The relationships among working alliance, group cohesion and homework engagement in group cognitive behaviour therapy for social anxiety disorder

Homework as a driver of change in psychotherapy

“…Third, accumulating research demonstrates that therapist behaviors related to the selection, planning, and review of homework play a crucial role in facilitating client engagement with homework and influencing outcomes (Bryant et al, 1999;Conklin et al, 2018;Hildebrand-Burke et al, 2023;Jungbluth & Shirk, 2013;Ryum et al, 2010a;Weck et al, 2013). These effects persist even when controlling for confounding variables such as the therapeutic alliance (Ryum et al, 2022), and the role of client feedback has also been incorporated and examined (McEvoy et al, 2023;Yew et al, 2021). Furthermore, a recent review conducted as part of the interorganizational Task Force on Psychotherapy Skills and Methods That Work (Hill & Norcross, 2023) systematically reviewed and summarized results on therapist behaviors associated with immediate (in-session) and intermediate (session-tosession) outcomes of BSH.…”

Between‐session homework and processes of change

“…Specifically, all authors noted how BSH may help clients (1) build awareness or insight (a stance of curiosity toward inner mental life; new perspective on thoughts and though processes, etc.) through specific task such as psychoeducation and sharing of rationale (Church et al, 2023;Hammersmark et al, 2023;Magistrale et al, 2023;Murphy et al, 2023;Wachen, 2023;Warwar, 2023), writing about unresolved feelings toward a significant other (Warwar, 2023), writing an impact statement (Wachen, 2023), using work-/task sheets (McEvoy et al, 2023;Murphy et al, 2023;Wachen, 2023), experimenting with new behaviors (e.g., Magistrale et al, 2023), or experiential tasks (e.g., Hammersmark et al, 2023); as well as (2) change behaviors by extending in-session work and (new) behaviors into clients' daily lives through the practice of new skills (e.g., exposure, activity scheduling, trying out new ways of relating, thought worksheet, etc. ; Church et al, 2023;Hammersmark et al, 2023;Magistrale et al, 2023;Murphy et al, 2023;.…”

“…While the field appears to be moving toward a more assimilative and integrative view of psychotherapy that acknowledges the importance of both techniques (BSH) and the therapeutic relationship as essential for the process and outcome of psychotherapy (Derubeis & Lorenzo‐Luaces, 2017; Hofmann & Barlow, 2014; Wampold et al, 2017), the case studies illustrate how their relative importance is of continued interest also when discussing between‐session assignments (e.g., McEvoy et al, 2023; Ryum et al, 2022; Yew et al, 2021). Different theoretical approaches tend to emphasize distinct components of the therapeutic relationship— transference, the real relationship, and the working alliance (Gelso & Hayes, 1998).…”