The Future of Psychotherapy Homework Research
Summary
Time spent with a therapist is crucial to achieving a person’s mental health goals. However, work done between sessions can also determine whether therapy outcomes are ‘good’ or ‘great’. Many therapists use homework to maintain progress towards therapy objectives. These activities are crucial in bridging the gap between sessions.
Most adults who undertake certain types of psychotherapy (evidence-based) end up significantly better off than they would be without treatment. We know this through a particular type of research design called ‘meta-analysis’. This approach combines the results of multiple studies to answer a specific question. In this case, ‘How effective is psychotherapy homework?’
We have learned much about homework in recent years, but many questions remain unanswered. Here at EmotiPal, we aspire to meaningfully contribute to advancing knowledge in this area, helping to make therapy ‘come alive’ in daily life through effective homework activities.
Research priorities
There are 5 priority areas for future research:
Mechanisms of change
We know that psychotherapy homework helps people, so now we must better understand HOW homework acts to encourage change for better.
‘Mechanisms’ could refer to factors such as:
- A more ‘can do’ attitude towards tackling life challenges, or
- Improve ability to recognise and respond to unhelpful thinking patterns.
Better understanding of key ingredients such as these will help us to leverage homework for positive outcomes.
Therapist training
We need to research how we should train therapists to give, explain and review homework, because therapist skill in this area is important in helping clients engage with between session activities.
For example, encouraging a client to review their own homework may work better than a therapist sharing their observations on a completed task.
Cross-cultural research
Homework research to date has mainly been conducted in Western populations using Cognitive Behaviour Therapy (CBT). We need to better understand homework adaptation for different cultural, language and social contexts.
For example, perhaps homework need to be framed in different ways (e.g., ‘self-improvement’ or ‘supporting the community’) to account for cultural practices
Focus on engagement
Future research should look at how much clients engaged with homework, not just ask ‘Did you do it?’ This is because effort and meaning taken from exercises are often more important that simply completing tasks.
For example, reflecting on a thought diary entry with genuine curiosity may yield better outcomes than simply ‘filling in the boxes’.
Technology and innovation
We should study how apps and online platforms can make therapy homework easier to complete and more effective. We also need to know which technology tools work best to help people engage with exercises and the therapy process between sessions.
EmotiPal’s role:
EmotiPal can play a role in advancing these research priorities. Examples include:
- Our platform allows therapists and clients to observe and measure how homework activities foster different therapeutic changes.
- We can use EmotiPal to structure a therapist’s approach for assigning and reviewing homework effectively.
- EmotiPal can lower barriers to cultural adaptation by helping therapists tailor exercises to fit with a client’s unique cultural background and circumstances.
- EmotiPal emphasises engagement with homework activities, not just exercise completion. This allows us to collect richer datasets researchers say we need.
- EmotiPal is a platform that allows for testing of digital features to determine what functions boost homework and therapy success.
EmotiPal can help researchers address some of the most urgent research priorities in psychotherapy homework. It is both a therapeutic tool and a research platform for generating data and insights we need to make therapy more effective.
At EmotiPal, we welcome collaboration with therapists, clients, and researchers to unlock the full potential of psychotherapy homework.
References
1. Kazantzis, N., Whittington, C., & Dattilio, F. (2010). Meta-analysis of homework effects in cognitive and behavioral therapy: A replication and extension. Clinical Psychology: Science and Practice, 17(2), 144–156.
2. 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.
3. Kazantzis, N., Lampropoulos, G. K., & Deane, F. P. (2005). A national survey of practicing psychologists’ use and attitudes toward homework in psychotherapy. Journal of Consulting and Clinical Psychology, 73(4), 742–748.
4. Kazantzis, N., Deane, F. P., & Ronan, K. R. (2000). Homework assignments in cognitive and behavioral therapy: A meta-analysis. Clinical Psychology: Science and Practice, 7(2), 189–202.
5. Kazantzis, N., & Lampropoulos, G. K. (2002). Reflecting on homework in psychotherapy: What can we conclude from research and experience? Journal of Clinical Psychology, 58(5), 577–585.
6. Prasko, J. (2022). Homework in cognitive behavioral supervision. Psychology Research and Behavior Management, 15, 202–210.