Homework in psychotherapy

Homework in psychotherapy is sometimes assigned to patients as part of their treatment. In this context, homework assignments are introduced to practice skills taught in therapy, encourage patients to apply the skills they learned in therapy to real life situations, and to improve on specific problems encountered in treatment. For example, a patient with deficits in social skills may learn and rehearse proper social skills in one treatment session, then be asked to complete homework assignments before the next session that apply those newly learned skills (e.g., going to a social engagement or greeting five people each day).

Homework is most often used in cognitive behavioral therapy (CBT) for the treatment of mood and anxiety disorders, although other theoretical frameworks may also incorporate homework. Some of the types of homework used in CBT include thought records and behavioral experiments. Patients using thought records are instructed to write down negative cognitions on the thought record form and weigh the evidence both for and against the negative thoughts, with the goal being to come up with new, balanced thoughts in the process. Behavioral experiments are used as homework to help patients test out thoughts and beliefs directly. Studies have shown that homework completion and accuracy predict favorable outcomes in psychotherapy and may help patients stay in remission. However, some therapists are concerned that assigning homework makes therapy too formal and reduces the impact of the individual sessions.

Most of the literature published on homework in psychotherapy to date focuses on homework use during CBT, which involves changing patients' thoughts and behaviors to reduce the symptoms of the mental disorders from which they are suffering. A variety of homework assignments exist in CBT. These tasks can range from scheduling a daily exercise routine to practicing progressive muscle relaxation five times a day to monitoring and recording one's negative automatic thoughts throughout the day. In practice, these homework assignments are meant to help patients lift their mood, practice and master skills they developed in therapy, and progressively improve between treatment sessions. Research has found that homework compliance positively predicts successful outcomes in therapy, and therapists are now looking for better ways to implement homework, so that more individuals may receive its benefits.

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