CBT and Stages of Homework
Encouraging and facilitating homework is a key feature of cognitive behavioral therapy. Initially, homework assignments were mainly in the form of additional studies aimed at obtaining or giving information. In the following sessions, the contents of the homework begin to form the techniques created to support the cognitive change with life.
In a recent study, it was stated that informing patients about their homework during the session, encouraging them to complete their homework and identifying the factors that cause this situation if patients do not do their first homework will increase the commitment to future homework.
Therefore, before giving to the patients, therapist should explain the the importance and content of homework.
Therapist assigns the process. However it should be decided together and the assignments should be appropriate to the client’s problems.
Presenting the assignments to the clients by the therapist. Assignments should be clear, and therapist should give necessary explanations about the importance of the assignments to the clients .
Acceptance of assignments by the client The assignments should be acceptable according to the client’s abilities and status.
Submitting the instructions of the assigned assignments to the client The instructions of the assignments should be understood by the patient.
Therapist asks the client questions about the assignments. Accordingly therapist identifies the factors that prevent assignment.
Informing the client about the assignments he / she has done to the therapist.
Figure 1. Six-Stage Model of Homework
The type of homework given may vary from patient to patient. One of the important points in this process is to ensure that the patient continues his / her efforts to reach the therapeutic goals outside the sessions with his / her homework assignments. Therapists may suggest standard homework, such as reading therapy notes and planning activities during sessions, or ask their patients for any homework that they think may be useful after a problem discussed during the session. Thus, therapists can assign assignments that the patient believes are easy and are therefore more likely to do so.
What is important in this process is that therapists and patients agree on the frequency and duration of their homework.
Deciding homework assignments with patients may increase the completion rate of homework assignments. However, especially after the first sessions, patient may not have enough information about his / her homework assignments. Therefore, after the first sessions, the following homework assignments are the best for the patients.
- Create a list of objectives
- Reading a book about CBT to give information
- Psychoeducation materials
- Self monitoring
- Activity recording In the following sessions, the therapist can ask the patients the following questions to cooperate with the patient to decide on their homework:
- Would you like to apply this technique (which can be any technique) that we discussed together during the session when you are alone this week?
- If you read these notes before you leave home, do you think this can help you?
- What do you think you can do about the thoughts that bother you? (The therapist must have previously acquired skills in coping with the patient’s problem