Homework Assignments in Cognitive and Behavioral Therapy: A Meta-Analysis

Kazantzis, Nikolaos

doi:10.1093/clipsy/7.2.189

Cited by 160 publications

(218 citation statements)

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“…This is consistent with recommendations by Kazantzis et al (2000), who argued that in order to avoid biases associated with retrospective ratings, homework adherence should be assessed at regular intervals during therapy. Addis and Jacobson (1996) used longitudinal data on homework adherence and symptom change over the course of therapy and showed that homework adherence during earlier phases of therapy predicted treatment outcome in cognitive behavioral treatment for depression.…”

Section: Discussionsupporting

confidence: 87%

“…Studies of homework adherence (or compliance) have generally shown that clients who are on average more adherent with therapy homework gain more from treatment than clients who are not (for a quantitative review see, Kazantzis, Deane, & Ronan, 2000). However, the relationship between therapy homework adherence and treatment outcome is not always strong (Kazantzis, 2000).…”

Section: Introductionmentioning

confidence: 99%

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Measuring Homework Utility in Psychotherapy: Cognitive-Behavioral Therapy for Adult Attention-Deficit Hyperactivity Disorder as an Example

Yovel

Safren

2006

Cogn Ther Res

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Homework, or practice of skills learned in treatment, is a critical component of cognitive-behavioral therapy (CBT). However, no matter how much effort clients put into their therapy homework, this effort can only be useful if adherence to homework is related to improvement in symptoms. Although homework adherence (the extent to which clients practice skills learned in therapy outside of sessions) has been studied with respect to psychotherapy outcomes, 'homework utility', a potentially important mechanism of action in cognitive behavioral treatments, has yet to be operationally defined as a distinct construct, and it has yet to be studied with respect to psychotherapy outcome. We therefore propose an operational definition of therapy homework utility: the extent to which homework adherence is associated with parallel symptom improvement across time throughout treatment for each individual client. In this capacity, an indicator of homework utility is operationalized as the within subject correlation of sessionby-session homework adherence with session-by-session symptom change. We used a sample of clients who underwent CBT for attention-deficit hyperactivity disorder in adulthood as an example to quantify homework utility and examine its association to treatment outcome. Consistent with our hypotheses, homework utility was significantly associated with overall therapy outcome. Homework utility may be an important construct relevant to the mechanism of action of structured psychotherapies, and examining within subject sessions-by-session correlations with symptomatic change may be a useful way to examine other psychotherapy process variables.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Measuring Homework Utility in Psychotherapy: Cognitive-Behavioral Therapy for Adult Attention-Deficit Hyperactivity Disorder as an Example

Yovel

Safren

2006

Cogn Ther Res

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“…Homework has generally been related to beneficial therapeutic outcomes (see meta-analysis by Kazantsis, Deane, & Ronan, 2000) and many homework activities involve some kind of writing. Homework assignments in behavior therapy often merely record or very briefly describe some aspect of daily or weekly functioning.…”

Section: Homework Diariesmentioning

confidence: 99%

Integrating writing into psychotherapy practice: A matrix of change processes and structural dimensions.

Kerner

Fitzpatrick²

2007

Psychotherapy: Theory, Research, Practice, Training

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Research on therapeutic writing indicates that it can offer a range of physical and psychological benefits. There is no consensus, however, concerning how writing achieves these benefits. To address this question, the authors propose a matrix framework with emotional-cognitive change processes (what can be activated) along its horizontal dimension and abstract-concrete structure (how the processes are activated) along its vertical dimension. On the horizontal dimension, writing can encourage clients who are distant from their emotional world to approach or to modulate emotional intensity, and to create meaning and coherence. Along the vertical dimension, these processes can be activated through tasks that vary in structure, including programmed writing, diaries, journaling, autobiography, storytelling, and poetry. Finally, the authors consider constraints on writing that apply to particular client groups. The matrix framework is meant to encourage clinicians to use therapeutic writing and to assist researchers in framing questions to advance our knowledge of writing as a therapeutic practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

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“…In an attempt to consolidate the evidence to date, Kazantzis, Deane, and Ronan (2000) conducted a meta-analysis of 27 experimental and correlational studies and found that psychotherapy involving homework assignments results in better treatment outcome than psychotherapy without homework (Kazantzis & Lampropoulos, 2002).…”

mentioning

confidence: 99%

Relationship Between Homework Completion and Outcome in Cognitive Behaviour Therapy

Rees

McEvoy

Nathan

2005

Cognitive Behaviour Therapy

104

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Homework or between-session learning has long been considered an essential aspect of effective cognitive behaviour therapy. However, it has received relatively less empirical attention than other components of cognitive behaviour therapy. In general, studies have found that homework completion is predictive of outcome in psychotherapy. However, the amount of homework completed by a patient represents only one aspect of this important therapeutic component. This study investigated both the quantity and the quality of homework completed during a 10-week group cognitive and behavioural treatment program for anxious and depressed patients. It explored the relationship between various aspects of homework completion and outcomes on several different variables. A total of 94 patients were included in the analysis. It was found that both quantity and quality of homework completed predicted outcome on measures of depression, anxiety and quality of life at post-treatment and at 1-month follow-up. The results were strongest for the amount of homework completed, suggesting that clinicians should encourage patients to complete homework even if the homework content is not entirely accurate. The results of this study highlight the importance of homework as a central part of effective cognitive and behavioural treatment.

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Homework Assignments in Cognitive and Behavioral Therapy: A Meta-Analysis

Cited by 160 publications

References 0 publications

Measuring Homework Utility in Psychotherapy: Cognitive-Behavioral Therapy for Adult Attention-Deficit Hyperactivity Disorder as an Example

Measuring Homework Utility in Psychotherapy: Cognitive-Behavioral Therapy for Adult Attention-Deficit Hyperactivity Disorder as an Example

Integrating writing into psychotherapy practice: A matrix of change processes and structural dimensions.

Relationship Between Homework Completion and Outcome in Cognitive Behaviour Therapy

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