adult psychotherapy homework planner pdf

adult psychotherapy homework planner pdf

The Importance of Homework in Adult Psychotherapy

1. Benefits of Homework in Adult Psychotherapy

Studies have shown that participation in psychotherapy increases when we have concrete assignments to complete. It is not that completing the homework makes therapy more effective; rather, it is showing up that does. But it is completing homework that brings these changes about. Interactive classes in most subjects have the same philosophy—we come to learn, not learn to come. Once we’ve arrived, our attention has an easier time staying focused, but it can sometimes take an active process to get ourselves out of the living room and into the lecture hall. The homework has proved that point. It can be a beacon saying 11:00. It is Monday. You committed to attending class today—time to get up.

Gain the confidence and knowledge to complete a Sudoku puzzle, and you will probably find it an enjoyable and uplifting experience. Turn the experience into an assignment, and you may find yourself avoiding it at all costs, even if it is in your best interest. We often dread doing something more when there is an added sense of urgency. A benefit of homework in adult psychotherapy is that it can help to create a sense of urgency and accountability. Left to our own devices, we delay, we postpone, we extend into time. Having something be “due” can help in our decision making. It forces us to direct our focus.

2. Types of Homework Assignments in Psychotherapy

The use of homework assignments is common in different psychotherapy approaches, such as cognitive-behavioral therapy (CBT), narrative therapy, solution-focused therapy, and cognitive change therapy, among others. It is important for the therapist to keep in mind that direct change is neither the starting point in the therapeutic process nor the automatic result of it. Thus, in addition to using the homework intervention, the therapist must plan to develop other strategies that depend on the specific historical context of the patient and evoke the activation of the mechanisms of change that the client possesses. Given the importance of active practice, unique therapeutic tasks in research and clinical reports have been pointed out as the therapist’s most transformative strategy, surpassing cognitive restructuring and intervening behaviors.

In the field of psychotherapy and counseling, homework assignments help to personalize the therapeutic process, making it more specific to the individual needs of the client. These tasks are designed so that the client can perform the therapeutic strategies outside of the sessions, with the aim of promoting changes by putting these strategies into practice. In line with this, the empirical evidence on the effectiveness of psychotherapy highlights the importance of active practice, promoting changes in the areas of functioning that are the subject of therapeutic intervention. Several authors argue that changes in cognitions regarding symptoms and life events will occur after the patient puts strategies into practice, rather than directly by means of cognitive correction phenomena.

3. Strategies for Effective Homework Completion

Results both generally confirmed previous findings emphasizing the importance of homework in cognitive-behavioral therapy, and provided specific information about homework’s role in psychodynamic, humanistic, and eclectic treatments. That cognitive-behavioral therapists assign and ensure patient completion of homework more frequently than therapists with other theoretical orientations is consistent with previous research as well as Freeman and Leen (1988) who found that cognitive-behavioral therapists view homework as a crucial component of psychotherapy to a greater extent than therapists of other orientations. It is also consistent with the components of practices research has shown common to cognitive-behavioral therapists, including conducting therapy with a clear theoretical model, structuring the course of treatment to achieve patient improvement quickly, providing patients with concrete instructions for behavioral or situational changes, and actively seeking feedback on patients’ treatment responses.

Although homework played a less important role in the other stages, therapists continued to assign and patients agreed to complete homework fairly consistently throughout treatment. Among adherent dyads, therapists assigned homework on average during 48% of all session hours, and patients completed 40%. Cognitive-behavioral therapists were more adherent to the homework paradigm in every session before termination, both in assigning homework and in ensuring patient completion. This is interesting in light of the fact that we did not specifically recruit cognitive-behavioral therapists for the broader multi-method study. Therapists used a number of strategies to encourage homework completion, including developing a written plan of action, providing written instructions, calling patients to check in and provide encouragement, helping patients overcome obstacles to homework completion, and physical exercise.

4. Overcoming Challenges in Completing Psychotherapy Homework

Another common issue in assigning homework is the challenge of making the new learning meaningful to each patient, and transferring it from the therapy room to patients’ daily lives. This can also be especially challenging for people with low self-esteem. Patients might be highly insecure in interactions with therapists. Furthermore, repeated unsuccessful experiences over time can result in a loss of faith and interest in the process, leading to a decision to stop treatment. Patients might be less likely to follow through with these homework. Therefore, understanding a patient’s context can be a key step that allows for the creation of compensatory strategies to control obstacles that come their way.

Challenges in completing homework for patients in psychotherapy may include patients experiencing anything ranging from a lack of comprehension of the tasks, uncertainty regarding the therapeutic alliance, including fears of criticism, to patients’ lack of motivation, embarrassment, or anxiety. Others could involve patients’ different cultural patterns and socio-economic conditions. Some potential solutions to these challenges regarding homework assignments might include acknowledging patients’ concerns, developing a mutual understanding of the purpose of the homework that each patient is given, and creating a warm and accepting therapeutic context. It is essential that patients understand the tasks that are assigned to them.

5. Maximizing the Therapeutic Impact of Homework

In using homework, therapists are also able to externalize psychological issues. As members work outside of the group and prepare to share their work inside of the group, the group becomes a “mirror” to their real-life interactions. When an individual discusses the behaviors they used in overcoming resistance and writing homework they need in therapy, these coping tools become “solidified” as the behaviors they fell back on in life. If participants in a couple’s group speak to one another from a script created the prior evening in session (I encourage scripts in beginning couple’s therapy), they have practiced a mindful, healthy interaction in session before they are thrown back into the chaos of their lives. While all members are engaged in the same exercise, connection and understanding of differences are gained. In homework being discussed continually in group, “relational” group technique is utilized in conjunction with “interpretive” psychoanalysis. Similar to creating continuity between members and therapists, there are hints to the fact that the members will “dream up” each other as they undergo analysis. Furthermore, members may then re-experience conflict externally in the group and begin to be able to communicate better with each other.

In a conflicting group phenomenon, members may form cliques in opposition to other cliques within the group or to the therapist. As described, a therapist may work fruitlessly to “flatten” the group only to find they have resurrected quickly. Group therapists should focus as best they can on remaining secure in themselves to withstand the pressure of cliques uniting against them and cast aspersions on psychodynamic efforts. When the group therapists are able to sail past the opposition and join in the opposition-less, they will discover the “flattening” of the group occurs naturally. Members stop forming cliques when they believe the therapist is genuine and engaged and they see a shift from their old negative patterns of behavior.