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Assigning Homework in Cognitive Behavioral Therapy

A counselor discusses this week's therapy homework with a man in blue.

It’s certainly true that therapy outcomes depend in part on the work taking place in each session. But for this progress to reach its full impact, clients need to use what they learn in therapy during their daily lives. 

Assigning therapy “homework” can help your clients practice new skills during the week. While many types of therapy may involve some form of weekly assignment, homework is a key component of cognitive behavior therapy. 

Types of Homework

Some clients may respond well to any type of homework, while others may struggle to complete or find benefit in certain assignments. It’s important for clients to step outside of their comfort zone in some ways. For example, it’s essential to learn to challenge unwanted thoughts and increase understanding of feelings and emotions, especially for people who struggle with emotional expression. 

But there isn’t just one way to achieve these goals. Finding the right type of homework for each client can make success more likely. 

There are many different types of therapy homework. Asking your client to practice breathing exercises when they feel anxious or stressed? That’s homework. Journaling about distressing thoughts and ways to challenge them, or keeping track of cognitive distortions ? Also homework.

Some clients may do well with different assignments each week, while others may have harder times with certain types of homework. For example:

  • An artistic client may not get much from written exercises. They might, however, prefer to sketch or otherwise illustrate their mood, feelings, or reactions during the week. 
  • Clients who struggle with or dislike reading may feel challenged by even plain-language articles. If you plan to assign educational materials, ask in your first session whether your client prefers audio or written media. 

When you give the assignment, take a few minutes to go over it with your client. Give an example of how to complete it and make sure they understand the process. You’ll also want to explain the purpose of the assignment. Someone who doesn’t see the point of a task may be less likely to put real effort into it. If you give a self-assessment worksheet early in the therapy process, you might say, “It can help to have a clear picture of where you believe you’re at right now. Later in therapy I’ll ask you to complete another assessment and we can compare the two to review what’s changed.” 

Mental Health Apps

Some people may also find apps a useful way to develop and practice emotional wellness coping skills outside of therapy. Therapy apps can help people track their moods, emotions, or other mental health symptoms. They can provide a platform to practice CBT or other therapy skills. They can also offer structured mindfulness meditations or help clients practice other grounding techniques. 

If you’re working with a client who’s interested in therapy apps, you might try using them in treatment. Just keep in mind that not all apps offer the same benefits. Some may have limitations, such as clunky or confusing interfaces and potential privacy concerns. It’s usually a good idea to check whether there’s any research providing support for—or against—a specific app before recommending it to a client. 

Trusted mental health sources, such as the American Psychological Association or Anxiety and Depression Association of America websites, may list some popular mental health apps, though they may not specifically endorse them. These resources can be a good starting place. Other organizations, including Northwestern University’s Center for Behavioral Intervention Technologies and the Defense Department of the United States, have developed their own research-backed mental health apps. 

You can also review apps yourself. Try out scenarios or options within the app to get to know how the app works and whether it might meet your client’s needs. This will put you in a position to answer their questions and help give them tips on getting the most out of the app. 

Benefits of Homework

Some of your clients may wonder why you’re assigning homework. After all, they signed up for therapy, not school. 

When clients ask about the benefits of therapy homework, you can point out how it provides an opportunity to put things learned in session into practice outside the therapy session. This helps people get used to using the new skills in their toolbox to work through issues that come up for them in their daily lives. More importantly, it teaches them they can use these skills on their own, when a therapist or other support person isn’t actively providing coaching or encouragement. This knowledge is an important aspect of therapy success. 

A 2010 review of 23 studies on homework in therapy found evidence to suggest that clients who completed therapy homework generally had better treatment outcomes. This review did have some limitations, such as not considering the therapeutic relationship or how clients felt about homework. But other research supports these findings, leading many mental health experts to support the use of therapy homework, particularly in CBT. Homework can be one of many effective tools in making therapy more successful. 

Improving Homework Compliance

You may eventually work with a client who shows little interest in homework and doesn’t complete the assignments. You know this could impede their progress in therapy, so you’ll probably want to bring this up in session and ask why they’re having difficulty with the homework. You can also try varying the types of homework you assign or asking if your client is interested in trying out a mental health app that can offer similar benefits outside your weekly sessions. 

When you ask a client about homework non-compliance, it’s important to do it in a way that doesn’t anger them, make them feel defensive, or otherwise damage the relationship you’re working to develop. Here are some tips for having this conversation:

  • Let them know homework helps them practice their skills outside of therapy. In short, it’s helping them get more out of therapy (more value for their money) and may lead to more improvement, sometimes in a shorter period of time than one weekly session would alone. 
  • Bring up the possibility of other types of homework. “If you don’t want to write anything down, would you want to try listening to a guided meditation or tips to help manage upsetting emotions?” 
  • Ask about it, in a non-confrontational way. You might say something like, “Is something making it difficult for you to complete the homework assignments? How can I help make the process easier for you?” 

The prospect of homework in therapy may surprise some clients, but for many people, it’s an essential element of success. Those put off by the term “homework” may view “skills practice” or similar phrasing more favorably, so don’t feel afraid to call it something else. The important part is the work itself, not what you call it.    References:

  • Ackerman, C. (2017, March 20). 25 CBT techniques and worksheets for cognitive behavioral therapy. Retrieved from https://positivepsychology.com/cbt-cognitive-behavioral-therapy-techniques-worksheets
  • ADAA reviewed mental health apps. (n.d.). Anxiety and Depression Association of America. Retrieved from https://adaa.org/finding-help/mobile-apps
  • Mausbach, B. T., Moore, R., Roesch, S., Cardenas, V., & Patterson, T. L. (2010). The relationship between homework compliance and therapy outcomes: An updated meta-analysis. Cognitive Therapy and Research, 34 (5), 429-438. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2939342
  • Mental health apps. (n.d.). The American Institute of Stress. Retrieved from https://www.stress.org/mental-health-apps
  • Novotney, A. (2016). Should you use an app to help that client? Monitor on Psychology, 47 (10), 64. Retrieved from https://www.apa.org/monitor/2016/11/client-app
  • Tang, W, & Kreindler, D. (2017). Supporting homework compliance in cognitive behavioural therapy: Essential features of mobile apps. JMIR Mental Health, 4(2). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5481663

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  • Last edited on September 9, 2020

Homework in CBT

Table of contents, why do homework in cbt, how to deliver homework, strategies to increase confidence.

Homework assignments in Cognitive Behavioural Therapy (CBT) can help your patients educate themselves further, collect thoughts, and modify their thinking.

Homework is not something that you just assign randomly. You should make sure you:

  • tailor the homework to the patient
  • provide a rationale for why the patient needs to do the homework
  • uncover any obstacles that might prevent homework from being done (i.e. - busy work schedule, significant neurovegetative symptoms)

Types of homework

Types of homework assignments.

Behavioural Activation Getting active, depressed patients out of bed or off the couch, and helping them resume normal activity
Monitoring automatic thoughts From the first session forward, you will encourage your patients to ask themselves, “What’s going through my mind right now?”
Evaluating and responding to automatic thoughts At virtually every session, you will help patients modify their inaccurate and dysfunctional thoughts and write down their new way of thinking. Patients will also learn to evaluate their own thinking and practice doing so between sessions.
Problem-solving At virtually every session, you will help patients devise solutions to their problems, which they will implement between sessions.
Behavioural skills To effectively solve their problems, patients may need to learn new skills, which they will practice for homework.
Behavioural experiments Patients may need to directly test the validity of automatic thoughts that seem distorted, such as “I’ll feel better if I stay in bed”
Bibliotherapy Important concepts you are discussing in session can be greatly reinforced when patients read about them in black and white.
Preparing for the next session Preparing for the next therapy session. The beginning part of each therapy session can be greatly speeded up if patients think about what is important to tell you before they enter your office.

You should also decide the frequency of the homework should be assigned: should it be daily, weekly?

If your patient does not do homework, that’s OK! Explore as a team, in a non-judgmental way, to explore why the homework was not done. Here are some ways to increase adherence to homework:

  • Tailor the assignments to the individual
  • Provide a rationale for how and why the assignment might help
  • Determine the homework collaboratively
  • Try to start the homework during the session. This creates some momentum to continue doing the homework
  • Set up systems to remember to do the assignments (phone reminders, sticky notes
  • It is better to start with easier homework assignments and err on the side of caution
  • They should be 90-100% confident they will be able to do this assignment
  • Covert rehearsal - running through a thought experiment on a situation
  • Change the assignment - It is far better to substitute an easier homework assignment that patients are likely to do than to have them establish a habit of not doing what they had agreed to in session
  • Intellectual/emotional role play - “I’ll be the intellectual part of you; you be the emotional part. You argue as hard as you can against me so I can see all the arguments you’re using not to read your coping cards and start studying. You start.”

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Supporting Homework Compliance in Cognitive Behavioural Therapy: Essential Features of Mobile Apps

1 Discipline of Psychiatry, Department of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada

David Kreindler

2 Division of Youth Psychiatry, Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada

3 Centre for Mobile Computing in Mental Health, Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada

4 Department of Psychiatry, University of Toronto, Toronto, ON, Canada

Cognitive behavioral therapy (CBT) is one of the most effective psychotherapy modalities used to treat depression and anxiety disorders. Homework is an integral component of CBT, but homework compliance in CBT remains problematic in real-life practice. The popularization of the mobile phone with app capabilities (smartphone) presents a unique opportunity to enhance CBT homework compliance; however, there are no guidelines for designing mobile phone apps created for this purpose. Existing literature suggests 6 essential features of an optimal mobile app for maximizing CBT homework compliance: (1) therapy congruency, (2) fostering learning, (3) guiding therapy, (4) connection building, (5) emphasis on completion, and (6) population specificity. We expect that a well-designed mobile app incorporating these features should result in improved homework compliance and better outcomes for its users.

Homework Non-Compliance in CBT

Cognitive behavioral therapy (CBT) is an evidence-based psychotherapy that has gained significant acceptance and influence in the treatment of depressive and anxiety disorders and is recommended as a first-line treatment for both of these [ 1 , 2 ]. It has also been shown to be as effective as medications in the treatment of a number of psychiatric illnesses [ 3 - 6 ]. Homework is an important component of CBT; in the context of CBT, homework can be defined as “specific, structured, therapeutic activities that are routinely discussed in session, to be completed between sessions” [ 7 ]. Completion of homework assignments was emphasized in the conception of CBT by its creator, Aaron Beck [ 8 ]. Many types of homework are prescribed by CBT practitioners, including symptom logs, self-reflective journals, and specific structured activities like exposure and response prevention for obsessions and compulsions. These can be divided into the following 3 main categories: (1) psychoeducational homework, (2) self-assessment homework, and (3) modality-specific homework. Psychoeducation is an important component in the early stage of therapy. Reading materials are usually provided to educate the client on the symptomatology of the diagnosed illness, its etiology, as well as other treatment-relevant information. Self-assessment strategies, including monitoring one’s mood using thought records, teach the patients to recognize the interconnection between one’s feelings, thoughts, and behaviors [ 8 ]. For example, depressed patients may be asked to identify thinking errors in daily life and document the negative influences these maladaptive thinking patterns can produce on their behaviors. Various psychiatric disorders may require different types of modality-specific homework. For example, exposure to images of spiders is a treatment method specific to arachnophobia, an example of a “specific phobia” in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) [ 9 ]. Homework is strategically created by the therapist to correct and lessen the patient’s psychopathology. The purpose of these exercises is to allow the patients to practice and reinforce the skills learned in therapy sessions in real life.

Homework non-compliance is one of the top cited reasons for therapy failure in CBT [ 10 ] and has remained a persistent problem in the clinical practice. Surveys of practitioners have suggested rates of non-adherence in adult clients of approximately 20% to 50% [ 10 , 11 ] while adherence rates in adolescents have been reported to be approximately 50% [ 12 ]. Many barriers to homework compliance have been identified in the literature; to facilitate discussions, they can be divided into internal and external factors. Internal factors originate from a client’s own psychological environment while external ones are created by external influences. Internal factors that have been identified include lack of motivation to change the situation when experiencing negative feelings, the inability to identify automatic thoughts, disregard for the importance or relevance of the homework, and the need to see immediate results [ 12 - 14 ]. Various external factors have also been identified, including the effort associated with pen-and-paper homework formats, the inconvenience of completing homework because of the amount of time consumed, not understanding of the purpose of the homework, lack of instruction, and failure to anticipate potential difficulties in completing the homework [ 14 - 16 ]. There is strong evidence suggesting that homework compliance is integral to the efficacy of CBT in a variety of psychiatric illnesses. In the treatment of depression with CBT, homework compliance has been correlated with significant clinical improvement and shown to predict decreases in both subjective and objective measures of depressive symptoms [ 17 - 23 ]. Similarly, homework compliance is correlated with short-term and long-term improvement of symptoms in anxiety disorders, including generalized anxiety disorder (GAD), social anxiety disorder (SAD), hoarding, panic disorder, and post-traumatic stress disorder (PTSD) [ 17 , 24 - 32 ]. Fewer studies have been done on homework compliance in other psychiatric conditions, but better homework compliance has been correlated with significant reductions in pathological behaviors in psychotic disorders [ 33 , 34 ], cocaine dependence [ 35 , 36 ], and smoking [ 37 ]. Two meta-analyses further support the notion that greater homework adherence is associated with better treatment outcomes in depression, anxiety-related disorders, and substance use [ 38 , 39 ].

The Utility of Technology in Enhancing CBT Homework

Despite its demonstrated efficacy, access to CBT (as well as other forms of psychotherapy) remains difficult due to the limited number of practicing psychotherapists and the cost of therapy sessions [ 40 ]. With the rise of mass-market mobile communication devices such as the iPhone or other kinds of mobile devices with app capabilities (smartphones), new solutions are being sought that will use these devices to provide therapy to patients in a more cost-effective manner. Mobile phones with app capabilities are portable devices that combine features of a cellphone and a hand-held computer with the ability to wirelessly access the Internet. Over time, ownership of mobile phones in North America has grown [ 41 , 42 ] and progressively lower prices have further reduced barriers to their use and ownership [ 43 , 44 ]. As more and more people acquire mobile phones, the acceptance of and the demand for mobile health solutions have been on the rise [ 45 ]. Boschen (2008), in a review predating the popularization of the modern mobile phone, identified the unique features of the mobile telephone that made it a potentially suitable vehicle for adjunctive therapeutic applications: portability, acceptability, low initial cost, low maintenance cost, social penetration and ubiquity, “always on,” “always connected,” programmability, audio and video output, keypad and audio input, user-friendliness, and ease of use [ 46 ]. Over the last decade, modern mobile phones have supplanted the previous generation of mobile telephones; progressive increases in their computing power, ongoing advances in the software that they run and interact with (eg, JAVA, HTML5, etc.), common feature sets across different operating systems such as Google Inc.'s Android or Apple Inc.'s iOS, and adoption of common hardware elements across manufacturers (eg, touch screens, high-resolution cameras, etc) have enabled the development of platform-independent apps for mobile phones, or at least apps on different platforms with comparable functionality (eg, apps written for Apple's HealthKit or the apps written for Microsoft's HealthVault).

The popularization of the smartphone presents a unique opportunity to enhance CBT homework compliance using adjunctive therapeutic applications such that well-designed mobile software may be able to diminish barriers to CBT [ 40 ] by making CBT therapists' work more cost-effective. However, there are no guidelines and no existing research that directly address the design of mobile phone apps for this purpose. Given this gap in the literature, we searched MEDLINE (1946 to April 2015) and PsycINFO (1806 to April 2015) for all articles related to “cognitive behavioral therapy”, “homework”, “mobile applications” and “treatment compliance or adherence”, and reviewed articles related to (1) mobile technologies that address homework completion, (2) essential features of therapy, or (3) barriers to homework completion in CBT. In this article, we propose a collection of essential features for mobile phone-based apps that will optimally support homework compliance in CBT.

A Proposed List of Essential Features for Mobile Apps That Optimally Support CBT Homework Compliance

In order to be effective for patients and acceptable to therapists, an optimal mobile phone app to support CBT homework compliance should conform to the CBT model of homework while addressing barriers to homework compliance. Tompkins (2002) provides a comprehensive guideline on the appropriate ways to provide CBT homework such that homework should be meaningful, relevant to the central goals of therapy, salient to focus of the session, agreeable to both therapist and client, appropriate to sociocultural context, practiced in session to improve skill, doable, begin small, have a clear rationale, include written instructions, and include a backup plan with homework obstacles [ 47 ]. In addition, the therapist providing the homework needs to be curious, collaborative, reinforce all pro-homework behavior and successful homework completion, and emphasize completion over outcome [ 47 ]. By combining Tompkins' guidelines with the need to reduce barriers to homework compliance (as described above), we obtained the following list of 6 essential features that should be incorporated into mobile apps to maximize homework compliance: (1) congruency to therapy, (2) fostering learning, (3) guiding therapy, (4) building connections, (5) emphasizing completion, and (6) population specificity.

Congruency to Therapy

Any intervention in therapy needs to be relevant to the central goals of the therapy and salient to the focus of the therapeutic session. A mobile app is no exception; apps have to deliver useful content and be congruent to the therapy being delivered. There are different types of homework in CBT, including (1) psychoeducational homework; (2) self-assessment homework; and (3) modality-specific homework. Which types are assigned will depend on the nature of the illness being treated, the stage of treatment, and the specific target [ 48 ]. An effective app supporting homework compliance will need to be able to adjust its focus as the therapy progresses. Self-monitoring and psychoeducation are major components in the early stage of therapy. Thought records can be used in depression and anxiety while other disorders may require more specific tasks, such as initiating conversation with strangers in the treatment of SAD. Therefore, the treatment modules delivered via mobile phones should meet the specific needs of therapy at each stage of therapy, while also providing psychoeducation resources and self-monitoring capabilities.

Psychoeducational Homework

While there are large amounts of health-related information on the Internet, the majority of information is not easily accessible to the users [ 49 ]. Mobile apps can enhance psychoeducation by delivering clear and concise psychoeducational information linked to the topics being covered in therapy. As psychoeducation is seen as a major component of mobile intervention [ 50 ], it has been incorporated into several mobile apps, some of which have been shown to be efficacious in treating various psychiatric conditions, including stress [ 51 ], anxiety and depression [ 52 ], eating disorders [ 53 ], PTSD [ 54 ], and obsessive compulsive disorder (OCD) [ 55 ]. For example, Mayo Clinic Anxiety Coach is a mobile phone app “designed to deliver CBT for anxiety disorders, including OCD” [ 55 ]. The app contains a psychoeducational module that teaches the user on “the use of the application, the cognitive-behavioral conceptualization of anxiety, descriptions of each anxiety disorder, explanations of CBT, and guidance for assessing other forms of treatment” [ 55 ]. The benefits of delivering psychoeducation via a mobile phone app are obvious: the psychoeducational information becomes portable and is easily accessed by the patient. Furthermore, the information is also curated and validated by proper healthcare authorities, which builds trust and reduces the potential for misinformation that can result from patient-directed Internet searches. However, psychoeducation on its own is not optimal. Mobile interventions that also incorporate symptom-tracking and self-help interventions have resulted in greater improvement when used for depression and anxiety symptoms than those that deliver only online psychoeducation [ 50 ].

Self-Assessment Homework

In contrast to conventional, paper-based homework, mobile apps can support in-the-moment self-assessments by prompting the user to record self-report data about the user’s current state [ 56 ]. While information collected retrospectively using paper records can be adversely affected by recall biases [ 57 ], mobile apps enable the patient to document his or her thoughts and feelings as they occur, resulting in increased accuracy of the data [ 58 ]. Such self-assessment features are found in many mobile apps that have been shown to significantly improve symptoms in chronic pain [ 59 , 60 ], eating disorders [ 61 ], GAD [ 62 ], and OCD [ 55 ]. Continuing with the previous example, the Mayo Clinic Anxiety Coach offers a self-assessment module that “measures the frequency of anxiety symptoms” with a self-report Likert-type scale [ 55 ]. The app tracks users’ progress over time based on the self-assessment data; users reported liking the record of daily symptom severity scores that the application provides.

Modality-Specific Homework

Evidence suggests that a variety of modality-specific homework assignments on mobile apps are effective, including relaxation practices, cognitive therapy, imaginal exposure in GAD and PTSD [ 54 , 57 ], multimedia solutions for skill learning and problem solving in children with disruptive behavior or anxiety disorders [ 63 ], relaxation and cognitive therapy in GAD [ 62 ], or self-monitoring via text messages (short message service, SMS) to therapists in bulimia nervosa [ 61 ]. Mayo Clinic Anxiety Coach, for example, has a treatment module for OCD that “guides patients through the use of exposure therapy” [ 55 ]; patients can use this to build their own fear hierarchies according to their unique diagnoses. Users reported liking the app because it contains modality-specific homework that can be tailored to their own needs. Novel formats, such as virtual reality apps to create immersive environments, have been experimented with as a tool for facilitating exposure in the treatment of anxiety disorders with mostly positive feedback [ 64 - 66 ]. Apps that provide elements of biofeedback (such as heart rate monitoring via colorimetry of users' faces using the mobile phone's camera), have recently begun to be deployed. So-called ”serious games,“ (ie, games developed for treatment purposes), are also showing promise in symptom improvement in certain cases [ 51 , 67 , 68 ].

Fostering Learning

Doing CBT homework properly requires time and effort. As noted above, any sense of inconvenience while doing the homework may hamper a patient’s motivation to complete the homework. While patients may appreciate the importance of doing homework, they often find the length of time spent and the lack of clear instructions discouraging, resulting in poor engagement rates [ 49 , 52 ]. Therefore, it makes sense that the tasks should be simple, short in duration to begin with, and include detailed instructions [ 47 ], since homework completion rates have been shown to be correlated with patients’ knowing exactly what to do [ 33 , 69 ]. Many apps incorporate text messaging-based services or personalized feedback to encourage dynamic interactions between the therapist and the client [ 59 ]. However, the types of homework delivered by these apps are fixed. An app that adapts the contents to the user’s progress in learning homework tasks would be more engaging and effective since therapy should be a flexible process by nature. Ideally, the app would monitor and analyze the user’s progress and adjust the homework's content and difficulty level accordingly. While the effectiveness of this type of app has not been studied, a similar app has been described in the literature for treating GAD [ 62 ]. This app, used in conjunction with group CBT, collected regular symptom rating self-reports from patients to track anxiety. Based on patients’ ratings, the app would respond with encouraging comments and invite patients to practice relaxation techniques or prompt the patient to complete specific built-in cognitive therapy modules if their anxiety exceeded a threshold rating. Despite the simple algorithm used to trigger interventions, use of the app with group CBT was found to be superior to group CBT alone.

Guiding Therapy

Therapists have a number of important roles to play in guiding and motivating clients to complete homework. First, the therapist needs to address the rationale of the prescribed homework and work with the client in the development of the treatment plan [ 47 ]. Failure to do this has been identified as a barrier to homework compliance. Second, the therapist should allow the patient to practice the homework tasks during the therapy sessions [ 47 ] in order to build confidence and minimize internal barriers, such as the failing to identify automatic thoughts. Lastly, the therapist has to be collaborative, regularly reviewing homework progress and troubleshooting with the patients [ 47 , 70 ]; this can be done during or in between homework assignments, either in-person or remotely (ie, via voice or text messaging) [ 60 , 71 ].

Reviewing and troubleshooting homework has been seen as a natural opportunity for apps to augment the role of therapists. Individualized guidance and feedback on homework is found in many Internet-based or mobile apps that have been shown to be effective in treating conditions such as PTSD [ 72 ], OCD [ 55 ], chronic pain [ 59 , 60 ], depression and suicide ideation [ 71 ], and situational stress [ 73 ]. Moreover, providing a rationale for homework, ensuring understanding of homework tasks, reviewing homework, and troubleshooting with a therapist have each individually been identified as predictors of homework compliance in CBT [ 74 , 75 ]. However, despite incorporating a variety of features including self-monitoring, psychoeducation, scheduled reminders, and graphical feedback [ 52 ], automated apps with minimal therapist guidance have demonstrated elevated homework non-completion rates of up to 40%, which is less than ideal.

Building Connections

The effects of technology should not interfere with but rather encourage a patient’s ability to build meaningful connections with others [ 76 ]. The therapeutic alliance between the therapist and the client is the strongest predictor of therapeutic outcome [ 77 ] and has been suggested to predict level of homework compliance as well [ 78 ]. While there is no evidence so far to suggest that technology-based interventions have an adverse effect on the therapeutic alliance [ 79 , 80 ], this conclusion should not be generalized to novel technologies as their impact on therapeutic alliance has not been well studied [ 81 ].

An arguably more significant innovation attributable to technology has been its potential to allow patients to form online communities, which have been identified as useful for stigma reduction and constructive peer support systems [ 82 ]. Online or virtual communities provide patients with a greater ability to connect with others in similar situations or with similar conditions than would be possible physically. Internet-delivered CBT that includes a moderated discussion forum has been shown to significantly improve depression symptoms [ 83 ]. Furthermore, professional moderation of online communities increases users’ trust of the service [ 84 ]. Therefore, including social platforms and online forums in a mobile app may provide additional advantages over conventional approaches by allowing easier access to social support, fostering collaboration when completing homework, and enabling communication with therapists.

Emphasizing Completion

A patient’s need to see immediate symptomatic improvement is an impediment to homework compliance since the perception of slow progress can be discouraging to the user [ 35 ]. To address this issue, it is important for both therapists and mobile apps to emphasize homework completion over outcome [ 47 ]. While a therapist can urge the client to finish uncompleted homework during the therapy session to reinforce its importance [ 47 , 85 ], there is little a therapist can do in between therapy sessions to remind clients to complete homework. In contrast, a mobile app can, for example, provide ongoing graphical feedback on progress between sessions to motivate users [ 52 , 86 ], or employ automatic text message reminders, which have been demonstrated to significantly improve treatment adherence in medical illnesses [ 87 ]. These features have previously been incorporated into some technology-based apps for homework adherence when treating stress, depression, anxiety, and PTSD [ 52 , 54 , 88 ] with significant symptom improvement reported in one paper [ 71 ].

Population Specificity

Homework apps should, where relevant or useful, explicitly be designed taking into account the specific characteristics of its target audience, including culture, gender, literacy, or educational levels (including learning or cognitive disabilities). One example of how culture-specific design features can be incorporated can be found in Journal to the West, a mobile app for stress management designed for the Chinese international students in the United States, which incorporates cultural features into its game design [ 89 ]. In this game, breathing activity is associated with the concept of “Qi” (natural energy) in accordance with Chinese traditions; the name of the game itself references to a famous Chinese novel and the gaming environment features inkwash and watercolor schemes of the East Asian style, making the experience feel more “natural” as reported by the users. A different approach to tailoring design is taken by the computer-based games described by Kiluk et al [ 68 ] that combine CBT techniques and multi-touch interface to teach the concepts of social collaboration and conversation to children with autism spectrum disorders. In these games, the touch screen surface offers simulated activities where children who have difficulties with peer engagement can collaborate to accomplish tasks. Children in this study demonstrated improvement in the ability to provide social solutions and better understanding of the concepts of collaboration. Although the population-specific design is intuitively appealing, the degree to which it can enhance homework compliance has yet to be investigated.

Other Considerations

There are several additional issues specific to mobile apps that should be carefully considered when developing mobile apps for homework compliance. Because of screen sizes, input modes, the nature of electronic media, etc, standard CBT homework may need to be translated or modified to convert it into a format optimal for delivery via a mobile phone [ 47 ]. The inclusion of text messaging features remains controversial, in part because of concerns about client-therapist boundary issues outside the therapy sessions [ 90 ]. One potential solution is to use automated text messaging services to replace direct communication between the therapist and the client so the therapist can't be bombarded by abusive messages [ 52 , 61 , 91 , 92 ]. Privacy and security issues are also real concerns for the users of technology [ 93 ], although no privacy breaches related to text messaging or data security have been reported in studies on mobile apps so far [ 88 , 94 - 98 ]. Designers of mobile apps should ensure that any sensitive health-related or personal data is stored securely, whether on the mobile device or on a server.

Finally, while this paper focused on “essential” features of apps, this should not be misunderstood as an attempt to itemize all elements necessary for designing a successful piece of software. Good software design depends on many important elements that are beyond the scope of this paper, such as a well-designed user interface [ 99 ] that is cognitively efficient relative to its intended purpose [ 100 ] and which makes effective use of underlying hardware.

The popularization and proliferation of the mobile phone presents a distinct opportunity to enhance the success rate of CBT by addressing the pervasive issue of poor homework compliance. A variety of barriers exist in traditional, paper-based CBT homework that can significantly hamper clients’ motivation to complete homework as directed. The 6 essential features identified in this paper can each potentially enhance homework compliance. Therapy congruency focuses the features of the app on the central goal of therapy and fostering learning eases engagement in therapy by reducing barriers. Apps should help the therapist guide the client through therapy and not hinder the therapeutic process or interfere with patient’s building connections with others. It is crucial that homework completion be emphasized by the app, not just homework attempting. Population-specific issues should also be considered depending on the characteristics of targeted users.

As an example of how this applies in practice, “Mental Health Telemetry-Anxiety Disorders” (MHT-ANX) is a new mobile app developed by the Centre for Mobile Computing in Mental Health at Sunnybrook Health Sciences Centre in Toronto that helps patients monitor their anxiety symptoms using longitudinal self-report. The symptom log is therapy congruent to the practice of CBT since it promotes patients' awareness of their anxiety symptoms and the symptoms’ intensity. The simplicity of the app makes it easy for patients to learn to use, consistent with the need for fostering learning and increasing compliance. The MHT-ANX app was designed to share patient data with their clinicians, helping clinicians guide patients through therapy and more readily engage in discussion about symptom records, thus potentially enhancing the therapeutic relationship. Homework completion is emphasized both by automated text message reminders that the system sends and by questions presented by MHT-ANX that focus on how homework was done. While there are few population-specific design issues obvious at first glance in MHT-ANX, the focus groups conducted as part of our design process highlighted that our target group preferred greater privacy in our app rather than ease of sharing results via social media, and prioritized ease-of-use. While not yet formally assessed, reports from staff and early users suggest that MHT-ANX has been helpful for some patients with promoting homework compliance.

Limitations and Future Challenges

The feature list we have compiled is grounded in current technology; as technology evolves, this list may need to be revised. For example, as artificial intelligence [ 101 ] or emotional sensing [ 102 ] develops further, we would expect that software should be able to dynamically modify its approach to the user in response to users' evolving emotional states.

This paper presents our opinion on this topic, supported by a survey of associated literature. Our original intention was to write a review of the literature on essential features of apps supporting CBT homework compliance, but there was no literature to review. The essential features that are the focus of this article are summaries of key characteristics of mobile apps that are thought to improve homework compliance in CBT, but randomized trials assessing the impact of these apps on homework compliance have not yet been done. We would anticipate synergistic effects when homework-compliance apps are used in CBT (eg, if measures of progress collected from an app were used as feedback during therapy sessions to enhance motivation for doing further CBT work), but the actual impact and efficacy of therapy-oriented mobile apps cannot be predicted without proper investigation.

Abbreviations

CBTcognitive behavioral therapy
GADgeneralized anxiety disorder
MHT-ANXMental Health Telemetry-Anxiety Disorders
OCDobsessive compulsive disorder
PTSDpost-traumatic stress disorder
SADsocial anxiety disorder

Conflicts of Interest: None declared.

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What Is Therapy Homework?

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Types of Therapy That Involve Homework

If you’ve recently started going to therapy , you may find yourself being assigned therapy homework. You may wonder what exactly it entails and what purpose it serves. Therapy homework comprises tasks or assignments that your therapist asks you to complete between sessions, says Nicole Erkfitz , DSW, LCSW, a licensed clinical social worker and executive director at AMFM Healthcare, Virginia.

Homework can be given in any form of therapy, and it may come as a worksheet, a task to complete, or a thought/piece of knowledge you are requested to keep with you throughout the week, Dr. Erkfitz explains.

This article explores the role of homework in certain forms of therapy, the benefits therapy homework can offer, and some tips to help you comply with your homework assignments.

Therapy homework can be assigned as part of any type of therapy. However, some therapists and forms of therapy may utilize it more than others.

For instance, a 2019-study notes that therapy homework is an integral part of cognitive-behavioral therapy (CBT) . According to Dr. Erkfitz, therapy homework is built into the protocol and framework of CBT, as well as dialectical behavior therapy (DBT) , which is a sub-type of CBT.

Therefore, if you’re seeing a therapist who practices CBT or DBT, chances are you’ll regularly have homework to do.

On the other hand, an example of a type of therapy that doesn’t generally involve homework is eye movement desensitization and reprocessing (EMDR) therapy. EMDR is a type of therapy that generally relies on the relationship between the therapist and client during sessions and is a modality that specifically doesn’t rely on homework, says Dr. Erkfitz.

However, she explains that if the client is feeling rejuvenated and well after their processing session, for instance, their therapist may ask them to write down a list of times that their positive cognition came up for them over the next week.

"Regardless of the type of therapy, the best kind of homework is when you don’t even realize you were assigned homework," says Erkfitz.

Benefits of Therapy Homework

Below, Dr. Erkfitz explains the benefits of therapy homework.

It Helps Your Therapist Review Your Progress

The most important part of therapy homework is the follow-up discussion at the next session. The time you spend reviewing with your therapist how the past week went, if you completed your homework, or if you didn’t and why, gives your therapist valuable feedback on your progress and insight on how they can better support you.

It Gives Your Therapist More Insight

Therapy can be tricky because by the time you are committed to showing up and putting in the work, you are already bringing a better and stronger version of yourself than what you have been experiencing in your day-to-day life that led you to seek therapy.

Homework gives your therapist an inside look into your day-to-day life, which can sometimes be hard to recap in a session. Certain homework assignments keep you thinking throughout the week about what you want to share during your sessions, giving your therapist historical data to review and address.

It Helps Empower You

The sense of empowerment you can gain from utilizing your new skills, setting new boundaries , and redirecting your own cognitive distortions is something a therapist can’t give you in the therapy session. This is something you give yourself. Therapy homework is how you come to the realization that you got this and that you can do it.

"The main benefit of therapy homework is that it builds your skills as well as the understanding that you can do this on your own," says Erkfitz.

Tips for Your Therapy Homework

Below, Dr. Erkfitz shares some tips that can help with therapy homework:

  • Set aside time for your homework: Create a designated time to complete your therapy homework. The aim of therapy homework is to keep you thinking and working on your goals between sessions. Use your designated time as a sacred space to invest in yourself and pour your thoughts and emotions into your homework, just as you would in a therapy session .
  • Be honest: As therapists, we are not looking for you to write down what you think we want to read or what you think you should write down. It’s important to be honest with us, and yourself, about what you are truly feeling and thinking.
  • Practice your skills: Completing the worksheet or log are important, but you also have to be willing to put your skills and learnings into practice. Allow yourself to be vulnerable and open to trying new things so that you can report back to your therapist about whether what you’re trying is working for you or not.
  • Remember that it’s intended to help you: Therapy homework helps you maximize the benefits of therapy and get the most value out of the process. A 2013-study notes that better homework compliance is linked to better treatment outcomes.
  • Talk to your therapist if you’re struggling: Therapy homework shouldn’t feel like work. If you find that you’re doing homework as a monotonous task, talk to your therapist and let them know that your heart isn’t in it and that you’re not finding it beneficial. They can explain the importance of the tasks to you, tailor your assignments to your preferences, or change their course of treatment if need be.

"When the therapy homework starts 'hitting home' for you, that’s when you know you’re on the right track and doing the work you need to be doing," says Erkfitz.

A Word From Verywell

Similar to how school involves classwork and homework, therapy can also involve in-person sessions and homework assignments.

If your therapist has assigned you homework, try to make time to do it. Completing it honestly can help you and your therapist gain insights into your emotional processes and overall progress. Most importantly, it can help you develop coping skills and practice them, which can boost your confidence, empower you, and make your therapeutic process more effective.

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Conklin LR, Strunk DR, Cooper AA. Therapist behaviors as predictors of immediate homework engagement in cognitive therapy for depression . Cognit Ther Res . 2018;42(1):16-23. doi:10.1007/s10608-017-9873-6

Lebeau RT, Davies CD, Culver NC, Craske MG. Homework compliance counts in cognitive-behavioral therapy . Cogn Behav Ther . 2013;42(3):171-179. doi:10.1080/16506073.2013.763286

By Sanjana Gupta Sanjana is a health writer and editor. Her work spans various health-related topics, including mental health, fitness, nutrition, and wellness.

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7 Solution-Focused Therapy Techniques and Worksheets (+PDF)

solution focused therapy techniques

It has analyzed a person’s problems from where they started and how those problems have an effect on that person’s life.

Out of years of observation of family therapy sessions, the theory and applications of solution-focused therapy developed.

Let’s explore the therapy, along with techniques and applications of the approach.

Before you read on, we thought you might like to download our three Positive Psychology Exercises for free . These science-based exercises will explore fundamental aspects of positive psychology including strengths, values, and self-compassion, and will give you the tools to enhance the wellbeing of your clients, students, or employees.

This Article Contains:

5 solution-focused therapy techniques, handy sft worksheets (pdf), solution-focused therapy interventions, 5 sft questions to ask clients, solution-focused brief therapy (sfbt techniques), 4 activities & exercises, best sft books, a take-home message.

Solution-focused therapy is a type of treatment that highlights a client’s ability to solve problems, rather than why or how the problem was created. It was developed over some time after observations of therapists in a mental health facility in Wisconsin by Steve de Shazer and Insoo Kim Berg and their colleagues.

Like positive psychology, Solution Focused Therapy (SFT) practitioners focus on goal-oriented questioning to assist a client in moving into a future-oriented direction.

Solution-focused therapy has been successfully applied to a wide variety of client concerns due to its broad application. It has been utilized in a wide variety of client groups as well. The approach presupposes that clients have some knowledge of what will improve their lives.

The following areas have utilized SFT with varying success:

  • relationship difficulties
  • drug and alcohol abuse
  • eating disorders
  • anger management
  • communication difficulties
  • crisis intervention
  • incarceration recidivism reduction

Goal clarification is an important technique in SFT. A therapist will need to guide a client to envision a future without the problem with which they presented. With coaching and positive questioning, this vision becomes much more clarified.

With any presenting client concern, the main technique in SFT is illuminating the exception. The therapist will guide the client to an area of their life where there is an exception to the problem. The exception is where things worked well, despite the problem. Within the exception, an approach for a solution may be forged.

The ‘miracle question’ is another technique frequently used in SFT. It is a powerful tool that helps clients to move into a solution orientation. This question allows clients to begin small steps toward finding solutions to presenting problems (Santa Rita Jr., 1998). It is asked in a specific way and is outlined later in this article.

Experiment invitation is another way that therapists guide clients into solution orientation. By inviting clients to build on what is already working, clients automatically focus on the positive. In positive psychology, we know that this allows the client’s mind to broaden and build from that orientation.

Utilizing what has been working experimentally allows the client to find what does and doesn’t work in solving the issue at hand. During the second half of a consultation with a client, many SFT therapists take a break to reflect on what they’ve learned during the beginning of the session.

Consultation breaks and invitations for more information from clients allow for both the therapist and client to brainstorm on what might have been missed during the initial conversations. After this break, clients are complemented and given a therapeutic message about the presenting issue. The message is typically stated in the positive so that clients leave with a positive orientation toward their goals.

Here are four handy worksheets for use with solution-focused therapy.

  • Miracle worksheet
  • Exceptions to the Problem Worksheet
  • Scaling Questions Worksheet
  • SMART+ Goals Worksheet

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Compliments are frequently used in SFT, to help the client begin to focus on what is working, rather than what is not. Acknowledging that a client has an impact on the movement toward a goal allows hope to become present. Once hope and perspective shift occurs, a client can decide what daily actions they would like to take in attaining a goal.

Higher levels of hope and optimism can predict the following desirable outcomes (Peterson & Seligman, 2004):

  • achievement in all sorts of areas
  • freedom from anxiety and depression
  • improved social relationships
  • improved physical well being

Mind mapping is an effective intervention also used to increase hope and optimism. This intervention is often used in life coaching practices. A research study done on solution-focused life coaching (Green, Oades, & Grant, 2006) showed that this type of intervention increases goal striving and hope, in addition to overall well-being.

Though life coaching is not the same as therapy, this study shows the effectiveness of improving positive behavior through solution-focused questioning.

Mind mapping is a visual thinking tool that helps structure information. It helps clients to better analyze, comprehend, and generate new ideas in areas they might not have been automatically self-generated. Having it on paper gives them a reference point for future goal setting as well.

Empathy is vital in the administration of SFBT. A client needs to feel heard and held by the practitioner for any forward movement to occur. Intentionally leaning in to ensure that a client knows that the practitioner is engaged in listening is recommended.

Speaking to strengths and aligning those strengths with goal setting are important interventions in SFT. Recognizing and acknowledging what is already working for the client validates strengths. Self-recognition of these strengths increases self-esteem and in turn, improves forward movement.

The questions asked in Solution-Focused Therapy are positively directed and in a goal-oriented stance. The intention is to allow a perspective shift by guiding clients in the direction of hope and optimism to lead them to a path of positive change. Results and progress come from focusing on the changes that need to be made for goal attainment and increased well being.

1. Miracle Question

Here is a clear example of how to administer the miracle question. It should be delivered deliberately. When done so, it allows the client to imagine the miracle occurring.

“ Now, I want to ask you a strange question. Suppose that while you are sleeping tonight and the entire house is quiet, a miracle happens. The miracle is that the problem which brought you here is solved. However, because you are sleeping, you don’t know that the miracle has happened. So, when you wake up tomorrow morning, what will be different that will tell you that a miracle has happened and the problem which brought you here is solved? ” (de Shazer, 1988)

2. Presupposing change questions

A practitioner of solution-focused therapy asks questions in an approach derived way.

Here are a few examples of presupposing change questions:

“What stopped complete disaster from occurring?” “How did you avoid falling apart.” “What kept you from unraveling?”

3. Exception Questions

Examples of exception questions include:

1. Tell me about times when you don’t get angry. 2. Tell me about times you felt the happiest. 3. When was the last time that you feel you had a better day? 4. Was there ever a time when you felt happy in your relationship? 5. What was it about that day that made it a better day? 6. Can you think of a time when the problem was not present in your life?

4. Scaling Questions

These are questions that allow a client to rate their experience. They also allow for a client to evaluate their motivation to change their experience. Scaling questions allow for a practitioner to add a follow-up question that is in the positive as well.

An example of a scaling question: “On a scale of 1-10, with 10 representing the best it can be and one the worst, where would you say you are today?”

A follow-up question: “ Why a four and not a five?”

Questions like these allow the client to explore the positive, as well as their commitment to the changes that need to occur.

5. Coping Questions

These types of questions open clients up to their resiliency. Clients are experts in their life experience. Helping them see what works, allows them to grow from a place of strength.

“How have you managed so far?” “What have you done to stay afloat?” “What is working?”

3 Scaling questions from Solution Focused Therapy – Uncommon Practitioners

The main idea behind SFBT is that the techniques are positively and solution-focused to allow a brief amount of time for the client to be in therapy. Overall, improving the quality of life for each client, with them at the center and in the driver’s seat of their growth. SFBT typically has an average of 5-8 sessions.

During the sessions, goals are set. Specific experimental actions are explored and deployed into the client’s daily life. By keeping track of what works and where adjustments need to be made, a client is better able to track his or her progress.

A method has developed from the Miracle Question entitled, The Miracle Method . The steps follow below (Miller & Berg, 1996). It was designed for combatting problematic drinking but is useful in all areas of change.

  • State your desire for something in your life to be different.
  • Envision a miracle happening, and your life IS different.
  • Make sure the miracle is important to you.
  • Keep the miracle small.
  • Define the change with language that is positive, specific, and behavioral.
  • State how you will start your journey, rather than how you will end it.
  • Be clear about who, where, and when, but not the why.

motivation homework therapy

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A short selection of exercises which can be used

1. Solution-focused art therapy/ letter writing

A powerful in-session task is to request a client to draw or write about one of the following, as part of art therapy :

  • a picture of their miracle
  • something the client does well
  • a day when everything went well. What was different about that day?
  • a special person in their life

2. Strengths Finders

Have a client focus on a time when they felt their strongest. Ask them to highlight what strengths were present when things were going well. This can be an illuminating activity that helps clients focus on the strengths they already have inside of them.

A variation of this task is to have a client ask people who are important in their lives to tell them how they view the client’s strengths. Collecting strengths from another’s perspective can be very illuminating and helpful in bringing a client into a strength perspective.

3. Solution Mind Mapping

A creative way to guide a client into a brainstorm of solutions is by mind mapping. Have the miracle at the center of the mind map. From the center, have a client create branches of solutions to make that miracle happen. By exploring solution options, a client will self-generate and be more connected to the outcome.

4. Experiment Journals

Encourage clients to do experiments in real-life settings concerning the presenting problem. Have the client keep track of what works from an approach perspective. Reassure the client that a variety of experiments is a helpful approach.

motivation homework therapy

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These books are recommended reads for solution-focused therapy.

1. The Miracle Method: A Radically New Approach to Problem Drinking – Insoo Kim Berg and Scott D. Miller Ph.D.

The Miracle Method

The Miracle Method by Scott D. Miller and Insoo Kim Berg is a book that has helped many clients overcome problematic drinking since the 1990s.

By utilizing the miracle question in the book, those with problematic drinking behaviors are given the ability to envision a future without the problem.

Concrete, obtainable steps in reaching the envisioned future are laid out in this supportive read.

Available on Amazon .

2. Solution Focused Brief Therapy: 100 Key Points and Techniques – Harvey Ratney, Evan George and Chris Iveson

Solution-Focused Brief Therapy

Solution Focused Brief Therapy: 100 Key Points and Techniques is a well-received book on solution-focused therapy. Authors Ratner, George, and Iveson provide a concisely written and easily understandable guide to the approach.

Its accessibility allows for quick and effective change in people’s lives.

The book covers the approach’s history, philosophical underpinnings, techniques, and applications. It can be utilized in organizations, coaching, leadership, school-based work, and even in families.

The work is useful for any practitioner seeking to learn the approach and bring it into practice.

3. Handbook of Solution-Focused Brief Therapy (Jossey-Bass Psychology) – Scott D. Miller, Mark Hubble and Barry L. Duncan

Handbook of Solution-Focused Brief Therapy

It includes work from 28 of the lead practitioners in the field and how they have integrated the solution-focused approach with the problem-focused approach.

It utilizes research across treatment modalities to better equip new practitioners with as many tools as possible.

4. More Than Miracles: The State of the Art of Solution -Focused Therapy  (Routledge Mental Health Classic Editions) – Steve de Shazer and Yvonne Dolan

More Than Miracles

It allows the reader to peek into hundreds of hours of observation of psychotherapy.

It highlights what questions work and provides a thoughtful overview of applications to complex problems.

Solution-Focused Therapy is an approach that empowers clients to own their abilities in solving life’s problems. Rather than traditional psychotherapy that focuses on how a problem was derived, SFT allows for a goal-oriented focus to problem-solving. This approach allows for future-oriented, rather than past-oriented discussions to move a client forward toward the resolutions of their present problem.

This approach is used in many different areas, including education, family therapy , and even in office settings. Creating cooperative and collaborative opportunities to problem solve allows mind-broadening capabilities. Illuminating a path of choice is a compelling way to enable people to explore how exactly they want to show up in this world.

Thanks for reading!

We hope you enjoyed reading this article. Don’t forget to download our three Positive Psychology Exercises for free .

  • de Shazer, S. (1988). Clues: Investigating solutions in brief therapy. New York, NY: W.W. Norton and Co.
  • Green, L. S., Oades, L. G., & Grant, A. M. (2006). Cognitive-behavioral, solution-focused life coaching: Enhancing goal striving, well-being, and hope. The Journal of Positive Psychology, 1 (3), 142-149.
  • Miller, S. D., & Berg, I. K. (1996). The miracle method: A radically new approach to problem drinking. New York, NY: W.W. Norton and Co.
  • Peterson, C., & Seligman, M. E. P., (2004).  Character strengths and virtues: A handbook and classification (Vol. 1). New York, NY: Oxford University Press.
  • Santa Rita Jr, E. (1998). What do you do after asking the miracle question in solution-focused therapy. Family Therapy, 25( 3), 189-195.

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Empowering Recovery: Transformative Therapy Homework Assignments

The power of therapy homework.

Therapy homework is an integral part of the therapeutic process that extends the benefits of therapy beyond the therapy room. It involves assignments and activities that clients are encouraged to complete between therapy sessions to facilitate healing, growth, and recovery. By actively engaging in therapy homework, individuals can take ownership of their progress and empower themselves on their journey towards well-being.

What is Therapy Homework?

Therapy homework refers to the tasks, exercises, and activities assigned by therapists to their clients with the aim of reinforcing and extending the benefits of therapy. These assignments are tailored to address specific therapeutic goals and objectives, focusing on areas such as self-reflection, skill-building, and behavioral changes. Therapy homework can take various forms, including journaling, self-reflection exercises, mindfulness practices, and behavioral experiments.

Therapy homework serves as a bridge between therapy sessions, allowing individuals to apply the insights gained in therapy to their daily lives. It encourages active participation and engagement in the therapeutic process, enabling clients to develop a deeper understanding of themselves, their emotions, and their thought patterns. Through regular completion of therapy homework, individuals can cultivate new coping strategies, enhance self-awareness, and promote personal growth.

How Therapy Homework Can Support Recovery

Therapy homework plays a crucial role in supporting recovery by reinforcing the therapeutic work done during sessions. Here are some ways in which therapy homework can contribute to the recovery process:

  • Continuity of Learning:  Therapy homework provides a continuous learning experience, allowing clients to build upon the insights gained during therapy sessions. It helps reinforce new skills, coping strategies, and perspectives, facilitating lasting change and growth.
  • Application of Skills:  By engaging in therapy homework, individuals have the opportunity to apply the skills and techniques learned in therapy to real-life situations. This practical application helps strengthen and solidify new behaviors and thought patterns.
  • Increased Self-Awareness:  Therapy homework encourages self-reflection and introspection, fostering a deeper understanding of one’s emotions, behaviors, and patterns of thinking. This increased self-awareness can lead to greater insight and personal growth.
  • Empowerment:  Active participation in therapy homework empowers individuals to take charge of their own healing process. It allows them to be proactive in their recovery journey, develop a sense of agency, and take ownership of their progress.
  • Consolidation of Progress:  Regular completion of therapy homework reinforces the progress made in therapy sessions. It helps maintain momentum, prevents relapse, and supports long-term recovery.

Therapy homework is a collaborative process between the therapist and the client. It involves setting realistic goals, tailoring assignments to suit individual preferences and needs, and providing ongoing support and feedback. By embracing therapy homework, individuals can enhance their therapeutic experience, accelerate their progress, and empower themselves on their path to recovery . To explore specific examples of therapy homework assignments, check out our articles on  therapy homework for anxiety  and  therapy homework for depression .

Types of Therapy Homework Assignments

Therapy homework assignments play a vital role in supporting the therapeutic process and helping individuals make progress towards their goals. There are several types of therapy homework assignments that therapists can assign to their clients. Here, we will explore three common types:  journaling and self-reflection exercises ,  behavioral and habit-forming assignments , and  mindfulness and meditation practices .

Journaling and Self-Reflection Exercises

Journaling and self-reflection exercises are powerful tools for promoting self-awareness and personal growth. Through the act of writing, individuals can explore their thoughts, emotions, and experiences in a structured manner. Journaling can help individuals gain insights into their patterns of thinking, identify triggers, and reflect on their progress.

Therapists may assign specific journaling prompts or provide worksheets to guide clients in their self-reflection journey. These exercises can focus on various topics, such as exploring emotions, identifying cognitive distortions, practicing gratitude, or tracking behaviors. Journaling can also be used as a platform for  therapy homework for self-expression  and  therapy homework for creativity .

Behavioral and Habit-Forming Assignments

Behavioral and habit-forming assignments are designed to help individuals make positive changes in their behavior and develop healthier habits. These assignments are often action-oriented and require individuals to practice new skills or engage in specific activities outside of therapy sessions.

For example, a therapist may assign tasks related to assertiveness training, stress management techniques, anger management strategies, or goal setting exercises. These assignments encourage individuals to actively apply the concepts discussed in therapy to their daily lives. By practicing new behaviors and breaking old patterns, individuals can work towards their therapeutic goals.

Mindfulness and Meditation Practices

Mindfulness and meditation practices are widely recognized for their ability to promote relaxation, reduce stress, and increase self-awareness. Therapists may assign mindfulness exercises and meditation practices as part of therapy homework to help individuals cultivate mindfulness in their daily lives.

These assignments can include guided meditations, breathing exercises, body scans, or mindful awareness activities. By incorporating mindfulness into their routine, individuals can learn to observe their thoughts and emotions without judgment, cultivate present-moment awareness, and develop a greater sense of calm and clarity.

By incorporating a variety of therapy homework assignments, therapists can cater to the unique needs of each individual and provide a well-rounded approach to therapy. It’s important for therapists to assess client goals and preferences when assigning homework, ensuring that the assignments are relevant, engaging, and align with the client’s therapeutic journey. For more therapy homework ideas, check out our article on  therapy homework ideas .

Customizing Assignments for Individual Needs

To ensure the effectiveness of therapy homework assignments, it is essential to  customize  them according to the  individual needs  of each client. This personalized approach allows therapists to address specific goals and objectives, tailoring the assignments to suit the client’s preferences and circumstances.

Assessing Client Goals and Objectives

Before creating therapy homework assignments, therapists must first  assess  their clients’ goals and objectives. By understanding what clients hope to achieve through therapy, therapists can design assignments that align with their desired outcomes. For example, if a client’s goal is to improve their communication skills, therapy homework assignments may focus on practicing active listening, assertiveness, or conflict resolution. By linking the assignments directly to the client’s goals, the therapeutic process becomes more targeted and effective.

Tailoring Assignments to Suit Individual Preferences

Each client is unique, and their preferences and learning styles should be taken into consideration when designing therapy homework assignments. Some clients may prefer written exercises and journaling, while others may be more receptive to artistic or creative expression . By tailoring the assignments to suit individual preferences, therapists can increase engagement and motivation, leading to a more productive therapeutic experience.

For example, a client who enjoys writing may find value in self-reflection exercises or the use of  writing and narrative therapy techniques . On the other hand, a client who is more visually oriented might benefit from artistic assignments or creative expression through art therapy. By incorporating activities that resonate with the client’s preferences, therapy homework becomes more enjoyable and meaningful.

By customizing therapy homework assignments, therapists can optimize the therapeutic process and enhance client outcomes. It ensures that assignments are directly aligned with the client’s goals and objectives, promoting a sense of ownership and motivation in their recovery journey. Additionally, tailoring assignments to suit individual preferences increases engagement and enjoyment, fostering a positive therapeutic alliance.

Remember to explore a variety of therapy homework ideas to meet the diverse needs of your clients. Whether it’s therapy homework for self-esteem, mindfulness, relaxation, or any other topic, the key is to create assignments that are relevant, meaningful, and effective. By providing personalized and tailored assignments, therapists can empower their clients in their recovery process.

Incorporating Creativity in Therapy Assignments

To enhance the therapeutic process and encourage self-expression, incorporating  creativity  into therapy assignments can be highly beneficial. Creative activities provide clients with a unique outlet for exploring their emotions, thoughts, and experiences. In this section, we will explore two popular approaches:  art therapy and creative expression  as well as  writing and narrative therapy techniques .

Art Therapy and Creative Expression

Art therapy involves using various artistic mediums to facilitate self-expression, reflection, and healing. Through painting, drawing, sculpting, or collage-making, clients can tap into their creativity and communicate their inner world visually. Art therapy can be particularly effective for individuals who struggle with verbal expression or find it challenging to articulate their emotions.

Engaging in art therapy allows clients to explore their thoughts and feelings in a non-threatening and non-judgmental manner. The creative process itself can be therapeutic, providing a sense of control, empowerment, and catharsis. Art therapists often guide clients in interpreting their artwork, helping them uncover deeper insights and gain a better understanding of themselves.

Integrating creative expression into therapy assignments can offer clients an opportunity to engage with their emotions in a different way. For example, a therapist might suggest creating a collage that represents their goals, dreams, or emotions. This visual representation can serve as a powerful tool for self-reflection and exploration. To learn more about incorporating art therapy into your practice, explore our article on  therapy homework for creative expression .

Writing and Narrative Therapy Techniques

Writing can be a powerful therapeutic tool that allows clients to explore their thoughts, emotions, and experiences. Narrative therapy techniques, such as journaling, letter writing, or storytelling, can help clients gain insight, process challenging events, and reframe their narratives.

Journaling is a widely used form of therapy homework that involves writing down thoughts, feelings, and experiences in a journal or diary. This practice provides an opportunity for self-reflection, self-expression, and problem-solving. Clients can explore their innermost thoughts, identify patterns, and track progress over time. To discover various journaling exercises for therapy, refer to our article on  therapy homework for journaling .

Another approach is letter writing, where clients address letters to themselves, others, or even abstract concepts like their fears or past traumas. This process can be cathartic and empowering, allowing clients to express emotions that may be difficult to articulate in person. Writing a letter can help clients gain closure, find forgiveness , or express gratitude. It provides a safe space for processing emotions and can be revisited as a source of reflection and growth.

By incorporating these creative techniques into therapy assignments, therapists can encourage clients to explore their inner worlds and gain new perspectives. It’s important to remember that creativity is a personal experience, and different clients may resonate with different forms of expression. As a therapist, offering a range of options and tailoring assignments to suit individual preferences can enhance the therapeutic process.

Maximizing the Benefits of Therapy Homework

To ensure the effectiveness of  therapy homework assignments , it’s important to implement strategies that maximize their benefits. By setting realistic expectations, providing ongoing support and feedback, and fostering collaboration between the therapist and client, therapy homework can become a powerful tool for transformation and growth.

Setting Realistic Expectations

When assigning therapy homework, it’s crucial to set realistic expectations for the client. This involves discussing the purpose, goals, and anticipated outcomes of the assignments. By clearly communicating the objectives and potential benefits, clients can better understand the value of their efforts and remain motivated throughout the process.

It’s important to emphasize that therapy homework is not a quick fix but rather a gradual process. Encourage clients to approach their assignments with patience and self-compassion , understanding that progress takes time. By managing expectations, clients are more likely to stay committed and experience the full benefits of therapy homework.

Providing Ongoing Support and Feedback

Support and feedback from the therapist play a crucial role in maximizing the benefits of therapy homework. Regular check-ins and discussions about the assignments allow clients to seek clarification, express concerns, and receive guidance. This ongoing support helps clients stay engaged and motivated, knowing that their therapist is there to provide assistance and encouragement.

Additionally, providing constructive feedback on completed assignments is essential for growth and improvement. Acknowledge the effort and progress made by the client, while also providing suggestions and insights to enhance their understanding and application of the concepts discussed in therapy. This feedback loop strengthens the therapeutic relationship and boosts the client’s confidence in their ability to succeed.

Collaboration Between Therapist and Client

Collaboration between the therapist and client is key to optimizing the benefits of therapy homework . By involving the client in the assignment selection process, therapists can tailor the tasks to suit the client’s individual needs, preferences, and therapeutic goals. This collaborative approach fosters a sense of ownership and empowerment, motivating clients to actively engage in their recovery journey.

Regular communication between therapy sessions is crucial for maintaining this collaboration. Clients should feel comfortable reaching out to their therapist for guidance, clarification, or support related to their assignments. This open line of communication ensures that the therapy homework remains aligned with the client’s evolving needs and allows for adjustments when necessary.

By setting realistic expectations, providing ongoing support and feedback, and fostering collaboration, therapists can help clients maximize the benefits of therapy homework. This approach not only enhances the effectiveness of the assignments but also empowers clients to take an active role in their own recovery journey. To explore a wide range of therapy homework ideas and resources, visit our article on  therapy homework ideas .

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COMMENTS

  1. How to Design Homework in CBT That Will Engage Your Clients

    Practitioners looking to support these clients using homework might start by sending their clients one or two audio meditations via Quenza, such as the Body Scan Meditation or S.O.B.E.R. Stress Interruption Mediation. That way, the client will have tools on hand to help manage their anxiety in stressful situations.

  2. Sending Homework to Clients in Therapy: The Easy Way

    Homework is an essential part of Cognitive-Behavioral Therapy (CBT; Beck, 2011; Mausbach, Moore, Roesch, Cardenas, & Patterson, 2010). Successful therapy relies on using assignments outside of sessions to reinforce learning and practice newly acquired skills in real-world settings (Mausbach et al., 2010).

  3. 20 Positive Psychotherapy Exercises, Sessions and Worksheets

    Rationale: Biswas-Diener, Kashdan, and Minhas (2011) argue against just identifying one's strengths as it represents a fixed mindset and decreases motivation. He suggests that we should treat strengths as "potentials for excellence" to foster belief in the possibility of improvement where therapy can lead us to develop them further.

  4. Goal Setting Made Easy: Expert Therapy Homework Tips and Techniques

    Therapy homework plays a crucial role in the therapeutic process, providing clients with an opportunity to reinforce what they have learned during therapy sessions and work towards their goals outside of the therapeutic setting. ... It enhances motivation and provides a roadmap for progress throughout the therapy journey. Break Down Goals into ...

  5. Empower Your Clients: Effective Therapy Homework Ideas Unveiled

    For more ideas on therapy homework assignments, check out our article on therapy homework assignments. Incorporating Client Goals and Interests Incorporating the client's goals and interests into therapy homework is an effective way to increase motivation and engagement.

  6. The Path to Self-Discovery: Effective Therapy Homework for Self

    Therapy homework plays a crucial role in the therapeutic process, especially when it comes to fostering self-expression and personal growth. ... It provides individuals with tangible evidence of their growth and serves as a source of motivation and encouragement. By regularly monitoring progress, individuals can observe patterns, identify areas ...

  7. Homework in Cognitive Behavioral Supervision: Theoretical Background

    Homework in Therapy. While specific recommendations for the practical usage of homework have been clearly articulated since the early days of CBT, 11, 12 practitioners state that they do not follow these recommendations. 13-15 For example, many physicians admit that they forget homework or do not focus on standard specifications when, where, how often, and how long the task should last.

  8. Assigning Homework in Cognitive Behavioral Therapy

    Cognitive behavioral therapy (CBT) is known to be a highly effective approach to mental health treatment. One factor underlying its success is the homework component of treatment. It's certainly ...

  9. Homework in CBT

    Explore as a team, in a non-judgmental way, to explore why the homework was not done. Here are some ways to increase adherence to homework: Tailor the assignments to the individual. Provide a rationale for how and why the assignment might help. Determine the homework collaboratively. Try to start the homework during the session.

  10. Supporting Homework Compliance in Cognitive Behavioural Therapy

    Homework Non-Compliance in CBT. Cognitive behavioral therapy (CBT) is an evidence-based psychotherapy that has gained significant acceptance and influence in the treatment of depressive and anxiety disorders and is recommended as a first-line treatment for both of these [1,2].It has also been shown to be as effective as medications in the treatment of a number of psychiatric illnesses [3-6].

  11. Therapy Homework: Purpose, Benefits, and Tips

    Below, Dr. Erkfitz shares some tips that can help with therapy homework: Set aside time for your homework: Create a designated time to complete your therapy homework. The aim of therapy homework is to keep you thinking and working on your goals between sessions. Use your designated time as a sacred space to invest in yourself and pour your ...

  12. How Much Does Homework Matter in Therapy?

    A meta-analysis is a statistical summary of a body of research. It can be used to identify the average impact of psychotherapy homework on treatment outcomes across numerous studies. The results ...

  13. Unlocking Emotional Growth: Effective Therapy Activities for Homework

    Enhancing Accountability and Motivation in Therapy Homework. Accountability and motivation are crucial for the success of therapy homework. Setting clear goals and regular check-ins can help clients stay focused and committed to their therapeutic activities. Therapists can employ various strategies to enhance accountability and motivation ...

  14. Therapy Worksheets

    Acceptance and Commitment Therapy (ACT) focuses heavily on this skill due to its many benefits. These include better resilience, emotional tolerance, and overall well-being. This worksheet clarifies this important concept and translates the six underlying ACT principles into easier-to-understand terms... Favorite. 1.

  15. Therapy Worksheets, Tools, and Handouts

    Therapy Tools for Mental Health Professionals for therapists, by therapists Therapy Worksheets, Audio, Activities, and More Worksheets Interactives Videos Articles. Explore Tools by Topic Browse Therapist Aid by issue, like anger, trauma, and depression. Or dive into your favorite theory, from CBT to positive psychology. ...

  16. 17 Motivation Worksheets, Exercises & Activities (+ PDF)

    17 Tools To Increase Motivation and Goal Achievement. These 17 Motivation & Goal Achievement Exercises [PDF] contain all you need to help others set meaningful goals, increase self-drive, and experience greater accomplishment and life satisfaction. Created by Experts. 100% Science-based.

  17. Cognitive Behavioral (CBT) Therapists in Moscow, ID

    Motivational Interviewing ... CBT is a structured collaboration between therapist and client and often calls for homework assignments. If you're looking for CBT therapy in Moscow or for a Moscow ...

  18. Revolutionize Your Sessions: Effective Homework for Therapy

    The Power of Therapeutic Homework. In the realm of therapy, therapeutic homework is a powerful tool that can revolutionize the effectiveness of sessions.This practice involves assigning specific tasks or exercises for clients to complete outside of therapy sessions, with the aim of enhancing the therapeutic process and promoting progress towards their goals.

  19. Olga Titova

    SPECIAL PSYCHOLOGIST, SPEECH AND LANGUAGE THERAPIST I am a special psychologist, a CBT specialist and SLT working with adults, adolescents and children. EDUCATION AND PROFESSIONAL DEVELOPMENT 2004-2009: Moscow Pedagogical State University, clinical psychologist & speech and language pathologist (diploma with distinction) 2012 - 2019 Russian National Research Medical University, paediatrics ...

  20. PDF MOSCOW MASTER CLASS 2018 22 23 September

    THERAPY INTERVENTIONS A 2-Day Master Class September 22 and 23, 2018 Presented by: Joan Farrell, PhD. & Ida Shaw, MA. Potential audience: people who had basic schema-therapy training and already actively practicing individual therapy sessions. Day 1 will focus on the conceptualization of impasses with client and therapist during therapy

  21. 7 Solution-Focused Therapy Techniques and Worksheets (+PDF)

    Miller, Hubble, and Duncan's Handbook of Solution-Focused Brief Therapy is a resource for any practitioner needing a toolbox in the therapy's approach. It includes work from 28 of the lead practitioners in the field and how they have integrated the solution-focused approach with the problem-focused approach.

  22. Empowering Recovery: Transformative Therapy Homework Assignments

    Therapy homework is a collaborative process between the therapist and the client. It involves setting realistic goals, tailoring assignments to suit individual preferences and needs, and providing ongoing support and feedback. By embracing therapy homework, individuals can enhance their therapeutic experience, accelerate their progress, and ...

  23. Find Psychologists, Counsellors, & Therapists in Moscow, Russia

    Our tools will help you identify and contact the best available therapist near you, be they a depression therapist, anxiety therapist, trauma therapist, or someone qualified to offer couples counselling in Moscow or online. Therapy is not suitable for emergencies. If you face a life-threatening situation, visit your nearest emergency centre.