Homework Compliance Counts in Cognitive-Behavioral Therapy
- 18 February 2013
- journal article
- research article
- Published by Informa UK Limited in Cognitive Behaviour Therapy
- Vol. 42 (3), 171-179
- https://doi.org/10.1080/16506073.2013.763286
Abstract
Background: Prior research has demonstrated that there is some association between treatment engagement and treatment outcome in behavioral therapy for anxiety disorders. However, many of these investigations have been limited by weak measurement of treatment engagement variables, failure to control for potentially important baseline variables, and failure to consider various treatment engagement variables simultaneously. The purpose of the present study is to examine the relationship between two treatment engagement variables (treatment expectancy and homework compliance) and the extent to which they predict improvement from cognitive-behavioral therapy (CBT) for anxiety disorders. Methods: 84 adults with a DSM-IV-defined principal anxiety disorder took part in up to 12 sessions of CBT or acceptance and commitment therapy. Pre- and post-treatment disorder severity was assessed using clinical severity ratings from a semi-structured diagnostic interview. Participants made ratings of treatment expectancy after the first session. Homework compliance was assessed each session by the treating clinician. Results: Contrary to hypotheses, treatment expectancy and homework compliance were poorly correlated. Regression analyses revealed that homework compliance, but not treatment expectancy, predicted a significant portion of the variance in treatment outcome (10%). Conclusions: The present research suggests that although treatment expectation and homework compliance likely represent unique constructs of treatment engagement, homework compliance may be the more important treatment engagement variable for outcomes. The present research suggests that improvement of homework compliance has the potential to be a highly practical and effective way to improve clinical outcomes in CBT targeting anxiety disorders.Keywords
This publication has 28 references indexed in Scilit:
- Randomized clinical trial of cognitive behavioral therapy (CBT) versus acceptance and commitment therapy (ACT) for mixed anxiety disorders.Journal of Consulting and Clinical Psychology, 2012
- Cognitive behavior therapy in medication non-responders with obsessive–compulsive disorder: A prospective 1-year follow-up studyJournal of Anxiety Disorders, 2011
- The impact of motivational interviewing on resistance in cognitive behavioural therapy for generalized anxiety disorderPsychotherapy Research, 2011
- ExpectationsJournal of Clinical Psychology, 2010
- Cognitive-Behavioral Therapy for Adult Anxiety DisordersThe Journal of Clinical Psychiatry, 2008
- The use of homework in psychotherapy: An introductionJournal of Clinical Psychology, 2002
- Psychometric properties of the credibility/expectancy questionnaireJournal of Behavior Therapy and Experimental Psychiatry, 2000
- Self-monitoring with panic and anxiety disorders.Psychological Assessment, 1999
- Common Methods Bias: Does Common Methods Variance Really Bias Results?Organizational Research Methods, 1998
- Predictors of Response to Cognitive-Behavioral Group Therapy for Social PhobiaJournal of Anxiety Disorders, 1997