couples therapy homework planner

couples therapy homework planner

The Importance of Homework in Couples Therapy

1. Benefits of Homework in Couples Therapy

It is important to offer well-designed homework to clients, and the therapeutic tasks are structured in the sessions’ narrative, and they are structured at the end of each session into practical and effective home assignments. Research shows that between session practice or what we call homework in psychotherapy works across all modalities. Many studies highlight assignments as associated with better outcomes in therapy. Thus, to borrow from the title of this piece, the clinical application of homework can close the gap between the sessions and the client’s singular insight and growth. And, through careful, informed, and intentionally designed practice, homework can go a long way towards placing the therapy process into the relationships and lives of the clients.

Helpers in therapy are all around when therapists are committed to shaping and guiding the couple towards taking their growth and transformation as they show themselves during the therapy sessions into their lived experience at home and with them serving as their principal resource. These transformative experiences—clients coming to know each other’s story, feelings, hopes—can be deeply revealing and transformational. The new responses can be deeply soothed and revealing ripple effects as a host of collateral changes in expanded social networks and relationships.

2. Creating Effective Homework Assignments

A standard procedure for many kinds of clients, considering client motivation and expectancies in particular. It is also central to the goal-setting tradition in therapy. Motivation work is more typically associated with individual clients, while expectancy work is much more often used in the context of couples therapy. Marital researchers have long known that expecting positive outcomes from doing something meaningful and distinct could lead to real change in the motivations and behaviors of unhappy couples divided on several counts. Whether these findings have the same implications for in-session or between-sessions expectancies in the context of couples therapy remains to be fully understood. Kimberly Johnson found that her training in PCCT unexpectedly drew her to take more of a partner perspective even when she was trying only to change her client’s views.

Before discussing specific kinds of homework assignments, it might be helpful to consider the types of tasks that seem to be most helpful for couples in therapy. Shapiro and Gottman instructed their therapists to follow a simple rule: stop things from getting worse and start them getting better. What might these simple instructions look like in practice? Below are 10 general tasks you might assign to a couple to get them started on their journey toward better ways of connecting. Some are well supported by research, while others are more speculative, drawn from the therapeutic experiences of seasoned clinicians. These tasks assume that therapy has not yet escalated to the point of helping clients parse the details of specific conflicts. People also differ considerably, so the therapist needs to be sensitive to significant variation in a couple’s personalities and specific concerns.

3. Strategies for Implementing Homework Assignments

Using homework early and frequently will further increase the likelihood of acceptance, compliance, and adherence. Given that “the devil lies in the details”, it is important that concrete instructions are provided in a step-by-step manner, such as advising (or modeling) how long to practice a particular skill or intervention. This further needs to be linked to desired changes. It is ineffective to ask a client to simply “listen” or “ask about their partner’s day”, but specifying that they should remain quiet for at least 90 seconds and encourage/ask “open-ended questions” instead of closed-ended, closed conversation generating actions. Of equal importance will be the decisions that a clinician makes that are consistent with the client’s strengths, thereby increasing rule-governed behavior or compliance. For example, if a clinician is aware of a client’s difficulty with materializing change but understands that a couple is able to sustain attention and commitment to a recurring task in each session for 2-3 minutes (the concept of ‘chunking’ in learning), repeated part-tasks at home will serve this couple well. It is important that home assignments are not only presented as “a necessary part of therapy progress but designed to ensure success and monitor group-session progress. Such attention to detail will also contribute to reinforcing the developing therapeutic alliance.

It is first important to acknowledge the inherent differences between in-session, live interactions and what clients experience in their home environment, which involve unpredictable daily life stressors. Given the gap between the sacred session time and a client’s reality at home, homework serves a multitude of purposes – a contained space of experiential learning and practice, teaching couples a new skill, and finally, having couples “live” a new experience. Homework provides a dedicated space for learning and practicing skills. In CBT, for example, homework allows clients to learn, practice, and integrate new skills when the therapist is not present. By engaging in new skills, clients can possibly create new associations and empower themselves by “figuring it out”. By experiencing a new way of managing unwanted feelings and thoughts, clients may feel more confident in the new behavior, which ultimately leads to increased use of skills at home. Skills not practiced are easily forgotten, and the same applies to couples therapy. Furthermore, homework serves the purpose of increasing rates of change and substantiating change or stability across sessions. As previously illustrated, the stronger the internalization of a new way of understanding a situation or responding to conflict, psychologically or intrapsychically, the more likely it will translate to in-session gains. Finally, supported, experienced-based practice during sessions or discussion from clients can provide important insight about a particular intervention or model in couples therapy. In effect, to “homework” means that what is learned or experienced during the session is reserved and practiced by the couple at home.

4. Overcoming Challenges in Completing Homework

Other participants may lack motivation or expect homework to take too much time. Examination of participant motivation for adhering to homework is quite limited, with Ticho suggesting such homework completion may be higher “when specific behaviors were directly linked to bringing about the structure and closeness the couples believed they would need to stay together”. This assertion has been substantiated by one study in which clients who completed homework assignments that reinforce each of the following elements of Behavioral Experiential Therapy demonstrated better relationship outcomes than their peers. Because of the obvious benefits to clients’ relationships, future research will need to better ensure that clients are motivated to complete their practical homework or facilitate supportive therapeutic surroundings.

Some couples may face challenges in doing their homework between their sessions, including a “time crunch,” as participants complete other in-session tasks, and poor motivation. When therapy emphasizes homework assignments, clients must find ways to complete them quickly amid other responsibilities. For instance, one of Otto’s and Ticho’s clients found completing practical exercises during therapist-assigned time challenging, as Otto’s client suggested the game was “an opportunity to move away from the treatment of the problem”. Explicitly discussing clients’ goals for doing their homework may also bolster their motivation. Some clients may not appreciate some assignments, possibly due to their difficulty or superficial nature. Consequently, as long as clients do not highly resist or ignore assignments, therapists should encourage couples to complete the most challenging assignments and adjust the less preferred ones to client interests.

5. Evaluating the Impact of Homework in Couples Therapy

The goal of this study was to evaluate the importance of homework in the context of skills-based couples therapy. Of course, in the context used by Christensen and colleagues (2004), an unsuccessful test for homework would not justify the conclusion that it is unnecessary in skills-based couples therapy. One possibility is that weekly therapist contact is not necessary in treatment of couples experiencing mild to moderate levels of distress. This assertion seems unlikely because the shape of the findings is similar when very severe problems are controlled: treating relationship distress as a categorical variable, rather than as linear, had no impact in any of the analyses. To pursue a more fine-grained approach in the future, we should attempt to explain why treatment effects are not moderated by homework, and why weekly contact with a therapist does not appear to be important in effective treatment of couples in the mild to moderate range of distress. Dysfunctional relationships are known to facilitate psychopathological behaviors in family members, in part through the coercion model: “Individuals are aggressive because they are influenced to be aggressive, not because they are inherently so” (Patterson, 1982). Established couples therapy models (e.g., Christensen & Jacobson, 2000) emphasize changing reactivity to the other partner, and treatment effects with moderately distressed couples ought to emerge much more quickly than at the end of a 14-week therapy.

Evidence of the impact of couples therapy homework has been mixed in studies that have included these and other outcomes. A test for the side effects of homework revealed one significant effect. At post-treatment, among treatment completers, couples which had reported greater change in satisfaction at mid-treatment reported a larger increase in frequency of past-month physical aggression when the amount of mid-treatment homework they had done was controlled. The finding is concerning, given similar results from a previous study, in which the amount of therapist-recommended individual homework that had been completed by therapy participants correlated with aggression both at post-treatment and at 5-month follow-up.