Homework

Description of the Strategy

Homework assignments are designed to engage clients in activities outside of the therapeutic context that facilitate movement toward accomplishing treatment goals. This technique is utilized by mental health professionals from various therapeutic backgrounds, and it can be employed in the treatment of a wide range of disorders. Research shows that the completion of homework between therapy sessions is related to a more positive therapeutic outcome. This chapter will address the following areas: the nature of homework, research on its effectiveness, populations on which it can be used, and considerations for incorporating this technique into therapy.

Homework refers to therapeutic assignments given to a client by a therapist that are to be completed between therapy sessions. Most homework assignments fall into one of three categories: written assignments, self-monitoring procedures, and skills practice.[Page 332]The type of assignments given to a particular client can vary depending on the theoretical orientation of the therapist and the presenting problems of the client.

The practice of assigning homework to clients became widespread as a result of the increased popularity of the cognitive-behavioral theoretical orientation, which focuses on identifying and changing clients' specific thoughts and behaviors that are seen to be problematic. The concept of assigning tasks for a client to complete between therapy sessions appeared as early as 1936 but was not formally operationalized until 1981, when John L. Shelton and Rona L. Levy produced a treatment handbook that established specific guidelines for homework assignments. This work supplemented the writings of Aaron Beck and colleagues during the late 1970s and early 1980s that emphasized homework assignment as an important component of cognitive-behavioral therapy.

Despite the origins of homework assignment as a therapeutic technique, its application is not limited to treatment conducted by cognitive-behavioral therapists. Homework techniques are utilized by therapists endorsing a wide range of theoretical orientations, including psychodynamic, family systems, humanistic, interpersonal, and eclectic approaches. Of 221 master's- and doctoral-level psychologists surveyed in New Zealand, 98% incorporated homework techniques into their practices and assigned homework in an average of 57% of their therapy sessions. Although more than half of the psychologists surveyed identified themselves as cognitive-behavioral in their therapeutic approach, 43% endorsed other theoretical backgrounds.

Homework assignments vary in form depending upon a number of client and therapist variables. However, there are some elements of homework implementation that can be used as guidelines. Generally speaking, assignments should be clear, specific, and concrete and should increase in difficulty as treatment progresses. The purpose of the homework should be explained to the client, and his or her concerns and attitudes toward each assignment should be solicited. It may also be helpful to outline each assignment in writing, which serves to create a formal record of the homework and to remind the client of the specific details of each assignment. In the case of weekly sessions, each therapy session should begin with a review of the client's progress in completing previously assigned homework and end with a summary of the assignment for the upcoming week. This allows the therapist to systematically reward the client's efforts in completing the previous assignment and outline the specific details of the next assignment.

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