Clinician experiences of homework in couples and family therapy: A survey of perceived impact on the working alliance

Abstract

The process of engaging clients in homework assignments has been studied extensively in research settings, but rarely have the challenges in the implementation of the science been considered in couples and family therapy. A survey was conducted of 226 clinicians regarding (1) their experience of homework adherence (quantity and quality) with couple and family clients, and (2) their experience of the impact of homework non‐completion (IHN) on the working alliance. Clinicians working with families reported less overall homework quantity and quality. However, across both couples and family clients, more negative IHN was reported among clinicians experiencing less homework quantity, both in terms of IHN bond (couple ρ = 0.71, p < 0.001; family ρ = 0.78, p < 0.001) and IHN agreement (couples ρ = 0.25, p < 0.001; ρ = 0.19, p = 0.006), and among clinicians with fewer years of clinical experience (r = 0.19, n = 136, p < 0.05). The present findings suggest that, in the context of couples and family therapy, there is a risk of perceived negative IHN on the working alliance. There would be merit to future investigations examining the processes of facilitating homework engagement within the context of a strong working alliance.

Integrating between-session homework in psychotherapy: A systematic review of immediate in-session and intermediate outcomes.

“…Therapist behavior has primarily been studied in relation to BSH adherence or compliance, and it is important to consider that therapist behaviors regarding BSH may have other unmeasured impacts (Kazantzis et al, 2022). Crucially, if the therapist has less than optimally selected and planned the task with the client, there is potential for negative views of the task, or negative interpretations of the process for the BSH, all of which will then impact on the completion (see theoretical model in Kazantzis & Miller, 2022).…”

Homework as a driver of change in psychotherapy

“…Psychotherapy is not universally beneficial. BSH, too, may prove either productive and conducive to the therapeutic process, or stressful and potentially counterproductive (Kazantzis et al, 2023). For instance, BSH may activate negative beliefs and instill feelings of pressure, anxiety, and fear of failure in some clients (Barnes et al, 2013; Fehm & Mrose, 2008; Finning et al, 2017), and has even been reported as the most significant challenge in treatment (Barnes et al, 2013).…”