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Therapist Skill and Patient Variables in Homework Compliance: Controlling an Uncontrolled Variable in Cognitive Therapy Outcome Research

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Abstract

Prior research suggests therapists' assignmentof homework, and patients' compliance with it, enhancesthe efficacy of cognitive therapy (CT). However, factorscontributing to homework compliance have received scant empirical attention. This study examinedspecific demographic and clinical patient variables(age, education, number of previous depressive episodes,depression severity, and learned resourcefulness) and a variety of therapist skills (general,CT-specific, and homework-focused) as they predictedhomework compliance among 26 patients in a 20-session CTprotocol for major depression. Patients who were more compliant with homework exhibitedsignificantly greater treatment response on onedepression measure but not another. Homework compliancewas most strongly predicted by therapists' reviewinghomework assigned previously, and by general therapeuticskills. Patients' age, education, depression severity,and learned resourcefulness were unrelated tocompliance; however, number of previous episodes was negatively related to compliance.

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Bryant, M.J., Simons, A.D. & Thase, M.E. Therapist Skill and Patient Variables in Homework Compliance: Controlling an Uncontrolled Variable in Cognitive Therapy Outcome Research. Cognitive Therapy and Research 23, 381–399 (1999). https://doi.org/10.1023/A:1018703901116

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