Abstract
Despite the importance attached to homework in cognitive-behavioral therapy for depression, quantitative studies of its impact on outcome have been limited. One aim of the present study was to replicate a previous finding suggesting that improvement can be predicted from the quality of the client's compliance early in treatment. If homework is indeed an effective ingredient in this form of treatment, it is important to know how compliance can be influenced. The second aim of the present study was to examine the effectiveness of several methods of enhancing compliance that have frequently been recommended to therapists. The data were drawn from 235 sessions received by 25 clients. Therapists' ratings of compliance following the first two sessions of treatment contributed significantly to the prediction of improvement at termination (though not at followup). However, compliance itself could not be predicted from any of the clients' ratings of therapist behavior in recommending the assignments.
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This research was carried out while the first author was employed by the MRC/ESRC Social and Applied Psychology Unit, Sheffield University, United Kingdom. Thanks are due to David Shapiro and Bill Stiles for their comments on an earlier draft of this paper, to David Shapiro, Michael Barkham, Gillian Hardy, and Shirley Reynolds for discussions on the design of the study and for their ratings, and to Anne Rees and Jane Hall for help with data collection.
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Startup, M., Edmonds, J. Compliance with homework assignments in cognitive-behavioral psychotherapy for depression: Relation to outcome and methods of enhancement. Cogn Ther Res 18, 567–579 (1994). https://doi.org/10.1007/BF02355669
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DOI: https://doi.org/10.1007/BF02355669