Sixty-eight percent of practicing psychologists frequently use between-session assignments with their patients, though cognitive-behavioral practitioners use them considerably more than those with other orientations, according to a report to be published in the August Journal of Consulting and Clinical Psychology (Vol. 73, No. 4).
In a randomized survey of 827 North American psychologists of varied theoretical orientations, the researchers, headed by psychologist Nikolaos Kazantzis, PhD, of Massey University in New Zealand, found that most of those surveyed thought their clients responded well to homework assignments, like journaling and readings, and completed them in a "moderate" amount of the time.
"Research contrasting psychotherapy with and without homework shows that homework significantly improves treatment outcomes," Kazantzis says. "But the data has been obtained almost exclusively in behavioral and cognitive-behavioral therapies. Relatively little is known about the actual use of homework in clinical practice, so we wanted to survey a broad group of practitioners."
As hypothesized, the 39 percent of psychologists who identified their orientation as cognitive-behavioral reported using more homework assignments, being more committed to the practice and giving more thought to using the time between sessions to make therapeutic progress than the rest of the sample, Kazantzis says. However, all theoretical groups in the study, including psychodynamic psychologists, reported some use of homework, he added.
Twenty-four percent of the sample identified as psychodynamic, and 31 percent of that group reported using homework to augment therapy.
The findings highlight the problems with researchers assuming that homework is a distinctive feature of cognitive-behavioral therapy, Kazantzis says, and suggest that theoretical and empirical work is needed to examine homework's effects across a range of therapy approaches.
"This survey supports the notion that many psychotherapy approaches incorporate homework," Kazantzis says. "The next step is to understand more about the mechanism by which homework produces its effects."