adult psychotherapy homework planner

adult psychotherapy homework planner

The Importance of Homework in Adult Psychotherapy

1. Introduction

Psychological treatment, employing homework, offers improved effectiveness over these psychotropic sticky plasters, both in outcomes and savings costs of typically long-term dose escalation for most sufferers. There have been many recent studies since 1990 to support these claims. What has not been well-documented in those studies, however, are three important factors: the strength of adherence of the patient to the homework; the influence of homework completion on compliance with treatment and treatment outcomes; and the reasons for the dropout seen in many psychological treatments when homework is assigned, a not-so-trivial fact the psychotherapeutic community essentially ignores in any formal study used to validate its efficacy. This paper will address this deficit by analyzing self-reports from adult psychotherapy patients, then discuss procedures to raise the effects of these research variables.

There are three elements missing from current treatments that characterize homework, which is a requirement of most psychosocial, psychotherapeutic interventions for adults. These deficits not only contribute to poor treatment outcomes, but also contribute to psychiatrists and psychologists under-prescribing psychotherapy to help relieve the suffering of millions of Americans in need of treatment. Current treatments fail to inform and educate individuals about the nature, causes, and treatment of emotional, cognitive, and behavioral problems. As a result, individuals find themselves undergoing the only types of interventions they can afford or their insurance will cover – the cheap, poorly effective stabilization, in-absentia treatments offered by pharmacy that essentially turn sufferers into chemical waste dumps for the drug industry.

2. Benefits of Homework in Adult Psychotherapy

Other theories and practices suggest that adults need to cope with the emotional and physiological consequences of recognizing that they are not as coherent, positive, and entity-like as typical speech suggests. To engage in the sometimes difficult business of moving from defense to effective problem solving demands equanimity, and the empirical understanding to produce a purposeful and just evaluation of choices. To facilitate the beginning of an emotional rehabilitation or an ongoing function evaluation, patients need to hold more comprehensive assumptions for future choices, know failures as predictable events, and be encouraged by the empirical expectations that their tentative choices predetermine their less assessable futures. Defending oneself against somber self-assessment aligns the affect by closing off self-corrections, and indirectly harms planning through dishonesty and skewed attributions of attainability. Cognitive-behavioral therapy (CBT) involves continuous reorienting dialogs, as a means of engagement, as a demonstration of that engagement’s therapeutic relevance.

Homework is commonly viewed as an integral part of psychotherapy, particularly in various forms of cognitive and behavioral treatments. Through guided role-play and discussion, patients bring into treatment the complex and diverse environments where they live and grow through the subtle architecture of their own choices, actions, consequences, and discoveries. By doing so, they develop deeper and more persistent insights, understanding, and change. But, there is very little specific data that tells us how homework works. Some studies suggest that homework is more effective than in-session work in producing good therapeutic outcomes. The weaknesses of such studies include the overstated generalizability and an implicit lack of scientific curiosity about what specific features of homework are beneficial. In the absence of dissections of “homework,” we rely on the vague definition and generally recognized importance from case studies, memoirs, and validated models of therapy, change, and sense-making.

3. Strategies for Effective Homework Assignments

Using dates and times is important with activities. The patient should know exactly when to initiate and when to terminate the activity. Sometimes, an exact duration for the activity will facilitate the patient’s initiation. Daily life situations may not motivate a paranoid patient, nor will expressing appreciation motivate the depressed patient. A patient that has a drug abuse pathology, or overly enjoys or under-enjoys positive reinforcers, may not feel rewarded when engaging in motivated activity. A substance abuse pathologic patient may present irritability when the targets are met, hence the therapy requirements and respective homework assignments should adjust accordingly, meeting the specific and individual needs of the patient at that specific time. Lacking an inventory for hobbies and enjoyments and, also a poor understanding about what skills and abilities the patient thinks are lacking will result in inappropriate assignments. Therapists may use scales like the Behavioral Activating Scale (BAS) and the Inventory of Pleasant Activities rewards (IPA). After making those assessments, it is easier to expound what recompensed assignments may be. When overburdened with excessive problems, the patient may fail to have life rhythm and avoid what the therapy proposes. Therapists can help break the tasks into smaller components or other strategies. By allowing the patient to make free choices, while we are balancing selective assignments, is another strategy in order for the patient’s motivation to arise and develop.

When choosing homework assignments, it is important to remember that people differ significantly in their readiness and ability to engage in particular types of behavior, at specific times in their lives. It is ideal to assign homework that is: time limited, specific, incremental, measurable, non-conflicting with other routine activities, inhibits procrastination, and addresses the concerns and interests of the patient. Medium difficulty improvements that gradually increase in difficulty and complexity are desirable. An activity that feels almost impossible to achieve creates anxiety and depression. When patients perceive what the clinician assigns as achievable or with minimum difficulty or almost respecting their strengths and limitations, they are more likely to engage in the task. It is advisable to assign items that the clinician can demonstrate to the patient. Thus a personal level of engagement or modeling with the tasks assigned by the patient helps to establish and maintain the patient’s motivation for completing the tasks.

4. Overcoming Challenges in Completing Homework

Troubleshooting common issues that impede successful homework completion is an integral aspect of CBT Case Management strategies. For example, with Socratic questioning, a therapist can guide a client through the process of identifying common erroneous thoughts prior to making behavioral changes. Identifying potential pitfalls and alternative coping strategies for hypothetical risk situations during in-session role-plays likewise prepares clients for successfully enacting these strategies outside the therapist’s office. Given the wide variety of client presenting issues encountered in adult clinical practices, clinicians face unique challenges related to homework completion. Psychotherapy homework completion is indeed a multifaceted problem. Home-based practice sessions for clients participating in any psychotherapeutic approach require detailed explanation and are typically further complicated by client-related therapeutic challenges or by contraindications associated with the client’s specific presenting issues.

The decision to assign homework in psychotherapy often brings a host of new challenges that have the potential to become major obstacles to treatment. Clients can struggle with a myriad of factors that might make the completion of psychotherapeutic homework a daunting or unrealistic task. High dropout rates and noncompliance with assigned treatment tasks present serious issues for every psychotherapeutic approach and have been noted as particularly troubling within the cognitive therapies. Indeed, in some CBT research, significant response is defined as compliance with homework tasks and does not necessarily involve changes within the client’s internal world or his or her capacity to handle future symptoms. Critics often point out that CBT’s negatively disproportionate emphasis on homework adherence is unwarranted in light of other therapy fundamentals and not suitable among clients with poor compliance rates.

5. Conclusion

We have also seen some degree of opening the black box of the psychotherapy process with regards to the attention to patients’ deeper associations. Therapists need to notice and interact with deeper processing in the session to allow it to develop. The present findings suggest that students might similarly benefit when a teacher presents contrast-inducing information with genuine respect for deeper levels of comprehension. I imagine that therapists would also benefit from scrutinizing the class work of their trainees for the various necessary skills.

This article has broadened our understanding of how psychotherapy grows into effective functioning. Therapists learn to enable patients to venture inward with emotional and cognitive associations. They teach patients to explore and share their deeper associations without becoming overwhelmed emotionally. In the Contrast Avoidance model of psychotherapy, contrast avoidance itself is seen to serve avoidant functions; and therapists, as agents of change, individually and interpersonally create stress-inducing contrast experiences. The evolution of the adult Psychotherapy Drama and Relational Ethics reflects this conclusion as well. There are applications here to the functioning of human creativity, as we are also complex information systems as we function.