The role of homework assignments in cognitive and behavioral therapies : a thesis presented in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Psychology at Massey University

Abstract

Homework assignments have long been considered crucial within cognitive and behavioral treatment formulations. A large number of commentary articles have suggested that when homework is administered systematically, client homework adherence and successful therapy outcome can be enhanced over and beyond the effects in cognitive and behavioral therapies. However, despite the apparent importance of homework, the relationship between homework assignments and outcome is a relatively uninvestigated aspect of therapy. Only a few studies have examined homework's effect on outcome in therapy, and little is currently known about its use in everyday clinical practice. This dissertation is an attempt to evaluate the findings of prior research, determine methodological limitations, and examine the role of homework assignments in promoting positive change in cognitive behavioral therapies. This dissertation starts with a description of the theoretical and practical rationale for the use of homework assignments in therapy. The results of a practitioner survey designed to investigate the use of homework assignments in clinical practice are next presented (Study 1). This is followed by a power survey of the statistical sensitivity among prior empirical research designed to examine the relationship between homework assignments and outcome (Study 2), and a meta-analytic aggregation designed to quantify the magnitude of homework's effect in cognitive and behavioral therapies (Study 3). Finally, the dissertation describes the results of an empirical study designed to examine the role of systematic homework administration and homework performance in predicting therapeutic change (Study 4).