Homework

Definition

Homework in behavior therapy refers to a variety of treatment-related tasks that are completed between therapy sessions. The content of these assignments varies as a function of the behavioral targets of focus.

Typically, a treatment target is addressed in a session and the client is provided with the necessary skills to complete the task(s) that will be assigned for homework. A specific homework assignment is agreed upon between the client and the clinician, and a due date set, typically at a subsequent treatment session. In the subsequent session, the clinician and the client discuss the homework assignment, successes are praised, difficulties are discussed, failures are examined, and solutions are generated. One example of a homework assignment for depression is for the client to engage in one fun activity a week. In the session prior to the homework assignment, the clinician and client make a list of a number of these activities for the client to choose from, and after the homework is assigned, each subsequent session begins with a discussion of the activity completed between sessions. The focus of these discussions may focus on increasing the client's awareness that fun is possible and that the client has the power to engage in activities that improve his or her mood. Another example of homework is in behavioral parent training, where homework is primarily used to practice and generalize skills that have been modeled and role-played in the therapist's office to the home environment.

Benefits

Although the specific goals and proposed benefits to homework assignments vary, there are some general assumed benefits to all therapy homework assignments. One benefit is that homework is thought to aid in the generalization of positive treatment gains to the client's or family's everyday life and interactions. For example, a parent may appropriately use positive reinforcement when practicing with the therapist. This parent, however, may have trouble in applying positive reinforcement with a noncompliant and demanding child in the home. Homework assignments are designed to bridge the gap between the therapeutic environment and the client's home environment both during and after completion of treatment. In addition, homework is thought to increase client perceptions of self-efficacy. Through successful completion of homework assignments, it is intended to build confidence in the client's abilities to handle challenging, treatment-relevant situations independent of the clinician. A third proposed benefit is practice of newly acquired skills. Finally, homework assignments are [Page 880]designed to allow the coverage of more treatment in a shorter amount of time. With the recent increase of third-party payment for psychotherapy, there has been a push for briefer, more effective, and less expensive therapies, and homework is one method for including more treatment at lower cost.

Research Basis

Generally, research indicates that homework adherence is associated with better treatment outcomes. Increased acceptance of the treatment rationale is associated with greater homework compliance, and homework appears to contribute unique variance to outcome. More research is needed to determine whether homework completion and better outcomes result from stronger client motivation or other factors associated with increased engagement in treatment.

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