Congruence of Patient Takeaways and Homework Assignment Content Predicts Homework Compliance in Psychotherapy

Jensen, Alexandra; Fee, Connie; Miles, Anthony L.; Beckner, Victoria; Owen, Daniela J.; Persons, Jacqueline B.

doi:10.1016/j.beth.2019.07.005

Cited by 12 publications

(13 citation statements)

References 35 publications

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“…Additionally, Veterans completing more homework between sessions also proved more likely to complete a full course of PTSD treatment. This finding matched previous research that has highlighted the crucial role of homework in establishing self-efficacy for using skills learned in psychotherapy (Jensen et al, 2020). Of the 581 Veterans who initiated treatment, 59% did not complete the recommended minimum dosage of eight sessions (Holder et al, 2020; Sripada et al, 2020), with findings being consistent with previous literature suggesting increased dropout rates for PTSD treatments among Veteran populations (Maguen et al, 2019).…”

Section: Discussionsupporting

confidence: 90%

PTSD telehealth treatments for veterans: Comparing outcomes from in-person, clinic-to-clinic, and home-based telehealth therapies.

Knowlton¹,

Nelson²

2021

Journal of Rural Mental Health

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Section: Discussionsupporting

confidence: 90%

PTSD telehealth treatments for veterans: Comparing outcomes from in-person, clinic-to-clinic, and home-based telehealth therapies.

Knowlton¹,

Nelson²

2021

Journal of Rural Mental Health

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“…For example, it is recommended to write down homework tasks and instructions (Cox et al 1988) in order to assure higher homework compliance. Moreover, a recent study provides preliminary support for the importance of designing homework tasks that are congruent with what the patient perceived helpful in the session (Jensen et al 2020). Since therapists were instructed to adhere to the homework assignments as scheduled, they were not entirely free to consider whether the homework type scheduled for a specific session was appropriate for the patients' current problem or situation.…”

Section: Discussionmentioning

confidence: 99%

The Role of Homework Engagement, Homework-Related Therapist Behaviors, and Their Association with Depressive Symptoms in Telephone-Based CBT for Depression

Haller

Watzke

2020

Cogn Ther Res

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Background Telephone-based cognitive behavioral therapy (tel-CBT) ascribes importance to between-session learning with the support of the therapist. The study describes patient homework engagement (HE) and homework-related therapist behaviors (TBH) over the course of treatment and explores their relation to depressive symptoms during tel-CBT for patients with depression. Methods Audiotaped sessions (N = 197) from complete therapies of 22 patients (77% female, age: M = 54.1, SD = 18.8) were rated by five trained raters using two self-constructed rating scales measuring the extent of HE and TBH (scored: 0-4). Results Average scores across sessions were moderate to high in both HE (M = 2.71, SD = 0.74) and TBH (M = 2.1, SD = 0.73). Multilevel mixed models showed a slight decrease in HE and no significant decrease in TBH over the course of treatment. Higher TBH was related to higher HE and higher HE was related to lower symptom severity. Conclusions Results suggest that HE is a relevant therapeutic process element related to reduced depressive symptoms in tel-CBT and that TBH is positively associated with HE. Future research is needed to determine the causal direction of the association between HE and depressive symptoms and to investigate whether TBH moderates the relationship between HE and depressive symptoms. Trial Registration ClinicalTrials.gov NCT02667366. Registered on

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“…Although many participants discussed their experiences using the apps during subsequent group sessions, homework forms tracking app use were very rarely submitted. Limited adherence to written homework activities is a well-known and common challenge for cognitive behavioral therapies (e.g., Beck & Beck, 1995 ; Jensen et al, 2020 ; Decker et al, 2016 ) and this project was affected by similar poor adherence. Due to very low rates of returned homework forms tracking app use between sessions ( n = 21 out of a possible 328), there was not enough data on participant app use to draw meaningful conclusions.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a Psychoeducational Group to Expand Mobile Application Knowledge and Use in a Veteran Residential Treatment Program

Harned

Dhami

Reger

2023

J. technol. behav. sci.

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Despite the availability of free, evidence-informed mental health mobile applications (apps) to support Veterans and Service Members, interventions are needed to ensure patients are aware of the developed resources. A psychoeducational group was developed and evaluated by a quality improvement project in the context of a Department of Veterans Affairs residential treatment program. Four weekly group sessions introduced 82 Veterans to two similarly themed apps at each group and supported Veteran installation, introduction to the clinical subject matter, app orientation and demonstration, and device/app troubleshooting. Although 94% owned a smartphone, prior to the group, seven of eight apps introduced during the group had been used by fewer than 10% of participants. Following group participation, the proportion of participants agreeing that they were comfortable using mental health apps increased from 33% at baseline to 75%. Similarly, relative to 54% of participants at baseline who agreed that they were aware of available mental health mobile applications, the proportion rose to 89% after the group. Most participants rated three apps as “helpful” or “very helpful” (Breath2Relax, Mindfulness Coach, and PTSD Coach) and most participants reported they were likely to use these apps in the future. Results and qualitative feedback identified needed improvements to the group, including the replacement of some featured apps and the inclusion of automated app usage metrics. Well-designed implementation studies of dissemination strategies are needed to inform best practices for the adoption of these promising interventions.

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Congruence of Patient Takeaways and Homework Assignment Content Predicts Homework Compliance in Psychotherapy

Cited by 12 publications

References 35 publications

PTSD telehealth treatments for veterans: Comparing outcomes from in-person, clinic-to-clinic, and home-based telehealth therapies.

PTSD telehealth treatments for veterans: Comparing outcomes from in-person, clinic-to-clinic, and home-based telehealth therapies.

The Role of Homework Engagement, Homework-Related Therapist Behaviors, and Their Association with Depressive Symptoms in Telephone-Based CBT for Depression

Evaluation of a Psychoeducational Group to Expand Mobile Application Knowledge and Use in a Veteran Residential Treatment Program

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