For healthcare & Wellbeing professionals

SpaceCare and the Future of Psychotherapy Homework Research

Prof. Jason Spendelow, Clinical Psychologist

Summary

Time spent with a therapist is crucial to achieving a person’s mental health goals. However, work done between sessions can also determine whether therapy outcomes are simply good or truly great. Many therapists use homework to maintain progress towards therapy objectives, helping bridge the gap between sessions.

 

Most adults who undertake certain types of evidence-based psychotherapy end up significantly better off than they would be without treatment. We know this through a particular type of research design called meta-analysis.

 

This approach combines the results of multiple studies to answer a specific question. In this case: How effective is psychotherapy homework? We have learned much about homework in recent years, but many questions remain unanswered. Here at SpaceCare, we aspire to contribute meaningfully to advancing knowledge in this area, helping to make therapy come alive in daily life through effective homework activities.

the future of psychotherapy homework research

Research Questions

There are five priority areas for future research.

1. Mechanisms of Change

We know that psychotherapy homework helps people, so now we must better understand how homework acts to encourage positive change.

Mechanisms could refer to factors such as:

  • A more can-do attitude towards tackling life challenges
  • Improved ability to recognise and respond to unhelpful thinking patterns

Better understanding of key ingredients such as these will help us leverage homework for stronger outcomes.

2. Therapist Training

We need to research how therapists should assign, explain, and review homework, because therapist skill in this area is important in helping clients engage with between-session activities.

For example, encouraging a client to review their own homework may work better than a therapist sharing their observations on a completed task.

3. Cross-Cultural Research

Homework research to date has mainly been conducted in Western populations using Cognitive Behaviour Therapy (CBT). We need to better understand how homework should be adapted for different cultural, language, and social contexts.

For example, homework may need to be framed in different ways, such as self-improvement or supporting the community, to better reflect cultural practices.

4. Focus on Engagement

Future research should look at how much clients engage with homework, not just ask whether they completed it. Effort and meaning taken from exercises are often more important than simply finishing the task.

For example, reflecting on a thought diary entry with genuine curiosity may yield better outcomes than simply filling in the boxes.

5. Technology and Innovation

We should study how apps and online platforms can make therapy homework easier to complete and more effective. We also need to know which technology tools work best to help people engage with exercises and the therapy process between sessions.

Research Benefits

  • The platform can help structure how therapists assign and review homework, supporting a more consistent and intentional approach to between-session activities.
  • It emphasises engagement with homework activities, not just exercise completion, enabling the collection of richer datasets that researchers increasingly identify as necessary.
  • Therapists and clients can observe and measure how different homework activities foster specific therapeutic changes over time.
  • The system can help lower barriers to cultural adaptation by allowing therapists to tailor exercises to fit a client’s unique cultural background and personal circumstances.
  • It also provides an environment where digital features can be tested to better understand which functions improve homework adherence and therapy outcomes.

Taken together, these features make the platform both a therapeutic tool and a research infrastructure for generating the data and insights needed to make psychotherapy homework more effective.

We welcome collaboration with therapists, clients, and researchers interested in unlocking the full potential of between-session therapeutic work.

References

  1. Kazantzis, N., Whittington, C., & Dattilio, F. (2010). Meta-analysis of homework effects in cognitive and behavioral therapy: A replication and extension. Clinical Psychology: Science and Practice, 17(2), 144–156.
  2. Mausbach, B. T., Moore, R., Roesch, S., Cardenas, V., & Patterson, T. L. (2010). The relationship between homework compliance and therapy outcomes: An updated meta-analysis. Cognitive Therapy and Research, 34(5), 429–438.
  3. Kazantzis, N., Lampropoulos, G. K., & Deane, F. P. (2005). A national survey of practicing psychologists’ use and attitudes toward homework in psychotherapy. Journal of Consulting and Clinical Psychology, 73(4), 742–748.
  4. Kazantzis, N., Deane, F. P., & Ronan, K. R. (2000). Homework assignments in cognitive and behavioral therapy: A meta-analysis. Clinical Psychology: Science and Practice, 7(2), 189–202.
  5. Kazantzis, N., & Lampropoulos, G. K. (2002). Reflecting on homework in psychotherapy: What can we conclude from research and experience? Journal of Clinical Psychology, 58(5), 577–585.
  6. Prasko, J. (2022). Homework in cognitive behavioral supervision. Psychology Research and Behavior Management, 15, 202–210.

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