation, and having a tendency to avoid techniques. Such as exposure or opening of painful memories for fear that the patient will be upset.

Novice therapists who identify with the “special superior person” scheme see the therapeutic situation as an opportunity to achieve excellent results and have high-performance expectations. There may be a tendency for the patient to idealize or, conversely, to devalue or distance himself from patients who do not improve or do their homework. The presence of a “special superior” scheme can be seen as overcompensation in response to “demanding standards” and “excessive self-sacrifice”, which have the thematic connotations of “not being good enough”. The supervision session sets the supervisee in a situation where the supervisor supervises homework through videotaped therapeutic sessions utilizing a cognitive therapy scale (CTS). 50 Feelings of superiority and exceptionality can, in some cases, be a way of dealing with the feelings of inferiority that they experience, that their use of homework is judged in this way.

In addition to recognizing the general responses to the scheme that most training students encounter, the supervisor should help the supervisor become aware of his or her idiosyncratic beliefs and coping styles, which some patients may trigger ( Box 5 ). The supervisor should encourage the supervisee to pay special attention to the “overlapping patterns” in which the therapist’s scheme and the patient’s scheme overlap, leading to the over-identification of the therapist with the patient. 33

Case Vignette – The Supervisor Advises the Therapist to Work with Core Beliefs and Conditional Rules

Homework in Supervisor Training

For supervisors, their supervisors’ training is important. An important part of this training is the practice of self-reflection, which should be requested directly in the meeting and as homework. It can be a task to capture situations in supervision in which they do not feel comfortable using the vicious circle, cognitive restructuring of automatic negative thoughts in these situations, capturing thoughts, emotions, bodily sensations and behaviors in situations where they are aware that they are experiencing countertransference reactions to the supervised therapist. It is also important that in their homework, they reflect on their concentration level during supervision sessions and consider what supervision skills they have used or what they have learned for the next session. A typical complex homework in supervision training is a video recording of supervision sessions and their analysis. The recorded supervision and analysis are then analyzed in the next supervision training meeting.

This article is designed as an overview of views and experiences. Its important element is work samples. This is also a limitation of this article. Assignment of homework in supervision and therapist and supervisor training lacks scientific information about its effectiveness. Nevertheless, assigning homework is an important part of cognitive behavioral therapy. We know quite well about its meaning in prescribing for patients. Less is known about their meaning and effectiveness in supervision. The supervisee encounters problems completing homework assignments for her patients that she brings to the supervisee. Why the patient does not complete the homework may be his problem, but his therapist may also have a part in it his requirements, which include how the homework is assigned, its suitability for the given patient, timing, and complexity. Homework can also belong to the training of supervisors and the supervision of supervision. Here, we do not know any research evidence about their effectiveness in using the most important part of supervision, the patient; however, they are experienced by supervisors and supervisees as useful and meaningful.

Homework in supervision and supervision requires further reflection on their meaning and subsequent research, which should examine their significance for the supervisee’s competence (supervisee) and the ultimate impact on the patient himself.

Homework presents one of the cornerstones of cognitive-behavioral therapy, CB supervision and the training of CBT supervisors. If applied consistently and collaboratively, homework enhances therapeutic outcomes and increases the patient’s self-confidence. Setting and maintaining a fruitful working alliance for homework can be challenging – issues with homework present one of the common reasons to seek a supervisory consultation. Supervision then focuses on examining the specific case and experienced problems, factors in the interaction between the therapist and their patient, and the therapist’s automatic thoughts, schemas, and behaviors that might maintain the issue. There are several ways to address this topic in supervision. Homework is usually part of supervision because of its usefulness. The supervised therapist may be given similar tasks as the patient receives in therapy: to describe the automatic thoughts that occur to him while guiding the patient, to test them and look for a more rational response, to conduct behavioral experiments, to clarify the core beliefs and conditioned assumptions that influence the formation of the therapeutic relationship, experiments with adequate communication with the patient and others. A therapist’s self-experience through practice can help them improve their therapeutic work.

Acknowledgments

This paper was supported by the research grant VEGA no. APVV-15-0502 Psychological, psychophysiological and anthropometric correlates of cardiovascular diseases.

The authors report no conflicts of interest in this work.

A Comprehensive Model of Homework in Cognitive Behavior Therapy

Original Article
Published: 03 July 2021
Volume 46 , pages 247–257, ( 2022 )

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Nikolaos Kazantzis ORCID: orcid.org/0000-0001-9559-4160 1 , 2 &
Allen R. Miller 2

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This article contributes a comprehensive model of homework in cognitive behavior therapy (CBT). To this end, several issues in the definition of homework and homework compliance are outlined, research on homework-outcome relations is critiqued, before an overview of classical and operant conditioning along with various cognitive theories are tied together in a c omprehensive model. We suggest engagement represents a more clinically meaningful construct than compliance (or adherence). We describe how established behavior and cognitive theories are relevant for understanding patient engagement and what between-session and in-session processes are useful in a comprehensive model. Our primary conclusion from the review of this literature is that current research has focused on limited aspects of homework and missed theoretically meaningful determinants of engagement. Further, little research has sought to examine the role of the therapist in facilitating these theoretically meaningful determinants. The literature on homework is the most advanced of the process research in CBT; the comprehensive model presented here offers clarity for the practicing clinician and represents a testable model for researchers interested in quantifying determinants of homework engagement and the process of integrating homework into CBT.

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A Commentary on the Science and Practice of Homework in Cognitive Behavioral Therapy

Keith S. Dobson

Cognitive Behavioral Therapy: The Case of Wally

Mediators and Moderators of Homework–Outcome Relations in CBT for Depression: A Study of Engagement, Therapist Skill, and Client Factors

Rui Ying Yew, Keith S. Dobson, … Nikolaos Kazantzis

Aizenstros, A., Bakker, D., Hofmann, S., Curtiss, J., & Kazantzis, N. (2020). Engagement with smartphone-delivered behavioural activation interventions: A study of the MoodMission smartphone application. Behavioural and Cognitive Psychotherapy . https://doi.org/10.1017/S1352465820000922

Article PubMed Google Scholar

Ajzen, I., & Fishbein, M. (1977). Attitude-behavior relations: A theoretical analysis and review of empirical research. Psychological Bulletin, 84 , 888–914.

Article Google Scholar

Asnaani, A., & Hofmann, S. G. (2012). Collaboration in multicultural therapy: Establishing a strong therapeutic alliance across cultural lines. Journal of Clinical Psychology, 68 (2), 187–197. https://doi.org/10.1002/jclp.21829

Article PubMed PubMed Central Google Scholar

Bakker, D., Kazantzis, N., Rickwood, D., & Rickard, N. (2018). A randomized controlled trial of three smartphone apps for enhancing public mental health. Behaviour Research & Therapy, 109 , 75–83.

Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84 , 191–215.

Article CAS PubMed Google Scholar

Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory . Prentice Hall.

Google Scholar

Bandura, A. (1989). Human agency in social cognitive theory. American Psychologist, 44 , 1175–1184.

Article CAS Google Scholar

Barlow, D. H., Farchione, T. J., Bullis, J. R., Gallagher, M. W., Murray-Latin, H., Sauer-Zavala, S., Bentley, K. H., Thompson- Hollands, J., Conklin, L. R., Boswell, J. F., Ametaj, A., Carl, J. R., Boettcher, H. T., & Cassiello-Robbins, C. (2017). The unified protocol for transdiagnostic treatment of emotional dis-orders compared with diagnosis-specific protocols for anxiety disorders: A randomized clinical trial. JAMA Psychiatry, 74 (9), 875–884. https://doi.org/10.1001/jamapsychiatry.2017.2164

Barlow, D. H., Farchione, T. J., Fairholme, C. P., Ellard, K. K., & Bois-SeauAllenEhrenreich-May, C. L. L. B. J. (2011). Unified protocol for transdiagnostic treatment of emotional disorders: Therapist guide . Oxford University Press.

Beck, A. T., Rush, A. J., Shaw, B., & Emery, G. (1979). Cognitive therapy of depression . Guilford Press.

Beck, J. S. (2005). Cognitive therapy for challenging problems: What to do when the basics don’t work . Guilford.

Beck, J. S. (2011). Cognitive behavior therapy: Basics and beyond (2nd ed.). Guilford Press.

Beck, J. S. (2020). Cognitive behavior therapy: Basics and beyond (3rd ed.). Guilford.

Beck, J. S., & Tompkins, M. A. (2007). Cognitive therapy. In N. Kazantzis & L. L’Abate (Eds.), Handbook of homework assignments in psychotherapy: Research, practice, prevention (pp. 51–63). Springer. https://doi.org/10.1007/978-0-387-29681-4_4

Chapter Google Scholar

Bouton, M. E. (1988). Context and ambiguity in the extinction of emotional learning: Implications for exposure therapy. Behaviour Research & Therapy, 26 , 137–149.

Brodley, B. T. (2006). Client-initiated homework in client-centered therapy. Journal of Psychotherapy Integration, 16 (2), 140–161. https://doi.org/10.1037/1053-0479.16.2.140

Bryant, M. J., Simons, A. D., & Thase, M. E. (1999). Therapist skill and patient variables in homework compliance: Controlling an uncontrolled variable in cognitive therapy outcome research. Cognitive Therapy and Research, 23 (4), 381–399. https://doi.org/10.1023/A:1018703901116

Bunnell, B. E., Nemeth, L. S., Lenert, L. A., Kazantzis, N., Deblinger, E., Higgins, K. A., & Ruggiero, K. J. (2021). Barriers associated with the implementation of homework in youth mental health treatment and potential mobile health solutions. Cognitive Therapy and Research, 45 (2), 272–286.

Burns, D. D., & Spangler, D. (2000). Does psychotherapy homework lead to changes in depression in cognitive behavioral therapy? Or does clinical improvement lead to homework compliance? Journal of Consulting and Clinical Psychology, 68 , 46–56.

Callan, J. A., Kazantzis, N., Park, S. Y., Moore, C., Thase, M. E., Emeremni, C. A., Minhajuddin, A., Kornblith, S., & Siegle, G. J. (2019). Effects of cognitive behavior therapy homework adherence on outcomes: Propensity score analysis. Behavior Therapy, 50 (2), 285–299. https://doi.org/10.1016/j.beth.2018.05.010

Callan, J. A., Sigle, G. J., Day, A., Thase, M. E., Kazantzis, N., Devito Dabbs, A. D., Rotondi, A., Sereika, S., & Dunbar Jacob, J. (2021). CBT MobileWork: Development and testing of a mobile mental health application using patient-centered design. Cognitive Therapy and Research, 45 , 287.

Conklin, L. R., Strunk, D. R., & Cooper, A. A. (2017). Therapist behaviors as predictors of immediate homework engagement in cognitive therapy for depression. Cognitive Therapy & Research . https://doi.org/10.1007/s10608-017-9873-6

Cronin, T. J., Lawrence, K. A., Taylor, K., Norton, P. J., & Kazantzis, N. (2015). Integrating between-session interventions (homework) in therapy: A focus on the therapeutic relationship and cognitive case conceptualization. Journal of Clinical Psychology, 71 , 439–450. https://doi.org/10.1002/jclp.22180

Dattilio, F. M., & Hanna, M. A. (2012). Collaboration in cognitive-behavioral therapy. Journal of Clinical Psychology, 68 , 146–158.

Dattilio, F. M., & Padesky, C. A. (1990). Cognitive therapy with couples . Professional Resource Exchange.

Deci, E. L., Eghrari, H., Patrick, B. C., & Leone, D. R. (1994). Facilitating internalization: The self-determination theory perspective. Journal of Personality, 62 , 119–142.

Deci, E. L., & Ryan, R. M. (2000). The “what” and “why” of goal pursuits: Human needs and the self-determination of behavior. Psychological Inquiry: An International Journal for the Advancement of Psychological Theory, 11 , 227–268.

DiClemente, C. C., Prochaska, J. O., Fairhurst, S. K., Velicer, W. F., Velasquez, M. M., & Rossi, J. S. (1991). The process of smoking cessation: An analysis of precontemplation, contemplation, and preparation stages of change. Journal of Consulting and Clinical Psychology, 59 , 295–304.

Dobson, D. J. G., & Dobson, K. S. (2013). In-session structure and collaborative empiricism. Cognitive and Behavioral Practice, 20 , 410–418.

Dobson, K. S., & Kazantzis, N. (in press). Cognitive theory in psychotherapy. APA Handbook of Psychotherapy.

Dobson, K., & Kazantzis, N. (2003). The therapist in cognitive-behavioral therapy: Introduction to a special section. Psychotherapy Research, 13 , 131–134. https://doi.org/10.1080/713869635

Dozois, D. J. A. (2010). Understanding and enhancing the effects of homework in cognitive-behavioral therapy. Clinical Psychology: Science and Practice, 17 , 157–161. https://doi.org/10.1111/j.1468-2850.2010.01205.x

Ellis, A. E. (1995). Changing rational-emotive therapy (RET) to rational emotive behavior therapy (REBT). Journal of Rational-Emotive and Cognitive-Behavior Therapy, 13 , 85–89.

Evans, I. M. (2015). How and why thoughts change: Foundations of cognitive psychotherapy . Oxford University Press.

Book Google Scholar

Fehm, L., & Kazantzis, N. (2004). Attitudes and use of homework assignments in therapy: A survey of German psychotherapists. Clinical Psychology & Psychotherapy, 11 , 332–343. https://doi.org/10.1002/cpp.419

Flückiger, C., Del Re, A. C., Wlodasch, D., Horvath, A. O., Solomonov, N., & Wampold, B. E. (2020). Assessing the alliance–outcome association adjusted for patient characteristics and treatment processes: A meta-analytic summary of direct comparisons. Journal of Counseling Psychology, 67 (6), 706–711. https://doi.org/10.1037/cou0000424

Franklin, M. E., Huppert, J. D., & Ledley, D. R. (2005). Obsessions and compulsions. In N. Kazantzis, F. P. Deane, K. R. Ronan, & L. L’Abate (Eds.), Using homework assignments in cognitive behavior therapy (pp. 219–236). Routledge.

Haarhoff, B. A., & Kazantzis, N. (2007). How to supervise the use of homework in cognitive behavior therapy: The role of trainee therapist beliefs. Cognitive and Behavioral Practice, 14 , 325–332. https://doi.org/10.1016/j.cbpra.2006.08.004

Haller, E., & Watzke, B. (2021). The role of homework engagement, homework-related therapist behaviors, and their association with depressive symptoms in telephone-based CBT for depression. Cognitive Therapy & Research, 45 , 224.

Hoelscher, T. J., Lichstein, K. L., & Rosenthal, T. L. (1984). Objective vs subjective assessment of relaxation compliance among anxious individuals. Behaviour Research and Therapy, 22 (2), 187–193. https://doi.org/10.1016/0005-7967(84)90107-4

Hoelscher, T. J., Lichstein, K. L., & Rosenthal, T. L. (1986). Home relaxation practice in hypertension treatment: Objective assessment and compliance induction. Journal of Consulting and Clinical Psychology, 54 (2), 217–221. https://doi.org/10.1037/0022-006X.54.2.217

Hofmann, S. G., & Hayes, S. C. (2018). The future of intervention science: Process-based therapy. Clinical Psychological Science, 7 (1), 37–50. https://doi.org/10.1177/2167702618772296

Holdsworth, E., Bowen, E., Brown, S., & Howat, D. (2014). Client engagement in psychotherapeutic treatment and associations with client characteristics, therapist characteristics, and treatment factors. Clinical Psychology Review, 34 (5), 428–450. https://doi.org/10.1016/j.cpr.2014.06.004

Huibers, M. J. H., Lorenzo-Luaces, L., Cuijpers, P., & Kazantzis, N. (2021). On the road to personalized psychotherapy: A research agenda based on cognitive behavior therapy for depression. Frontiers in Psychiatry, 1 , 607508. https://doi.org/10.3389/fpsyt.2020.607508

Jungbluth, N. J., & Shirk, S. R. (2013). Promoting homework adherence in cognitive-behavioral therapy for adolescent depression. Journal of Clinical Child & Adolescent Psychology, 42 (4), 545–553. https://doi.org/10.1080/15374416.2012.743105

Kanfer, F. H. (1970). Self-monitoring, methodological limitations, and clinical applications. Journal of Consulting and Clinical Psychology, 35 , 148–152.

Kazantzis, N. (2000). Power to detect homework effects in psychotherapy outcome research. Journal of Consulting and Clinical Psychology, 68 , 166–170. https://doi.org/10.1037/0022-006X.68.1.166

Kazantzis, N., Arntz, A., Borkovec, T., Holmes, E. A., & Wade, T. (2010a). Unresolved issues regarding homework assignments in cognitive and behavioral therapies: An expert discussion at AACBT. Behaviour Change, 27 , 119–129. https://doi.org/10.1375/bech.27.3.119

Kazantzis, N., Beck, J. S., Clark, D. A., Dobson, K. S., Hofmann, S. G., Leahy, R. L., & Wong, W. C. (2018). Socratic dialogue and guided discovery in cognitive behavioral therapy: A modified Delphi panel. International Journal of Cognitive Therapy, 11 (2), 140–157. https://doi.org/10.1007/s41811-018-0012-2

Kazantzis, N. (2018). Introduction to the special issue on processes of cognitive behavioral therapy: Does necessary, but not sufficient” still capture it? Cognitive Therapy & Research, 42 (2), 115–120. https://doi.org/10.1007/s10608-018-9891-z

Kazantzis, N., Beck, J. S., Dattilio, F. M., Dobson, K. S., & Rapee, R. M. (2013). Collaborative empiricism as the central therapeutic relationship element in CBT: An expert panel discussion at the 7th International Congress of Cognitive Psychotherapy. International Journal of Cognitive Therapy, 6 (4), 386–4000.

Kazantzis, N., Brownfield, N., Mosely, L., Usatoff, A., & Flighty, A. (2017a). Homework in CBT: A systematic review of adherence assessment in anxiety and depression treatment (2011–2016). Psychiatric Clinics of North America, 40 (4), 625–639. https://doi.org/10.1016/j.psc.2017.08.001

Kazantzis, N., & Dattilio, F. M. (2010). Definitions of homework, types of homework, and ratings of the importance of homework among psychologists with cognitive behavior therapy and psychoanalytic theoretical orientations. Journal of Clinical Psychology, 66 (7), 1–16. https://doi.org/10.1002/jclp.20699

Kazantzis, N., Dattilio, F. M., & Dobson, K. S. (2017b). The therapeutic relationship in cognitive behavior therapy: A clinician’s guide . Guilford.

Kazantzis, N., Deane, F. P., & Ronan, K. R. (2000). Homework assignments in cognitive and behavioral therapy: A meta-analysis. Clinical Psychology: Science and Practice, 7 , 189–202. https://doi.org/10.1093/clipsy.7.2.189

Kazantzis, N., Deane, F. P., Ronan, K. R., & L’Abate, L. (Eds.). (2005). Using homework assignments in cognitive behavioral therapy. New York: Routledge.

Kazantzis, N., Freeman, A., Fruzzetti, A. E., Persons, J. B., & Smucker, M. (2010b). Unresolved issues regarding the therapeutic relationship element of collaborative empiricism in cognitive and behavioural therapies: An expert panel discussion at AACBT. Behaviour Change, 27 , 119–129. https://doi.org/10.1375/bech.27.3.119

Kazantzis, N., & Hofmann, S. G. (2019). Additional approaches to treatment of depression. JAMA, 321 (16), 1635. https://doi.org/10.1001/jama.2019.2068

Kazantzis, N., & L’Abate, L. (2005). Theoretical foundations. In N. Kazantzis, F. P. Deane., K. R. Ronan., & L. L’Abate (Eds.), Using homework assignments in cognitive behavior therapy (pp. 9–33). Routledge.

Kazantzis, N., & L’Abate, L. (2007). Handbook of homework assignments in psychotherapy: Research, practice, & prevention . Springer. https://doi.org/10.1007/978-0-387-29681-4

Kazantzis, N., Lampropoulos, G. L., & Deane, F. P. (2005). A national survey of practicing psychologists’ use and attitudes towards homework in psychotherapy. Journal of Consulting and Clinical Psychology, 73 , 742–748. https://doi.org/10.1037/0022-006X.73.4.742

Kazantzis, N., MacEwan, J., & Dattilio, F. M. (2005). A guiding model for practice. In N. Kazantzis, F. P. Deane., K. R. Ronan., & L. L’Abate (Eds.), Using homework assignments in cognitive behavior therapy (pp. 359–407). New York: Routledge.

Kazantzis, N., Ronan, K. R., & Deane, F. P. (2001). Concluding causation from correlation: Comment on Burns and Spangler (2000). Journal of Consulting and Clinical Psychology, 69 , 1079–1083. https://doi.org/10.1037/0022-006X.69.6.1079

Kazantzis, N., & Stuckey, M. E. (2018). Inception of a discovery: Re-defining the use of Socratic dialogue in cognitive behavioral therapy. International Journal of Cognitive Therapy, 11 , 177–123. https://doi.org/10.1007/s41811-018-0015-z

Kazantzis, N., Whittington, C. J., & Dattilio, F. M. (2010c). Meta-analysis of homework effects in cognitive and behavioral therapy: A replication and extension. Clinical Psychology: Science and Practice, 17 , 144–156.

Kazantzis, N., Whittington, C. J., Zelencich, L., Norton, P. J., Kyrios, M., & Hofmann, S. G. (2016). Quantity and quality of homework compliance: A meta-analysis of relations with outcome in cognitive behavior therapy. Behavior Therapy, 47 , 755–772. https://doi.org/10.1016/j.beth.2016.05.002

Kelly, G. A. (1955). The psychology of personal constructs . Norton.

Klepac, R. K., Ronan, G. F., Andrasik, F., Arnold, K. D., Belar, C. D., Berry, S. L., et al. (2012). Guidelines for cognitive behavioral training within doctoral psychology programs in the United States: Report of the Inter-Organizational Task Force on Cognitive and Behavioral Psychology Doctoral Education. Behavior Therapy, 43 (4), 687–697. https://doi.org/10.1016/j.beth.2012.05.002

Kraepelien, M., Blom, K., Jernelöv, S., & Kaldo, V. (2021). Weekly self-ratings of treatment involvement and their relation to symptom reduction in internet cognitive behavioral therapy for insomnia. Cognitive Therapy & Research, 45 (2), 262–271. https://doi.org/10.1007/s10608-020-10151-y

Lambert, M. J., Harmon, S. C., & Slade, K. (2007). Directions for research on homework in psychotherapy and behavior change. In N. Kazantzis & L. L’Abate (Eds.), Handbook of homework assignments in psychotherapy: Research, practice, and prevention (pp. 407–424). Springer.

Leventhal, H. (1970). Findings and theory in the study of fear communications. In L. Berkowitz (Ed.), Advances in experimental social psychology (Vol. 3, pp. 119–186). Academic Press.

Levis, D. J., & Malloy, P. F. (1982). Research in infrahuman and human conditioning. In G. T. Wilson & C. M. Franks (Eds.), Contemporary behavior therapy: Conceptual and empirical foundations (pp. 65–118). Guilford Press.

Lieberman, P. A. (1993). Learning: Behavior and cognition . Brooks/Cole.

Maddock, J. W. (1975). Initiation problems and time structuring in brief sex therapy. Journal of Sex & Marital Therapy, 1 , 190–197.

Mahoney, M. J., Kazdin, A. E., & Lesswing, N. J. (1974). Behavior modification: Delusion or deliverance. In C. M. Franks & G. T. Wilson (Eds.), Annual review of behavior therapy and practice (Vol. 2, pp. 169–193). Brunner/Mazel.

Mahrer, A. R., Nordin, S., & Miller, L. S. (1995). If a client has this kind of problem, prescribe that kind of post-session behavior. Psychotherapy, 32 , 194–203.

Mausbach, B. T., Moore, R., Roesch, S., Cardenas, V., & Patterson, T. L. (2010). The relationship between homework compliance and therapy outcomes: An updated meta-analysis. Cognitive Therapy & Research, 34 , 429–438. https://doi.org/10.1007/s10608-010-9297-z

Mennin, D. S., Ellard, K. K., Fresco, D. M., & Gross, J. J. (2013). United we stand: Emphasizing commonalities across cognitive-behavioral therapy. Behavior Therapy, 44 , 234–248. https://doi.org/10.1016/j.beth.2013.02.004

Mischel, W. (1968). Personality and assessment . Wiley.

Mischel, W. (1973). Facing the issues. Journal of Abnormal Psychology, 82 , 541–542.

Neimeyer, R. A. (1985). The development of personal construct psychology . University of Nebraska Press.

Neimeyer, R. A., Kazantzis, N., Kassler, D. M., Baker, K. D., & Fletcher, R. (2008). Group cognitive behavior therapy for depression: Outcomes predicted by willingness to engage in homework, compliance with homework, and cognitive restructuring skill acquisition. Cognitive Behavior Therapy, 37 , 199–215. https://doi.org/10.1080/16506070801981240

Nelson, D. L., Castonguay, L. G., & Barwick, F. (2007). Directions for the integration of homework in practice. In N. Kazantzis & L. L’Abate (Eds.), Handbook of homework assignments in psychotherapy: Research, practice, and prevention (pp. 425–444). Springer.

Petrik, A. M., Kazantzis, N., & Hofmann, S. G. (2013). Distinguishing integrative from eclectic practice in cognitive behavioral therapies. Psychotherapy: Theory, Research, Practice, Training, 50 (3), 392–397. https://doi.org/10.1037/a0032412

Petty, R. E., & Cacioppo, J. T. (1981). Attitudes and persuasion: Classic and contemporary approaches . Brown.

Primakoff, L., Epstein, N., & Covi, L. (1986). Homework compliance: An uncontrolled variable in cognitive therapy outcome research. Behavior Therapy, 17 , 433–446.

Prochaska, J. O., & DiClemente, C. C. (1982). Transtheoretical therapy: Toward a more integrative model of change. Psychotherapy: Theory, Research and Practice, 19 , 276–288.

Prochaska, J. O., Velicer, W. F., Rossi, J. S., Goldstein, M. G., Marcus, B. H., Rakowski, W., et al. (1994). Stages of change and decisional balance for 12 problem behaviors. Health Psychology, 13 , 39–46.

Rescorla, R. A. (1988). Pavlovian conditioning: It’s not what you think it is. American Psychologist, 43 , 151–160.

Rogers, R. W., & Prentice-Dunn, S. (1997). Protection motivation theory. In David S. Gochman (Ed.), Handbook of Health Behavior Research (Vol.1. pp 113–132). New York: Plenum Press.

Rosenstock, I. M. (1960). What research in motivation suggests for public health. American Journal of Public Health, 50 , 295–301.

Article CAS PubMed PubMed Central Google Scholar

Ryum, T., Stiles, T. C., Svartberg, M., & McCullough, L. (2010). The effects of therapist competence in assigning homework in cognitive therapy with cluster C personality disorders: Results from a randomized controlled trial. Cognitive and Behavioral Practice, 17 (3), 283–289. https://doi.org/10.1016/j.cbpra.2009.10.005

Scheel, M. J., Seaman, S., Roach, K., Mullin, T., & Mahoney, K. B. (1999). Client implementation of therapist recommendations predicted by client perception of fit, difficulty of implementation, and therapist influence. Journal of Counseling Psychology, 46 (3), 308–316.

Shelton, J. L., & Ackerman, J. M. (1974). Homework in counseling and psychotherapy: Examples of systematic assignments for therapeutic use by mental health professionals . Thomas.

Shelton, J. L., & Levy, R. L. (1981a). Behavioral assignments and treatment compliance: A handbook of clinical strategies . Research Press.

Shelton, J. L., & Levy, R. L. (1981b). A survey of the reported use of assigned homework activities in contemporary behavior therapy literature. The Behavior Therapist, 4 , 13–14.

Skinner, B. F. (1971). Beyond freedom and dignity . Knopf.

Skinner, B. F. (1974). About behaviorism . Alfred A. Knopf.

Staats, A. W. (1996). Behavior and personality: Psychological behaviorism . Springer.

Startup, M., & Edmonds, J. (1994). Compliance with homework assignments in cognitive-behavioral psychotherapy for depression: Relation to outcome and methods of enhancement. Cognitive Therapy & Research, 18 , 567–579.

Strecher, V. J., Champion, V. L., & Rosenstock, I. W. (1997). In D. S. Gochman (Ed.), Handbook of Health Behavior Research I: Personal and Social Determinants (pp. 71–91). New York: Plenum Press.

Taylor, C. B., Agras, W. S., Schneider, J. A., & Allen, R. A. (1983). Adherence to instructions to practice relaxation exercises. Journal of Consulting and Clinical Psychology, 51 (6), 952–953.

Tee, J., & Kazantzis, N. (2011). Collaborative empiricism in cognitive therapy: A definition and theory for the relationship construct. Clinical Psychology: Science & Practice, 18 , 48–62. https://doi.org/10.1111/j.1468-2850.2010.01234.x

Tharp, R. G., & Wetzel, R. J. (1969). Behavior modification in the natural environment . Academic Press.

Webb, C. A., DeRubeis, R. J., & Barber, J. P. (2010). Therapist adherence/competence and treatment outcome: A meta-analytic review. Journal of Consulting and Clinical Psychology, 78 (2), 200–211. https://doi.org/10.1037/a0018912

Weck, F., Richtberg, S., Esch, S., Höfling, V., & Stangier, U. (2013). The relationship between therapist competence and homework compliance in maintenance cognitive therapy for recurrent depression: Secondary analysis of a randomized trial. Behavior Therapy, 44 (1), 162–172. https://doi.org/10.1016/j.beth.2012.09.004

Weinstein, N. D. (1993). Testing four competing theories of health-protective behavior. Health Psychology, 12 , 324–333.

Wheaton, M. G., & Chen, S. C. (2021). Homework completion in treating obsessive-compulsive disorder with exposure and ritual prevention: A review of the empirical literature. Cognitive Therapy and Research, 45 (2), 236–249. https://doi.org/10.1007/s10608-020-10125-0

Yew, R. Y., Dobson, K. S., Zypher, M., & Kazantzis, N. (2021). Mediators and moderators of homework-outcome relations in CBT for depression: A study of engagement, therapist skill, and client factors. Cognitive Therapy and Research, 45 (2), 209–223. https://doi.org/10.1007/s10608-019-10059-2

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The authors thank Aaron T. Beck and Judith S. Beck for helpful discussions and guidance on the topic of integrating homework into CBT.

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Kazantzis, N., Miller, A.R. A Comprehensive Model of Homework in Cognitive Behavior Therapy. Cogn Ther Res 46 , 247–257 (2022). https://doi.org/10.1007/s10608-021-10247-z

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How to Design Homework in CBT That Will Engage Your Clients
Homework assignments have been a central feature of the Cognitive-Behavioral Therapy (CBT) process since the 1970s (Kazantzis, 2005). Take-home assignments provide the opportunity to transfer different skills and lessons learned in the therapeutic context to situations in which problems arise.
Assigning Homework in Cognitive Behavioral Therapy
Cognitive behavioral therapy (CBT) is known to be a highly effective approach to mental health treatment. One factor underlying its success is the homework component of treatment. It’s certainly ...
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Homework assignments in Cognitive Behavioural Therapy (CBT) can help your patients educate themselves further, collect thoughts, and modify their thinking. How to deliver homework Homework is not something that you just assign randomly.
Supporting Homework Compliance in Cognitive Behavioural ...
Homework Non-Compliance in CBT. Cognitive behavioral therapy (CBT) is an evidence-based psychotherapy that has gained significant acceptance and influence in the treatment of depressive and anxiety disorders and is recommended as a first-line treatment for both of these [1,2].
CBT Techniques: 25 Cognitive Behavioral Therapy Worksheets
Cognitive-Behavioral Therapy Worksheets (PDFs) To Print and Use. If you’re a therapist looking for ways to guide your client through treatment or a hands-on person who loves to learn by doing, there are many cognitive-behavioral therapy worksheets that can help. 1. Coping styles worksheet.
Sending Homework to Clients in Therapy: The Easy Way
Homework is an essential part of Cognitive-Behavioral Therapy (CBT; Beck, 2011; Mausbach, Moore, Roesch, Cardenas, & Patterson, 2010). Successful therapy relies on using assignments outside of sessions to reinforce learning and practice newly acquired skills in real-world settings (Mausbach et al., 2010).
Therapy Homework: Purpose, Benefits, and Tips - Verywell Mind
Tips for Your Therapy Homework. Below, Dr. Erkfitz shares some tips that can help with therapy homework: Set aside time for your homework: Create a designated time to complete your therapy homework. The aim of therapy homework is to keep you thinking and working on your goals between sessions. Use your designated time as a sacred space to ...
Homework in Cognitive Behavioral Supervision: Theoretical ...
Most practicing CBT therapists report that they use homework and consider homework important for many problems 14 and believe in the role of homework in improving therapeutic outcomes. 24, 27 Encouraging and facilitating homework is a basic skill of a CBT therapist; therefore, it is an important part of supervision. 19, 20, 26 Homework needs to ...
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Fortunately, the research underpinning CBT homework is moving towards more clinically meaningful studies. Therapist skill in using homework has been shown to predict outcomes 9-10, and recently a study found that greater consistency of homework with the therapy session resulted in more adherence. 11 Our Cognitive Behavior Therapy Research Lab (currently based at the Turner Institute for Brain ...
A Comprehensive Model of Homework in Cognitive Behavior ...
This article contributes a comprehensive model of homework in cognitive behavior therapy (CBT). To this end, several issues in the definition of homework and homework compliance are outlined, research on homework-outcome relations is critiqued, before an overview of classical and operant conditioning along with various cognitive theories are tied together in a comprehensive model. We suggest ...