by Martin M. Antony, PhD, and Valerie Vorstenbosch, MA
Homework completion helps clients generalize therapy skills to their everyday lives, and many studies have found that greater homework compliance is associated with more positive outcomes. Thus, when clients fail to do their assigned homework, it is important that therapists address this issue as early as possible. Examples of homework assignments may include monitoring progress in therapy and practicing particular therapy skills (for example, cognitive restructuring, behavioral experiments, exposure practices, relaxation practices, and mindfulness meditation).
There are many reasons why clients are often noncompliant with homework assignments in therapy. They may face competing demands for their time, believe the assignments to be overly challenging or irrelevant, assume that the assignment will not be helpful, misunderstand what is expected for the assignment, or simply have limited motivation for change. Strategies for improving compliance depend on the reasons for noncompliance, so a first step to investigate factors that may be getting in the way of homework completion.
Therapists can improve homework compliance by involving the client in the generation of homework practices, attending to any problems in the therapeutic relationship, and being sure to ask about homework at the start of each session. You may also tailor the homework practices to your clients’ needs by ensuring that the practices are relevant to behaviors that the client wants to change, simplifying the homework practices, and trying homework practices in session before the client leaves (to make sure that the client understands what is expected). Of course, when clients do complete their homework, reward them with a smile and some reinforcing words. You can encourage the client to develop a routine for completing homework at specific times during the week and/or use motivational enhancement strategies to resolve ambivalence and facilitate readiness for change. If all else fails, you may choose to schedule telephone contacts before and/or after the client is scheduled to complete homework practices or schedule more frequent therapy sessions.