Encouraging homework completion among older adults in therapy

Abstract

A growing body of research suggests that homework assignments facilitate positive outcomes in psychotherapy. We describe a cognitive behavioral outpatient therapy that stresses the important role homework plays in psychotherapy outcomes and that is found to be successful for treating emotional distress in both older adults and family caregivers. Just as a number of barriers can make it difficult for older clients to commit to regular therapy appointments, a variety of factors can also influence their completion of homework. We also address key issues frequently encountered when fostering homework compliance among older adults and utilize case vignettes to illustrate successful approaches to address these barriers. We present basic tenets for effective homework completion regardless of age group as well as several methods to address homework challenges that we find to be particularly pertinent for therapists treating today's older adults.

Genetic Influence of COMT and BDNF Gene Polymorphisms on Resilience in Healthy College Students

“…Resilience is a positive trait that helps individuals deal with adversity and life-challenging experiences, facilitates healthy functioning, and works as a protective factor against stress-related psychopathology [2]. A better understanding of the neurobiological mechanisms underpinning resilience is very important to understanding the processes involved in the development of and recovery from psychiatric disorders.…”

“…Resilience refers to the positive capacity to deal with stress in a healthy way, restore homeostasis after a disruption, and grow through adversity [2]. It is considered to be a trait that plays a critical role in mental health, including as a protective factor against developing psychiatric disorders in the face of potential trauma [3].…”

Predictors of Treatment Response for Depression and Inadequate Social Support – The ENRICHD Randomized Clinical Trial

“…This is seen in other CBT trials with the medically well [14,15,16,17] and suggests that better homework adherence – for which there are several promising techniques – could increase the efficacy of CBT for post-MI depression [18,19,20]. Improved 6-month BDI scores were predicted by the number of depression-specific intervention components [21] delivered.…”

Reflecting on homework in psychotherapy: What can we conclude from research and experience?

“…Homework review includes asking the client what they have learned through completing their task (Garland & Scott, 2002), regardless of the task outcome (Coon & Gallagher-Thompson, 2002). There was also substantive agreement among contributors that exploring noncompliance provides valuable information about the client's difficulties, as well as his/her view of the homework activity in assisting with their problem (Leahy, 2002), while also identifying unpredicted obstacles to homework completion (Dattilio, 2002;Tompkins, 2002).…”

“…In this way, homework needs to be appropriate to the stage of therapy and take into consideration several client factors: (a) engagement in therapy and readiness to change, (b) skill level, and (c) degree of impaired functioning. The homework may also need to be modified so that it is suitable for a child's developmental level (Hudson & Kendall, 2002) or broken down into further smaller steps so that it is realistic for older adults (Coon & Gallagher-Thompson, 2002). In addition, therapists should ensure that the homework is carefully tailored to the client and their cultural background (Coon & Gallagher-Thompson;Tompkins, 2002).…”