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How to Engage Clients in Therapy Homework

Homework assignments that engage the client are essential for improved outcomes in cognitive behavioral therapy. Shaw et al found that therapists that were the most competent in administering cognitive behavioral homework had the best outcomes1. But engaging clients in homework is not easy. Being able to negotiate and include homework assignments is a difficult skill for therapists.

Psychotherapists that successfully incorporate homework in the therapeutic process manage a variety of factors related to (1) the client, (2) their own beliefs and views on psychotherapy, and (3) the task itself. Let's review them:

Client

Therapist

REFERENCES:
  1. 1 Therapist competence ratings in relation to clinical outcome in cognitive therapy of depression. Shaw, Brian F.; Elkin, Irene; et al. Journal of Consulting and Clinical Psychology, Vol 67(6), Dec 1999, 837-846.
  2. 2 Patients' perspective on homework assignments in cognitive–behavioural therapy, Lydia Fehm, Jana Mrose, Clinical Psychology & Psychotherapy. Volume 15, Issue 5, pages 320–328, September/October 2008.
  3. 3 Does psychotherapy homework lead to improvements in depression in cognitive-behavioral therapy or does improvement lead to increased homework compliance? Burns, D. D, Spangler, D. L, Journal of Consulting and Clinical Psychology, 68, 46–56, 2000.
  4. 4 Modifying therapeutic homework for patients with personality disorders. Arthur Freeman, Brad Rosenfield. Journal of Clinical Psychology. Volume 58, Issue 5, pages 513–524, May 2002.
  5. 5 The role of homework assignments in cognitive therapy for depression: Potential methods for enhancing adherence. Detweiler, J. B., & Whisman, M. A. Clinical Psychology: Science and Practice, 6, 267-282; 1999.
  6. 6 Critical issues in using homework assignments within cognitive–behavioural therapy for schizophrenia. Glaser, N.M., Kazantzis, N., Deane, F.P., & Oades, L.G. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 18(4), 247–261; 2000.
  7. 7 Making optimal use of homework to enhance your therapeutic effectiveness. Broder, M.S. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 18(1), 3–18: 2000.
  8. 8 Improving homework compliance in the treatment of generalized anxiety disorder. Leahy, R.L. Journal of Clinical Psychology, 58(5), 499–511: 2002.
  9. 9 Guidelines for enhancing homework compliance. Tompkins, M.A. Journal of Clinical Psychology, 58(5), 565–576; 2002.