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Sending Homework to Clients in Therapy: The Easy Way

Successful therapy relies on using assignments outside of sessions to reinforce learning and practice newly acquired skills in real-world settings (Mausbach et al., 2010).

Up to 50% of clients don’t adhere to homework compliance, often leading to failure in CBT and other therapies (Tang & Kreindler, 2017).

In this article, we explore how to use technology to create homework, send it out, and track its completion to ensure compliance.

Before you continue, we thought you might like to download our three Positive Psychology Exercises for free . These science-based exercises will explore fundamental aspects of positive psychology including strengths, values, and self-compassion, and will give you the tools to enhance the wellbeing of your clients, students, or employees.

This Article Contains:

Is homework in therapy important, how to send homework to clients easily, homework in quenza: 5 examples of assignments, 5 counseling homework ideas and worksheets, using care pathways & quenza’s pathway builder, a take-home message.

Cognitive-Behavioral Therapy has “been shown to be as effective as medications in the treatment of a number of psychiatric illnesses” (Tang & Kreindler, 2017, p. 1).

Homework is a vital component of CBT, typically involving completing a structured and focused activity between sessions.

Practicing what was learned in therapy helps clients deal with specific symptoms and learn how to generalize them in real-life settings (Mausbach et al., 2010).

CBT practitioners use homework to help their clients, and it might include symptom logs, self-reflective journals , and specific tools for working on obsessions and compulsions. Such tasks, performed outside therapy sessions, can be divided into three types (Tang & Kreindler, 2017):

• Psychoeducation Reading materials are incredibly important early on in therapy to educate clients regarding their symptoms, possible causes, and potential treatments.
• Self-assessment Monitoring their moods and completing thought records can help clients recognize associations between their feelings, thoughts, and behaviors.
• Modality specific Therapists may assign homework that is specific and appropriate to the problem the client is presenting. For example, a practitioner may use images of spiders for someone with arachnophobia.

Therapists strategically create homework to lessen patients’ psychopathology and encourage clients to practice skills learned during therapy sessions, but non-adherence (between 20% and 50%) remains one of the most cited reasons for CBT failure (Tang & Kreindler, 2017).

Reasons why clients might fail to complete homework include (Tang & Kreindler, 2017):

Internal factors

• Lack of motivation to change what is happening when experiencing negative feelings
• Being unable to identify automatic thoughts
• Failing to see the importance or relevance of homework
• Impatience and the wish to see immediate results

External factors

• Effort required to complete pen-and-paper exercises
• Inconvenience and amount of time to complete
• Failing to understand the purpose of the homework, possibly due to lack of or weak instruction
• Difficulties encountered during completion

Homework compliance is associated with short-term and long-term improvement of many disorders and unhealthy behaviors, including anxiety, depression, pathological behaviors, smoking, and drug dependence (Tang & Kreindler, 2017).

Greater homework adherence increases the likelihood of beneficial therapy outcomes (Mausbach et al., 2010).

With that in mind, therapy must find ways to encourage the completion of tasks set for the client. Technology may provide the answer.

The increased availability of internet-connected devices, improved software, and widespread internet access enable portable, practical tools to enhance homework compliance (Tang & Kreindler, 2017).

Clients who complete their homework assignments progress better than those who don’t (Beck, 2011).

Having an ideal platform for therapy makes it easy to send and track clients’ progress through assignments. It must be “user-friendly, accessible, reliable and secure from the perspective of both coach and client” (Ribbers & Waringa, 2015, p. 103).

In dedicated online therapy and coaching software, homework management is straightforward. The therapist creates the homework then forwards it to the client. They receive a notification and complete the work when it suits them. All this is achieved in one system, asynchronously; neither party needs to be online at the same time.

For example, in Quenza , the therapist can create a worksheet or tailor an existing one from the library as an activity that asks the client to reflect on the progress they have made or work they have completed.

The activity can either be given directly to the client or group, or included in a pathway containing other activities.

Here is an example of the activity parameters that Quenza makes possible.

A message can be attached to the activity, using either a template or a personally tailored message for the client. Here’s an example.

Once the activity is published and sent, the client receives a notification about a received assignment via their coaching app (mobile or desktop) or email.

The client can then open the Quenza software and find the new homework under their ‘To Do’ list.

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Quenza provides the ability to create your own assignments as well as a wide selection of existing ones that can be assigned to clients for completion as homework.

The following activities can be tailored to meet specific needs or used as-is. Therapists can share them with the client individually or packaged into dedicated pathways.

Such flexibility allows therapists to meet the specific needs of the client using a series of dedicated and trackable homework.

Examples of Quenza’s ready-to-use science-based activities include the following:

Wheel of Life

The Wheel of Life is a valuable tool for identifying and reflecting on a client’s satisfaction with life.

You can find the worksheet in the Positive Psychology Toolkit© , and it is also included in the Quenza library. The client scores themselves between 1 and 10 on specific life domains (the therapist can tailor the domains), including relationships, career development, and leisure time.

This is an active exercise to engage the client early on in therapy to reflect on their current and potential life. What is it like now? How could it look?

The wheel identifies where there are differences between perceived balance and reality .

The deep insights it provides can provide valuable input and prioritization for goal setting.

The Private Garden: A Visualization for Stress Reduction

While stress is a normal part of life, it can become debilitating and interfere with our everyday lives, stopping us from reaching our life goals.

We may notice stress as worry, anxiety, and tension and resort to avoidant or harmful behaviors (e.g., abusing alcohol, smoking, comfort eating) to manage these feelings.

Visualization is simple but a powerful method for reducing physical and mental stress, especially when accompanied by breathing exercises.

The audio included within this assignment helps the listener visualize a place of safety and peace and provides a temporary respite from stressful situations.

20 Guidelines for Developing a Growth Mindset

Research into neuroplasticity has confirmed the ability of the adult brain to continue to change in adulthood and the corresponding capacity for people to develop and transform their mindsets (Dweck, 2017).

The 20 guidelines (included in our Toolkit and part of the Quenza library) and accompanying video explain our ability to change mentally and develop a growth mindset that includes accepting imperfection, leaning into challenges, continuing to learn, and seeing ‘failure’ as an opportunity for growth.

Adopting a growth mindset can help clients understand that our abilities and understanding are not fixed; we can develop them in ways we want with time and effort.

Self-Contract

Committing to change is accepted as an effective way to promote behavioral change – in health and beyond. When a client makes a contract with themselves, they explicitly state their intention to deliver on plans and short- and long-term goals.

Completing and signing such a self-contract (included in our Toolkit and part of the Quenza library) online can help people act on their commitment through recognizing and living by their values.

Not only that, the contract between the client and themselves can be motivational, building momentum and self-efficacy.

The contract can be automatically personalized to include the client’s name but also manually reworded as appropriate.

The client completes the form by restating their name and committing to a defined goal by a particular date, along with their reasons for doing so.

Realizing Long-Lasting Change by Setting Process Goals

We can help clients realize their goals by building supportive habits. Process goals – for example, eating healthily and exercising – require ongoing actions to be performed regularly.

Process goals (unlike end-state goals, such as saving up for a vacation) require long-lasting and continuous change that involves monitoring standards.

This tool (included in our Toolkit and part of the Quenza library) can help clients identify positive actions (rather than things to avoid) that they must carry out repeatedly to realize change.

We have many activities that can be used to help clients attending therapy for a wide variety of issues.

In this section, we consider homework ideas that can be used in couples therapy, family therapy, and supporting clients with depression and anxiety.

Couples therapy homework

Conflict is inevitable in most long-term relationships. Everyone has their idiosyncrasies and individual set of needs. The Marital Conflicts worksheet captures a list of situations in which conflicts arise, when they happen, and how clients feel when they are (un)resolved.

Family therapy homework

Families, like individuals, are susceptible to times of stress and disruptions because of life changes such as illness, caring for others, and job and financial insecurity.

Mind the Gap is a family therapy worksheet where a family makes decisions together to align with goals they aspire to. Mind the gap is a short exercise to align with values and improve engagement.

How holistic therapist Jelisa Glanton uses Quenza

Homework ideas for depression and anxiety: 3 Exercises

The following exercises are all valuable for helping clients with the effects of anxiety and depression.

Activity Schedule is a template assisting a client with scheduling and managing normal daily activities, especially important for those battling with depression.

Activity Menu is a related worksheet, allowing someone with depression to select from a range of normal activities and ideas, and add these to a schedule as goals for improvement.

The Pleasurable Activity Journal focus on activities the client used to find enjoyable. Feelings regarding these activities are journaled, to track recovery progress.

Practicing mindfulness is helpful for those experiencing depression (Shapiro, 2020). A regular gratitude practice can develop new neural pathways and create a more grateful, mindful disposition (Shapiro, 2020).

Each activity can be tailored to the client’s needs; shared as standalone exercises, worksheets, or questionnaires; or included within a care pathway.

A pathway is an automated and scheduled series of activities that can take the client through several stages of growth, including psychoeducation , assessment, and action to produce a behavioral change in a single journey.

How to build pathways

The creator can add two pathway titles. The second title is not necessary, but if entered, it is seen by the client in place of the first.

Once named, a series of steps can be created and reordered at any time, each containing an activity. Activities can be built from scratch, modified from existing ones in the library, or inserted as-is.

New activities can be created and used solely in this pathway or made available for others. They can contain various features, including long- and short-answer boxes, text boxes, multiple choice boxes, pictures, diagrams, and audio and video files.

Quenza can automatically deliver each step or activity in the pathway to the client following the previous one or after a certain number of days. Such timing is beneficial when the client needs to reflect on something before completing the next step.

Practitioners can also designate steps as required or optional before the client continues to the next one.

Practitioners can also add helpful notes not visible to the client. These comments can contain practical reminders of future changes or references to associated literature that the client does not need to see.

It is also possible to choose who can see client responses: the client and you, the client only, or the client decides.

Tags help categorize the pathway (e.g., by function, intended audience, or suggested timing within therapy) and can be used to filter what is displayed on the therapist’s pathway screen.

Once designed, the pathway can be saved as a draft or published and sent to the client. The client receives the notification of the new assignment either via email or the coaching app on their phone, tablet, or desktop.

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Success in therapy is heavily reliant on homework completion. The greater the compliance, the more likely the client is to have a better treatment outcome (Mausbach et al., 2010).

To improve the likelihood that clients engage with and complete the assignments provided, homework must be appropriate to their needs, have a sound rationale, and do the job intended (Beck, 2011).

Technology such as Quenza can make homework readily available on any device, anytime, from any location, and ensure it contains clear and concise psychoeducation and instructions for completion.

The therapist can easily create, copy, and tailor homework and, if necessary, combine multiple activities into single pathways. These are then shared with the click of a button. The client is immediately notified but can complete it at a time appropriate to them.

Quenza can also send automatic reminders about incomplete assignments to the client and highlight their status to the therapist. Not only that, but any resulting questions can be delivered securely to the therapist with no risk of getting lost in a busy email inbox.

Why not try the Quenza application? Try using some of the existing science-based activities or create your own. It offers an impressive array of functionality that will not only help you scale your business, but also ensure proactive, regular communication with your existing clients.

We hope you enjoyed reading this article. Don’t forget to download our three Positive Psychology Exercises for free .

• Beck, J. S. (2011). Cognitive behavior therapy: Basics and beyond . Guilford Press.
• Dweck, C. S. (2017).  Mindset: The new psychology of success.  Robinson.
• 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.
• Ribbers, A., & Waringa, A. (2015). E-coaching: Theory and practice for a new online approach to coaching . Routledge.
• Shapiro, S. L. (2020).  Rewire your mind: Discover the science and practice of mindfulness. Aster.
• Tang, W., & Kreindler, D. (2017). Supporting homework compliance in cognitive behavioural therapy: Essential features of mobile apps. JMIR Mental Health , 4 (2).

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What Is Therapy Homework?

Sanjana is a health writer and editor. Her work spans various health-related topics, including mental health, fitness, nutrition, and wellness.

Dr. Sabrina Romanoff, PsyD, is a licensed clinical psychologist and a professor at Yeshiva University’s clinical psychology doctoral program.

Astrakan Images / Getty Images

Types of Therapy That Involve Homework

If you’ve recently started going to therapy , you may find yourself being assigned therapy homework. You may wonder what exactly it entails and what purpose it serves. Therapy homework comprises tasks or assignments that your therapist asks you to complete between sessions, says Nicole Erkfitz , DSW, LCSW, a licensed clinical social worker and executive director at AMFM Healthcare, Virginia.

Homework can be given in any form of therapy, and it may come as a worksheet, a task to complete, or a thought/piece of knowledge you are requested to keep with you throughout the week, Dr. Erkfitz explains.

This article explores the role of homework in certain forms of therapy, the benefits therapy homework can offer, and some tips to help you comply with your homework assignments.

Therapy homework can be assigned as part of any type of therapy. However, some therapists and forms of therapy may utilize it more than others.

For instance, a 2019-study notes that therapy homework is an integral part of cognitive-behavioral therapy (CBT) . According to Dr. Erkfitz, therapy homework is built into the protocol and framework of CBT, as well as dialectical behavior therapy (DBT) , which is a sub-type of CBT.

Therefore, if you’re seeing a therapist who practices CBT or DBT, chances are you’ll regularly have homework to do.

On the other hand, an example of a type of therapy that doesn’t generally involve homework is eye movement desensitization and reprocessing (EMDR) therapy. EMDR is a type of therapy that generally relies on the relationship between the therapist and client during sessions and is a modality that specifically doesn’t rely on homework, says Dr. Erkfitz.

However, she explains that if the client is feeling rejuvenated and well after their processing session, for instance, their therapist may ask them to write down a list of times that their positive cognition came up for them over the next week.

"Regardless of the type of therapy, the best kind of homework is when you don’t even realize you were assigned homework," says Erkfitz.

Benefits of Therapy Homework

Below, Dr. Erkfitz explains the benefits of therapy homework.

It Helps Your Therapist Review Your Progress

The most important part of therapy homework is the follow-up discussion at the next session. The time you spend reviewing with your therapist how the past week went, if you completed your homework, or if you didn’t and why, gives your therapist valuable feedback on your progress and insight on how they can better support you.

It Gives Your Therapist More Insight

Therapy can be tricky because by the time you are committed to showing up and putting in the work, you are already bringing a better and stronger version of yourself than what you have been experiencing in your day-to-day life that led you to seek therapy.

Homework gives your therapist an inside look into your day-to-day life, which can sometimes be hard to recap in a session. Certain homework assignments keep you thinking throughout the week about what you want to share during your sessions, giving your therapist historical data to review and address.

It Helps Empower You

The sense of empowerment you can gain from utilizing your new skills, setting new boundaries , and redirecting your own cognitive distortions is something a therapist can’t give you in the therapy session. This is something you give yourself. Therapy homework is how you come to the realization that you got this and that you can do it.

"The main benefit of therapy homework is that it builds your skills as well as the understanding that you can do this on your own," says Erkfitz.

Tips for Your Therapy Homework

Below, Dr. Erkfitz shares some tips that can help with therapy homework:

• Set aside time for your homework: Create a designated time to complete your therapy homework. The aim of therapy homework is to keep you thinking and working on your goals between sessions. Use your designated time as a sacred space to invest in yourself and pour your thoughts and emotions into your homework, just as you would in a therapy session .
• Be honest: As therapists, we are not looking for you to write down what you think we want to read or what you think you should write down. It’s important to be honest with us, and yourself, about what you are truly feeling and thinking.
• Practice your skills: Completing the worksheet or log are important, but you also have to be willing to put your skills and learnings into practice. Allow yourself to be vulnerable and open to trying new things so that you can report back to your therapist about whether what you’re trying is working for you or not.
• Remember that it’s intended to help you: Therapy homework helps you maximize the benefits of therapy and get the most value out of the process. A 2013-study notes that better homework compliance is linked to better treatment outcomes.
• Talk to your therapist if you’re struggling: Therapy homework shouldn’t feel like work. If you find that you’re doing homework as a monotonous task, talk to your therapist and let them know that your heart isn’t in it and that you’re not finding it beneficial. They can explain the importance of the tasks to you, tailor your assignments to your preferences, or change their course of treatment if need be.

"When the therapy homework starts 'hitting home' for you, that’s when you know you’re on the right track and doing the work you need to be doing," says Erkfitz.

A Word From Verywell

Similar to how school involves classwork and homework, therapy can also involve in-person sessions and homework assignments.

If your therapist has assigned you homework, try to make time to do it. Completing it honestly can help you and your therapist gain insights into your emotional processes and overall progress. Most importantly, it can help you develop coping skills and practice them, which can boost your confidence, empower you, and make your therapeutic process more effective.

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Conklin LR, Strunk DR, Cooper AA. Therapist behaviors as predictors of immediate homework engagement in cognitive therapy for depression . Cognit Ther Res . 2018;42(1):16-23. doi:10.1007/s10608-017-9873-6

Lebeau RT, Davies CD, Culver NC, Craske MG. Homework compliance counts in cognitive-behavioral therapy . Cogn Behav Ther . 2013;42(3):171-179. doi:10.1080/16506073.2013.763286

By Sanjana Gupta Sanjana is a health writer and editor. Her work spans various health-related topics, including mental health, fitness, nutrition, and wellness.

Homework in Psychotherapy: Its Purpose and Benefits

How Much Does Homework Matter in Therapy?

What research reveals about the work you do outside of therapy sessions..

Posted April 16, 2017 | Reviewed by Ekua Hagan

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Homework is an important component of cognitive behavior therapy (CBT) and other evidence-based treatments for psychological symptoms. Developed collaboratively during therapy sessions, homework assignments may be used by clients to rehearse new skills, practice coping strategies, and restructure destructive beliefs.

Although some clients believe that the effectiveness of psychotherapy depends on the quality of in-session work, consistent homework during the rest of the week may be even more important. Without homework, the insights, plans, and good intentions that emerge during a therapy session are at risk of being buried by patterns of negative thinking and behavior that have been strengthened through years of inadvertent rehearsal. Is an hour (or less) of therapeutic work enough to create change during the other 167 hours in a week?

Research on homework in therapy

Research on homework in therapy has revealed some meaningful results that can be understood collectively through a procedure called meta-analysis. A meta-analysis is a statistical summary of a body of research. It can be used to identify the average impact of psychotherapy homework on treatment outcomes across numerous studies. The results of four meta-analyses listed below highlight the value of homework in therapy:

• Kazantzis and colleagues (2010) examined 14 controlled studies that directly compared treatment outcomes for clients assigned to psychotherapy with or without homework. The data favored the homework conditions, with the average client in the homework group reporting better outcomes than about 70% of those in the no-homework conditions.
• Results from 16 studies (Kazantzis et al., 2000) and an updated analysis of 23 studies (Mausbach et al., 2010) found that, among those who received homework assignments during therapy, greater compliance led to better treatment outcomes. The effect sizes were small to medium, depending on the method used to measure compliance.
• Kazantzis et al. (2016) examined the relations of both quantity (15 studies) and quality (3 studies) of homework to treatment outcome. The effect sizes were medium to large, and these effects remained relatively stable when follow-up data were collected 1-12 months later.

Taken together, the research suggests that the addition of homework to psychotherapy enhances its effectiveness and that clients who consistently complete homework assignments tend to have better mental health outcomes. Finally, although there is less research on this issue, the quality of homework may matter as much as the amount of homework completed.

To enhance the quality of homework, homework assignments should relate directly to a specific goal, the process should be explained with clarity by the therapist, its method should be rehearsed in session, and opportunities for thoughtful out-of-session practice should be scheduled with ideas about how to eliminate obstacles to completion.

To find a therapist, please visit the Psychology Today Therapy Directory .

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.

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.

Kazantzis, N., Whittington, C., Zelencich, L., Kyrios, M., Norton, P. J., & Hofmann, S. G. (2016). Quantity and quality of homework compliance: a meta-analysis of relations with outcome in cognitive behavior therapy. Behavior Therapy, 47(5), 755-772.

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.

Joel Minden, Ph.D., is a clinical psychologist, author of Show Your Anxiety Who’s Boss , director of the Chico Center for Cognitive Behavior Therapy, and lecturer in the Department of Psychology at California State University, Chico.

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Why Do Some Therapists and Coaches Assign Homework In Between Sessions?

Caitlin harper.

When you start therapy or coaching, you probably expect to be doing most of the work in-session, working directly with your amazing coach or therapist. But what happens when the session ends?

If you’re just starting your therapy or coaching journey, it might surprise you to find that many therapists and coaches assign homework in between sessions, and it’s even an integral part of certain types of therapy, like cognitive behavioral therapy, or CBT. 

“It’s important to learn and fully understand the skills we explore during sessions and it is equally important to know how to apply those skills in your real life situations,” says Irene Chin, a therapist and MyWellbeing community member. “When I assign ‘homework’ it is to foster positive change in your life slowly but surely. However, the amount of homework can be tweaked to best fit your needs.”

If your school graduation days are behind you, you might think your homework days are long gone as well. But in this new stage of your learning and development, that might not be the case! Here are a few of our therapists and coaches on why they might assign homework in between sessions and what it might look like for you.

Why do coaches and therapists assign homework in between sessions?

Many times, therapists and coaches will assign homework so that you can practice the skills you explored during your session in the “real world.”

“While we work together on developing insight during our sessions, it’s between sessions when you have the opportunity to put these insights into practice in your life,” says Christine Carville. “Being able to take home specific tools to use in tough situations or emotionally charged moments allows for you to experience the learning and gain confidence. It’s like learning a language—you can go to class once or twice a week but it takes using the language on a daily basis to become fluent and confident. In a lot of ways, therapy is learning the language of emotional intelligence and in-vivo experience is vital.”

Some therapists and coaches find that assignments or other exercises to practice in between sessions can help clients gain a sense of continuity and growth as their therapy or coaching journey progresses.

“I have found that often people leave sessions feeling elated, unburdened, and with an increased sense of comfort and clarity,” says Sky Koltun. “Sometimes this experience can feel difficult to hold onto between sessions. I am always prepared to work with people to create a sense of continuity between sessions or come up with ways to hold or continue to cultivate what they feel they have gained from the work we do in the session. I have often recommended books, writing/journaling exercises, breathing, and meditation techniques, and help clients to create their own practices.”

Therapists and coaches who do assign homework sometimes believe that most of the work actually happens outside the session where you can apply what you learn when you worked together.

“I do assign work in any form that works best for you,” says Hannah Evans. “I can provide handouts and worksheets, book recommendations, journal prompts, behavior change activities to engage in, etc. Both you and I will discuss how the homework or activity went, exploring your thoughts, feelings, and interpretations to progress towards your therapy goals. There are 168 hours in a week and change will not occur in the one hour we meet each week. Therefore, most of the work for therapy happens outside of session where you apply the skills learned in session.”

In many situations, what you put into it is what you get out of it, and therapy and coaching are often no different. The more work you do outside of your sessions, the better your results can be.

“I always tell clients that coming to therapy and/or coaching is a bit like buying a gym membership: it's great that you have committed to bettering yourself, but you have to be patient and you have to be ready to put in consistent work to see results,” says William Hasek. “If you are only engaging in self-reflection for one hour a week with me, I don't think that will be of great benefit to you—just like you won't see many benefits if you only go to the gym one hour a week. You have to put in the time and energy outside of our sessions to experience the benefits.” 

But all of our coaches and therapists agree on one thing, and that is that you and your therapist or coach will work together to find what works best for you.

“I don't like to simply ‘assign’ activities for you to do outside of session because I want you to be active in creating solutions and committing to action, says William. “We will develop these activities collaboratively so you have a voice in the changes you are undertaking.”

What are some types of homework therapists or coaches might assign?

While homework can be worksheets or journaling, you might be surprised how varied and creative your “assignments” can be!

“Sometimes the homework can look like ‘Try to take note of what is happening before and after your anxiety sets in,’” says Evelina Rodriguez. “Other times I may offer an article, book, or activity to continue processing over the course of time between sessions.”

The homework doesn’t always look like “work” either.

“If you are struggling with burnout, I would encourage you to think about one simple yet pleasurable activity such as listening to  soothing music and schedule this specific event at a certain time of day,” says Catherine Kim.

In fact, homework often looks a lot like “real life,” which is kind of the point.

“Homework helps to reinforce skills discussed and practiced in session,” says Fanteema Barnes. “Assignments can range from completing worksheets, practicing mindfulness techniques, socializing, going on a date, reflecting on what we discussed in session, giving yourself compliments daily, engaging in a hobby, reading an article, purchasing a self-help book, watching a video or TED talk, or even having a conversation with a loved one.”

Leora Mandel gives a few more creative homework examples: 

• Free-form journal entries or letter writing 
• Planned pleasant events, such as attending a concert, cooking a favorite meal, making time to listen to a podcast, or paint
• Executing a plan brainstormed by you and I, such as beginning a new habit, reaching out to a person, beginning an application, or making a list
• Recording events to identify patterns—what time of day do negative thought spirals occur, and how often? Are there any recurring triggers? 
• Exercises with instructions involving the learning of a tool, such as a distress tolerance skill, and reflection of your experience practicing it

And your homework doesn’t have to stay the same—as you progress through your therapy or coaches journey, your assignments might change as you do.

“At the start of treatment, homework mostly consists of reflecting on behaviors, examining thoughts, and understanding relational and coping patterns,” says Shari Norton. “Toward the middle of treatment, homework may consist of practicing skills between sessions and through activities such as journaling. As treatment comes to an end, homework becomes less frequent, and consists of reflecting on changes that occurred from the start of sessions.

Again, your therapist or coach will work with you to determine the best course of action for you at that particular time in your life.

“Some people find the process of additional homework to be stress-inducing, adding yet another thing to their already piled-high list, and if this is the case then I might just ask the client to take a mental picture of something that happened to bring into the next session, maybe something around a triggering event, a dream, or just a thought that they keep ruminating about,” says Andrea Yuen-Sing Chan. “For others, homework helps to ease the transitions between sessions and to make the person feel as if they are doing something. In this case, because it can reduce anxiety and is also therapeutically useful, I will ask for journal entries, or to practice behavioral interventions and then to notate them in a journal. Occasionally I suggest a book or article that might be helpful to the client.”

Does every therapist or coach assign homework in between sessions?

If the idea of homework isn’t appealing to you, that’s totally fine too—not all coaches and therapists are into it either.

“I do not assign homework,” says Shaina Ferguson. “I believe that each of us have different ways of processing what may come up in therapy. You may find yourself reflecting upon the content of sessions outside of sessions and may want to journal or process through art or movement. You may choose to bring writing or other forms of expression into therapy and that is welcomed, but no formal homework will be assigned.”

Some therapists and coaches won’t assign you homework, but you’re more than welcome to develop exercises yourself and share them with your coach or therapist in-session.

“I believe that therapy has to be client-centered and based on your personal experience, not out of a book or on a worksheet,” says Autumn Potter. “I may ask you to take notice of certain experiences outside of a session or ask you to collect specific art materials. That being said, I also have clients who have come up with their own homework, such as ‘this week I am going to refrain from using Instagram.’ I believe that the directive coming from the client holds significantly more power than something I would assign.”

Homework doesn’t always fit with the kind of care you’re receiving, and that’s okay. But self-reflection is usually encouraged!

“I find that assigning homework does not fit well with my style of work which is more focused on expression of, and reflection on, feelings and thoughts within a supportive therapy relationship in order to build a level of insight that I feel can ultimately produce meaningful changes,” says Michael Nettis-Benstock. “At the same time, I feel that our work doesn’t stop at the end of the session and I always encourage you to reflect on what we discuss in our sessions throughout the week, but not in a way that feels like an assignment.”

Not everyone loves the word homework and your therapist or coach might call it something else entirely

“Part of the co-created coaching process depends on ‘fieldwork’ or homework in between sessions where clients are accountable for making real-world progress on short- and long-term goals,” says Ilysse Rimalovski.

“Oftentimes I assign small tasks in between sessions,” says Jordyn Norman. “I feel this is a good way to be able to measure progress.”

“I will at times assign what I like to call ‘projects’ in between sessions,” says Pam Skop. “The reason that I do this is that the real work happens outside of therapy. I generally meet with clients once a week for forty-five minutes and a lot can be discussed at that time, but it is what they do with that once they leave my office that leads to lasting changes. We will discuss the ‘project’ at the next session and use it as a learning tool to move forward.”

“Any ideas for tasks between sessions arise from our conversations during the session,” says Alena Gerst. “As you reveal to me what you feel you are lacking, we find ways to begin to slowly and intentionally integrate what you are searching for into your life. I call these tasks ‘Marching Orders’ (referring to the book The Artist's Way by Julia Cameron). Occasionally, these ‘assignments’ may feel challenging as you come to terms with what is true for you. But usually they are designed to unlock creativity, joy, and delight.”

“As a former teacher, I know that the word ‘homework’ might make some cringe, so I prefer to call it ‘practice,’” says Alison Abrams. “Time between sessions is priceless. It provides you with more time to extend the learning you do in our sessions into the real world.”

“There definitely will be times when I may make recommendations for ‘homework’ (or as I like to refer to it, ‘a challenge’) depending on what we're working through or if I think it could be relevant or helpful,” says Faith Bowen. “I typically don't do this every session—unless that is something you'd like.”

“I believe that I'm not here to help you grow just during the sessions but I want the growth and change to be sustainable in the long run,” says Kimberly Weimer. “I typically will cater your 'homeplay' (homework) around self-care tasks that you are interested in. This might include meditation, journaling, a gratitude practice, breathwork, yoga or some form of exercise. I will encourage readings, podcasts, and activities that fit with your struggles and goals.”

“For example if you have OCD you will have exposure exercise,” says Kimberly. “If you struggle with anxiety or depression you might have a thought journal and mindfulness exercises. If you are struggling with self-esteem or imposter syndromes you will likely be assigned affirmations and self love exercises. Homeplay is not mandatory but encouraged. I want you to have the skills to maintain the ‘new you’ long term and continue in your growth process even after we are no longer working together."

In the end, your therapist or coach is going to do what is right for you

“Our activities depend on your goals, what motivates you, and what has worked in the past,” says Krissi Franzen. “Most of our assignments involve being curious and experimenting, whether it's with coping strategies, grounding techniques, or practicing communication skills. If you're freaked out by homework, don't fret! If it's not a strategy that is successful for you, let's find things that do work!”

Mainly, you and your therapist or coach will work together to figure out what’s best. Be sure to share what’s working and not working for you so can find the best way forward for you.

“This is a conversation that we will have together!” says Em Kane. “If you're someone who enjoys being given homework and tasks for outside of sessions I can make that a component of our work. For others though this just adds stress, so it isn't necessary!”

Your therapist or coach is there to support you so you can get the care you deserve. Through your collaborative relationship, you can discuss how they can best facilitate your therapy or coaching journey. If you’re ready to get started, find your perfect match now. Still not sure if you might benefit from therapy or coaching? Our quiz might help.

“For some clients, homework is enjoyed, embraced and needed, however, not all clients like this,” says Christina Viera. “As a result, it is our job (client and therapist) to discover what works best for you, so that you can get the most out of therapy.”

Download MyWellbeing's 2024 Mental Health Planner!

Recommended reading, bring the spirit of the spa to your relationship, here's how to manage your negative thoughts, what is the difference between ssris and snris.

About the author

Caitlin is an organizational change strategist, advisor, writer, and the founder of Commcoterie, a change management communication consultancy. She helps leaders and the consultants who work with them communicate change for long-lasting impact. Caitlin is a frequent speaker, workshop facilitator, panelist, and podcast guest on topics such as organizational change, internal communication strategy, DEIBA, leadership and learning, management and coaching, women in the workplace, mental health and wellness at work, and company culture. Find out more, including how to work with her, at www.commcoterie.com .

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• Jan 30, 2023
• 26 min read

19 Tips to Motivate Clients With Therapy Homework- (Infographic)

Updated: Sep 14, 2023

Our team reached out to a group of therapists to find out what tips they had to offer on how to get clients to do their therapy homework. The infographic below is a collection summary of the quotes we received from 19 therapists.

While many of the interventions are known among professionals, each participant offers unique insight while answering the same question. The sessions that each therapist has with their clients are fantastic opportunities for discovery and figuring things out. The truth is that much of the learning and growth often come from the application of what has been discovered and figured out. In other words, you never get the full value of your in-person sessions without doing the homework!

Here are what our contributors recommended (you can find the full transcript and a link to the official article down below).

19 Therapists Weigh in On How to Motivate Clients Who Don’t Do Their Therapy Homework

Therapy sessions bring people to many new realizations. However, real learning takes place when a client attempts to apply these new ways of thinking and acting to their everyday life and to the goals they wish to accomplish. A big part of the process is the homework or exercises a therapist assigns to a client. If a client doesn’t do their homework, does this make the therapist's job much harder?

Below you will find the testimony of 19 different therapists that are weighing in on this very real and common occurrence. Each therapist gives their two cents on whether this issue is counter-productive, ways to get around, and more importantly ways to motivate their clients!

Tina Marie Del Rosario, LCSW, MSW, Adjunct Professor @ Pepperdine University

Owner of Healing Collective Therapy Group

https://healingcollectivetherapy.com

A common theme I see in people who lack motivation is the absence of self-compassion. Clients who show up faithfully are clearly displaying a form of motivation. But when it comes to doing the work, there are clients who meet resistance and acts of avoidance. .

What interventions have you found to be helpful in motivating clients?

I find that starting with a psychodynamic approach is necessary. Exploring what is coming up for the client when resistance and avoidance are present is often helpful. The thoughts, attitudes and emotions attached to these feelings have come from some past experience.

Identifying where it is coming from can help the client process said past experience(s) and recognize the lack of relevance it has to present day. More often than not, self-critical narratives are attached to the feelings of resistance.

These criticisms evoke both somatic symptoms and self-protection motivations that lead to avoidance. Becoming aware of what is coming up and how it is showing up is necessary to combat lack of motivation. Once identified, we can then work together to process it all and begin to change the narrative.

When clients realize their lack of motivation is not coming from “laziness” or “a character flaw,” they then can begin to remove the self-critical narratives and replace them with self-compassion.

With this new internal dynamic and the absence of self-criticism, clients find it easier to begin to motivate themselves to do the work.

Ellie Borden, BA, RP, PCC

Registered Psychotherapist, Clinical Director and Clinical Supervisor.

https://www.mindbydesign.ca

Resistance can be a common part of any change process. Some people struggling with different challenges may appear not to want to change. Even those clients who attend therapy loyally and recognize the need for change in their lives may fail to complete their homework or take the necessary steps outside therapy to modify their behavior.

This is a powerful moment in therapy and can give a therapist the insight necessary to recognize the deeper issues affecting someone's motivation to take the necessary steps toward the change they seek. Often, recognizing avoidant patterns or behavior is an opportunity to identify unresolved matters and the core elements that require healing.

Moreover, a therapist can help an individual reformat their why for change. It is important that someone's why is emotionally driven and leads to effortless motivation. The responsibility for change is the client's alone. However, a trained professional can give someone the objective perspective needed to get them moving in the right direction.

While a therapist can help a client become more motivated to change, ultimately, the onus is on the client to change. With that in mind, there are specific methods that therapists can use with clients to properly motivate them to make the needed changes in their lives.

One of the most widely used interventions for motivating clients is motivational interviewing. The goal of motivational interviewing is to help clients increase their intrinsic desire to change and achieve their goals in therapy. One of the techniques in motivational interviewing is bolstering the client's sense of self-efficacy by helping them recall examples of overcoming challenges in the past. This can allow the client to see that change is achievable and that the situation may not be as hopeless as they think. Developing discrepancies is another technique in motivational interviewing.

This involves a therapist helping the client voice their thoughts, feelings, and conflicts to call attention to the discrepancy between how the client is behaving and how they would like to behave. Motivational interviewing is a great way to help clients recognize their inner strengths and develop the desire to change.

There are many reasons why a client may resist taking the proper action discussed in therapy. One is fear of failure. Some clients, particularly those who are clinically depressed, do not have much faith in themselves or their ability to succeed. Even the slightest real or perceived setback can cause them to catastrophize or engage in negative self-talk such as I am so stupid or I am a failure who can never do anything right. With such a mindset, it is no wonder many clients are unwilling to attempt the steps required for positive change, even if they may truly desire to change. This is one reason why strengthening a client's self-efficacy is crucial.

Another cause of a client's resistance to change is a lack of clear goals. Some clients may struggle to articulate a vision of what desired change looks like, even if they sense that something has gone wrong. Helping the client develop a clear and realistic plan for change can give them additional motivation for following through with the often difficult and confusing work of pursuing meaningful changes in their lives.

Sarah F. O'Brien, LCSW, LLC

Thrive & Shine Counseling

https://www.sarahobrienlcsw.com

Without fail, as a therapist I will point out the discrepancy-mentioning to them how consistent they are with attending sessions, yet how inconsistent they are with completing homework. This usually sparks conversation and processing about why this may be happening for the client.

As a Clinical Social Worker, we are trained to assess a person fully within the context of their life circumstances, something we call BioPsychoSocialSpiritual assessment. With this, I may ask and find extenuating at-home circumstances that prevent clients from being able to complete homework i.e. too busy, not setting enough boundaries at work, ignoring self-care, over-committing to things that aren't beneficial to client's mental health.

What interventions have you found to be *helpful with motivating clients?

To increase client commitment to the change process, I use interventions such as:

*Psychoeducation* (explaining to them, with psychotherapy, most of 'the work' occurs outside of session to achieve desired change).

*Motivational Interviewing techniques* (to prompt and explore client reasons for lack of homework follow through and their awareness, if any, about this).

*Creative homework assignments* based on client's interests or talents (outside the box stuff that doesn't include worksheets or even writing anything down i.e. going for a walk and looking for different types of flowers or trees--this is a mindfulness practice. Or art/expressive assignments i.e. creating a playlist, making a collage or vision board, designing a room or space in their mind-- this is emotional processing, gaining new perspective, finding a safe 'place' to decompress).

*Encourage and suggest clients develop a reward system* for themselves for completing homework assignments (small gifts or tokens for completing that week's assignment, i.e. getting special coffee, taking an hour off work early, favorite dessert they rarely have etc. And larger tokens for consistent completion--every week for a month, for example, or tracking progress or having a breakthrough from the homework-- i.e. taking a weekend trip, taking a whole day off for self, purchasing non-practical or coveted item for self).

Although people willingly engage in therapy, the change process is often arduous and longer than we anticipate (or desire!). People lose motivation, it happens. Enjoyable assignments and rewards for completion are the external factors that motivate us until some positive change starts to occur. When noticeable, positive differences emerge from 'doing the work' outside of sessions, internal motivation often kicks in for clients and they WANT to keep doing homework BECAUSE it's producing the change they want to see in themselves.

Candace Kotkin-De Carvalho, LSW, LCADC, CCS, CCTP

Absolute Awakenings | Morris Plains, New Jersey

https://absoluteawakenings.com/

Therapy isn't a magic pill; clients need to work on their issues as part of the process. One strategy that may help is setting up firm boundaries. This can include scheduling regular appointments and requiring homework assignments between sessions. If a client repeatedly misses appointments or doesn't complete required tasks, it is helpful to schedule a check-in session to discuss this issue and help the client stay on track.

There may also be times when it's necessary to end therapy with a client who refuses to work on their issues. It can be challenging to make this decision, but it is important to do what's best for both the client and therapist to maintain a healthy professional relationship. If you are struggling with these issues, it may be helpful to seek out support from other mental health professionals or find a trusted mentor who can provide guidance.

Reflective listening and active listening can help clients feel heard and understood, which can ultimately motivate them to do the work. Reflective listening involves paraphrasing back to the client what you have heard them say. This way, empathy, and understanding are communicated, and the client feels more motivated to continue working on their issues. Active listening involves listening through nonverbal cues, such as eye contact, nodding, and facial expressions. This approach also encourages a client to articulate their own thoughts and feelings.

When it comes to doing their part in therapy, some clients may need additional support and guidance. This can include breaking down tasks into smaller parts, setting up time-bound goals, or providing positive reinforcement for progress made. If you give them homework assignments, check in with them at their next appointment to see how they are progressing and provide feedback or encouragement as needed.

For example, it may be overwhelming for some clients to make a major life change in one sitting, so you can help them develop a gradual plan to work toward their goals. Meanwhile, other clients may feel frustrated and unmotivated if they aren't making enough progress or meeting their goals quickly enough. In these cases, it can be helpful to provide positive reinforcement when they

make progress, such as offering verbal praise or tangible rewards.

Our behaviors are heavily affected by our thoughts, emotions, and environment. For clients who have been struggling with mental health issues for a long time, their thought patterns and coping mechanisms may be ingrained in their psyche. As a therapist, it is important to acknowledge that these behaviors may take time to change.

Often, this involves helping the client identify and understand unhealthy thought patterns and behaviors. This may involve identifying negative self-talk, challenging unhelpful beliefs, or learning coping strategies to better manage stress and anxiety. Accordingly, help the client focus on their strengths and build positive relationships with others. Acknowledging that they are working through a difficult time can provide support and motivation for them to keep going.

In addition, be mindful of your own thoughts and emotions as a therapist. For example, it is helpful to have regular supervision or check-ins with other mental health professionals so you can discuss any challenging client interactions. This will help ensure that your professional boundaries are maintained and that you provide the best support for your client.

Lauren Cook-McKay

Licensed Marriage, and Family Therapist and VP of Marketing at Divorce Answers

https://divorceanswers.com/

Although therapy is a two-way street in order to be successful, it's also a safe space for clients to be a mess. Dealing with incomplete homework usually involved capitalizing the inaction as a window to the realization of the issues they're dealing with in their lives.

Paradigm shifts were emphasized as a necessity, but the inaction itself is conceptualized as evidence of a barrier to wellness so it's leveraged for strategizing on better methods for management that are more suited to the client's capacities. We also make sure to leave room for these strategies to be adjusted until clients are ready to fully overcome their hindrances.

The most effective intervention that improves clients' motivations is the involvement of their support systems. Typically, the barriers they're facing and the reasons behind them being unpacked during the session bring forth the need to have sit-down talks with their loved ones. *Practicing that suggestion, they're able to verbally communicate the impact of the reactions and behaviors of the people around them which they've been repressing. *This frees them from their old self-concept and ultimately minimizes their hindrances.

After defining the specifics around the sequence of events that lead to the inaction of an assignment, analyses generally reveal that *clients feel unable due to complete them mostly due to the overwhelming pressure from expectations of accomplishing the assignment and/or apprehension of the mental labor being demanded by the task, as well as the potential impacts of the self-reflections that the task aims to bring to light. These reasons stop them from their tracks and/or deplete their mental energy to commit to the whole treatment.

Lawrence Barnier

Mental Health Officer

Women's Resources e-Information

https://www.wrei.org/

There are a few different ways to approach this situation. One way is to try to understand why the client is not doing the work. It could be that they do not understand what is expected of them, or they may feel overwhelmed and unsure of how to get started.

In these cases, it may be helpful to provide some guidance and support to help the client get started.

Another reason why a client may not be doing the work could be that they are not interested in changing their behavior. In these cases, the therapist may need to reassess the goals of therapy and decide if it is still appropriate to continue working with that client.

There are a number of interventions that can be helpful in motivating clients. One strategy is to set goals with the client and track their progress. This can help to provide feedback and encouragement and can help to show the client that they are making progress.

Another strategy is to provide positive reinforcement when the client demonstrates good behavior. This can help to encourage the client and can help to build a positive relationship with the therapist.

Finally, it is important to be understanding and supportive when the client does not meet their goals. This can help to provide motivation and can show the client that the therapist is there to help them.

Claudia Luiz

Psychoanalyst

http://www.claudialuiz.com

When clients “resist” in therapy, that resistance can yield more information than what the client can tell you consciously. If you focus on the resistances - why the homework isn’t getting done, why the client is stuck, why they can’t break negative patterns and integrate what they are learning - you are really getting into the zones that the client hasn’t been invited yet to explore.

We now know from neuroscience, the three areas of the brain that can hijack conscious effort. Fear, rage, and grief. When people are afraid of feeling things, they get stuck.

Neuroscience gives us a model for what the patient may be resisting. The other emotional zones, seeking, play, and love can be engaged in this exploration. The framework gives us a way of thinking of the clients' “stuckness” in a productive and creative way.

Joining the client in their “stuckness” with compassion and curiosity, while shifting the framework of what you are ultimately working on, avoids power struggles, or potentially shaming the client. It lets them know compassionately that we understand about resistances, and that talking more about feelings can hold the key to unlocking the mystery of what is standing in the way of progress.

Elisa Tidswell

Certified Coach and Therapist, Committed to Empowering Women, Breaking

Negative Generational Cycles, and Creating Economic Justice

https://elisatidswell.com

It's vital that therapists understand how to keep their clients accountable to their growth. Accountability is where therapists help their clients take action that will help them grow - and action is the only place where transformation takes place. Transformation is what clients pay their therapists for.

It's also really important that therapists get really good at accountability, otherwise, they can actually wind up demoralizing their clients. After all, if clients don't do their homework consistently they are likely to internalize it, believing that there is something wrong with them or that they are failing. This is the polar opposite of what therapists want for their clients.

So how can therapists help their clients do their homework? By cultivating an environment of curiosity and learning. Accountability is not about judgment or being 'told off', however, sadly this is exactly what many people believe it to be: they learned about accountability from their parents and school environments where not doing homework or handing in sub-par homework was met with shame. It's really important for therapists to dispel this mindset and ensure their clients know that accountability is about learning.

The best approach I have found after coaching hundreds of clients to stay accountable is to include three main parts to the accountability conversation. The first is for the client to share a win: something positive that's happened since they last met with their therapist. This could be an insight, a decision, a process (such as 'I felt my feelings!'), or something extrinsic, such as a pay rise. Sharing a win is important to put the client in a state of abundance and is commonly used by positive psychologists in their practice.

The second part is to consider a goal or homework that the client did do, and break it down to see why they did it. For example, what were they thinking, how were they feeling about it, how did the goal tie in with their values, what was their motivation to get it done, did they tell others about it, had they put it in their diary, and so on. The therapist and the client want to learn about what works for them so that they can double down on it.

The third part is to consider a goal or homework that the client didn't do and then see what they can learn from why they didn't do it. Was the goal too big and overwhelming, and actually needed to be broken down into smaller steps? Were they clear on how to get started with the homework or was their understanding fuzzy? Was the homework tied in with their vision or values? Had they put it in their diary? Did they have support from others? Was a limiting belief getting in the way? Once the therapist and client have learned more about why they didn't do it, they can create a new goal to support them in achieving the original one.

The best action a therapist can take in supporting their clients with their homework is to let go of judgement and to a growth mindset. They have to see accountability itself as a learning exercise where they can explore

what's going on for the client, and understand what works for them.

Trish Glynn, LMHC, CRC

Licensed mental health counselor

Owner and therapist at The Carey Center

https://careycenter.squarespace.com/

Therapy is all about meeting the client where they’re at. Of

course, therapy will work best when the client is actively engaged both in and outside the therapy room. Results tend to be better and come faster. But not everyone is doing the work when they leave the appointment. There can be many reasons as well as many ways to address this. As a therapist, you want to try to figure out the “why” as that will help you determine next best steps.

For example, maybe you’re assigning work that is “too much” or isn’t a good fit for them. Are you asking a client to journal every week when sitting down to write is a mismatch for them?

Part of therapy is figuring out why the client is stuck. That takes time and talking about it in order to understand what the individual reason and best response may be.

In some cases, we just need more details, and so we keep talking and exploring to figure it out.

The client has a reason for what they do or don’t do – and therapy is about finding that out. Progress can come from discussing things the client has maybe never talked about with anyone before.

Also, it can be helpful to seek out some emotionally compelling reasons for change. If you can come up with some really meaningful “why” that speaks to the client, that can create a shift. Logic is often useless. We often know why we should do things. Yet, we don’t. But emotion can get us moving. What interventions have you found to be helpful in motivating clients?

A lot depends on client preference. As a therapist, it’s important to build rapport and get to know who is in front of you. That’s the ideal way to figure out what will work best for them. Because something can be incredibly effective, but if it’s not a good fit for a particular person, it won’t matter. Often, an eclectic approach is best. We are all so very different. One of the most important elements in therapy is the relationship. That matters more than any particular intervention. That’s why people go to therapy to talk to someone – a self-help book, for example, can list out some

interventions, but nothing compares to the human relationship, the rapport, the empathy, and the positive regard, which occurs in the therapy room. You can’t buy that off a shelf. Elaborate on any details you find helpful for explaining the mindset of the client and how it changes.

Therapy involves understanding the current mindset of the client. We want to understand if it’s fixed, or more growth-oriented, for example. We want to consider how their mindset both helps and hinders them. It’s usually a fixed mindset that gets us into trouble. We think we can’t change and our circumstances, too, can’t change. We will give up more easily and ignore helpful feedback. With a growth mindset, we know we are a work in progress. We are more open to accepting challenges. We are more able to seek them out.

Changing from fixed to growth involves challenging current thoughts. For instance, you can get stuck making a lot of false assumptions. You can begin to question your thoughts. Is that true? How do I know? What else might be happening here? Am I being too black and white, and missing the grey areas?

We have to notice where our mindset is now. Then we begin questioning it. We begin really getting deliberate about looking at our thoughts. For most of us, we don’t really spend much time if any thinking about our thoughts. It can help to start pausing to consider what thoughts are in your mind. And then we can start examining them and challenging them. And that’s when we can begin to create a shift. We can’t change what we don’t look at and understand.

Janelle Marshall, LPC

Marshall Gray Counseling Services

https://www.marshallgraycounselling.com

How do you navigate clients who faithfully come to therapy, but don't do the work?

I check in with the client and help process any challenges that are interfering with their ability to do the work. Sometimes the perception of the client not “doing the work” is an indicator of emotional trauma or blockage that needs to be processed.

Journaling is one of my favorite interventions to share with clients. I find it helpful for clients to visualize their therapeutic goals and their thoughts behind how their lives will reflect the efforts attempted. Habit tracking is a tool that helps take motivation a step further with clients that are committed to the therapeutic process. I have a collection of reflective habit tracker journals that serve as a guide to help the user align their actions with their desired goals.

As a solution-focused therapist, I help prepare my clients to embrace the evolution of their mindset throughout our journey together. It’s also understood that the client’s anticipated mindset change is contingent upon their willingness to commit to the work assigned in and out of the session.

Miriam Manela

The Thrive Group

https://childrenbloom.com/

The best motivation for clients is first and foremost for the therapist to let go of having a NEED to change their client, to let go of convincing their client to change and to simply allow the client to do what they have been doing and nothing different.

I usually tell clients, without any judgment, but just to give them an awareness that typically when the follow-up program is kept then results are significantly faster. If there is no follow-up done, that is okay, I just like them to be aware that therapy can take quite a bit longer then.

The third technique I use in therapy to motivate clients to change from within themselves is to create intentions. Rather than giving the client something they need to do, I would make an intention with them, which they could say once a day to give themselves the awareness of their challenge. Or if not, they may only use their intention once a week when they come to me for a session.

An intention would sound something like, I noticed that when someone questions my authority, I get very agitated. or I noticed that when my child comes home from school, or my boss walks into my office I feel flustered, overwhelmed, frustrated or anxious, etc. So without needing to tell the client to do any specific exercise at home, we've instead created together an intention to repeat every day to give themselves awareness. I may have them create a reminder on their phone with it or post a sticky note in their bedroom or bathroom.

Just remembering their awareness helps them remember what to do to calm down, on their own.

Danielle Bagus, MSW, LSW

Relief Mental Health

https://www.reliefmh.com

When a client seeks out therapy, faithfully attends without fail but once in session we are going over the same issues over and over again and I have found they are not doing the work on themselves outside of the therapy sessions, I attempt to look for a support system that may help them.

This might be a significant other, a parent, sibling, friend, etc. I ask who is in their close circle who they trust to help hold them accountable. I will also hold them accountable but sometimes encouragement coming from a loved one or someone they don't want to let down will mean more.

I also have found that the homework might not necessarily match up with their skill set or what they are willing to put in at that time. Therefore, as their therapist, it's my responsibility to find a new method or way to connect with the client and help them be successful.

One size does not fit all when it comes to therapy. Therapists need to have lots of tools in their toolkit to meet the needs of the client and ultimately to meet the client where they are in the process of therapy.

I think this can really depend on the client and what they need out of therapy. I find that Cognitive Behavioral Therapy (CBT) works the best to motivate my clients to continue to do the work outside of therapy. CBT helps people with such a wide range of mental health issues and ultimately helps with really digging deep to find new ways of thinking, coping and behaving in certain situations.

Clients seek therapy for many different reasons. Some want to change their mindset, some wish to seek outside advice or help on a specific situation or topic (divorce, relationship, school based issues, family issues, etc.), some come because they have been diagnosed with a mental illness (bipolar, depression, schizophrenia, eating disorder, OCD) and need help maintaining a healthy mindset, some clients want an outside person to just listen, the list goes on. As a therapist, you are there to be an impartial, nonjudgmental resource for the client. You are there to help them realize different ways of doing things and different ways of thinking.

The client takes the first step in seeking out therapy but also needs to be the one doing the work and willing to change what they have always done with the guidance of their therapist. It's important for the therapist to always ask what the client wants out of therapy or a specific session. Sometimes the client doesn't know but I think our clients are more self-aware than they realize. If you can ask the right questions, they ultimately will tell you what they need, want or expect to get out of therapy in general or even a specific session.

Kellie Brown, LMHC, NCC, MCAP, (she, her)

Licensed Mental Health Counselor (LMHC)

Owner of Quiet Water Counseling in Florida

https://www.QuietWaterCounseling.com

Oftentimes when a client comes regularly to therapy but does not want to do work outside of sessions it comes down to the client being afraid of making changes in their lives. People get so use to doing things one way it is very hard to change directions and try something new.

So instead of setting clients up for failure by giving them a huge homework assignment that is very likely overwhelming and they probably won't do, I give them very small tasks to accomplish.

So instead of giving a client the homework assignment of going to an Alcoholics Anonymous meeting or joining a gym, I ask clients to research AA meetings, or research local gyms. The next week I might ask them to just drive to the location of the meeting, or drive to the gym location, but tell them they don't have to go in, I just want them to physically see where it is located.

Giving smaller homework assignments tends to help break down a huge change into something more manageable.

Elizabeth Mateer, MS, MA, LMHCA *(she/her/they)

Director, Divergent Wellbeing https://www.divergentwellbeing.com

Lead with curiosity. Asking why didn't you do X this week like we talked about automatically leads to defensiveness and shuts down motivation to discuss what happened. Something like After our conversation last week, you seemed excited to work on using that coping skill. I'm curious about what the barrier was when you thought about applying it this week. This framing allows the client to explore the *process* of doing the work, rather than the content of I didn't do it.

Don't let it go. As therapists, we tend to feel compassion and understanding toward our client's challenges. While this is an important skill in many aspects of therapy, it can sometimes be tempting to let it go when our clients are consistently not doing the work outside of therapy. This is not only avoidant ourselves, but it doesn't serve our clients by teaching them to take accountability for their well-being. We can still be compassionate while being direct.

Meet them where they are at. Clients know when they aren't doing what they said they would, and yet, they are still showing up. That says a lot about the relationship and trust you've already built with them. Highlighting any progress you see, regardless of how small, is an effective way to motivate clients to continue moving forward. Sometimes these clients just move at a slower pace than others we see coming into therapy ready to take action, and that's OK.

Self-reflect on what we are asking from them and if it is too much. Sometimes as therapists we see the potential a client has and give homework assignments that are beyond what is realistic in the present moment, especially if we have seen our clients for a long time and have an idea of what they are capable of. Is there a way to break down the work into smaller, more achievable pieces? For some clients, if a task seems too aspirational or unrealistic, they won't attempt it at all. Smaller steps towards progress are better than no progress at all.

Steve Carleton, LCSW, CACIII

Gallus Detox

https://www.gallusdetox.com/

Navigating clients who come to therapy but don't complete their homework can be difficult and often requires a tailored approach.

The first step is to create an honest dialogue with the client about why they are not completing the assigned tasks.It could be that the tasks are too challenging or time-consuming, or that they don't understand what is expected of them. It is important to understand the underlying reasons behind the lack of motivation, and build a plan together that works for both parties.

The next step is to offer alternative homework assignments that are tailored to each individual client's needs. This could include reading an article or book related to the problem being discussed in therapy, journaling about their thoughts and feelings, writing a letter to their future self, or attending a workshop or class related to the topic. It might even be more helpful to ask your client what they would like to work on or what they would find most helpful. This will help to make the homework assignments more meaningful and will give them a sense of ownership over their progress.

The last step is for the therapist to provide ongoing support and accountability for their client's progress. Check-ins at the end of each session are a great way to ensure that homework is being completed, and providing regular feedback can help the client stay motivated. Above all else, try to create an environment of understanding and acceptance that encourages your client to be open and honest about their progress. With patience and dedication, you can help your clients reach their goals.

Nirmala Bijraj, LMHC, NCC, She/Her/Hers*

Aligned Self, LLC

https://alignedself.co

I explore with them why they don't do the homework, what about getting it done, and doing it, makes it difficult.

I usually start with the least possibly intrusive change. We explore the change they want to make, identify the first step and then explore how to incorporate that change with the least amount of barriers and effort possible to start to build a new habit.

I've found if we start with something that feels like the least amount of effort, takes the least amount of time, and is the least intrusive on their life and schedule, then the client is most likely to do it.

For example: A client wants to work out in the mornings: *(this is a real scenario that I've worked with clients on with these steps). We start with building the habit of getting into gym clothes first thing in the morning when they wake up, the goal is to start the habit, we don't focus on how many times they work out or if they work out at all, just starting the first part of the process.

Then a week or two later or more depending on the client, we would add a 10-20 minute workout, something that they can actually make the time to do, 5 minutes if that's all the time they have to start with, again the least amount of effort that will help them start building the habit. And then continue to build on that habit until they're where they want to be with that goal.

Lindsey Ferris, MS, LMFTA

Individual & Couples Psychotherapist

https://www.talkhealthrive.com

If I notice that clients are coming regularly and sticking with therapy, but I'm not seeing progress or an effort to do out-of-session homework. I will bring this up directly to the client to ask them what they are seeing and how they are experiencing therapy. If they are seeing the changes and growth, they want to see, then I'll have them elaborate on this so I can understand from their perspective what growth and change looks like.

Oftentimes it takes checking in with my client to learn that they in fact are feeling the benefits and see growth in themselves in different ways than what I may be looking for, and it is a good idea to level set vs. assume that 'work' isn't being done or growth isn't happening.

If I find that clients are resistant to homework, or not making progress towards their therapeutic goals, I will address this directly and ask them what is getting in the way of doing homework and impacting their ability to engage fully in their therapy process. This can often lead to areas that need to be addressed first, before other priorities, so that any

therapy-interfering behavior can be resolved and progress can continue.

I find that oftentimes addressing directly with clients what I am observing in therapy interfering behavior or lack of compliance to homework can lead to thought-provoking insight and dialogue and instigate a change in how the client sees the way they show up for therapy. Once it is out on the table as a barrier to therapy compliance, the client and I can have an open dialogue about when either of us see it coming up in the room to work towards behaviors and changes that they want to see. When a client has insight into patterns that may be blocking them from growth, it can be a true aha moment that changes the engagement and adherence to therapeutic homework and growth.

William Schroeder

Licensed Counselor and Owner of Just Mind LLC

https://justmind.org/

Every therapist has clients like this and it's a helpful thing to not beat around the bush about. If you notice someone is saying they are motivated and then not doing the work, the meat of the therapy is digging into what's getting in the way.

Motivational interviewing could be one way to approach this. On a scale of 1-10, how motivated are you to see X change. If it's low, then that's helpful to know and you might need a new target. If it's high and there isn't follow through, then you need to see what ideas they have that might help them have success and assess their perception of those as well.

Sometimes trauma can get in the way and it can help to make sure this is properly assessed. There are a number of trauma screens but trauma can be a big barrier to change if it's not dealt with. Things like EMDR can be helpful in treating PTSD, for instance. 100% of single-trauma incidents and 77% of multiple-trauma survivors no longer met the diagnostic criteria for PTSD after 6 fifty-minute EMDR sessions.

It also can be helpful to assess ADHD to see if that's possibly a complicating factor. The World Health Organization has a simple test clinicians or clients can use to see if they might meet criteria.”

Alexandra Alex Cromer, LPC

Thrive Works

https://thriveworks.com/richmond-therapy/

A great tactic to navigate this is to have an honest conversation on their progress and introduce them to your theoretical framework/how you judge and measure client success.

The Transtheoretical Model of Change is my personal favorite, and it takes into account client motivation and any barriers that might be keeping them from making continued progress.

Another tactic is to discuss one of the main goals of therapy with a client; making the client more effective in their daily lives. Through this lens, we can invite the client into a bidirectional conversation in which we discuss progress and change as well as ways in which they believe your time together in therapy is effective.

I tend to favor a lot of motivational interviewing techniques as well as cognitive challenging skills to help motivate clients. If a client is faithfully attending session but is not doing the work, we could ask them a cognitive challenging question to get them to explore and identify their current patterns and routines and the efficacy of these.

Motivational interviewing techniques are similar in this way, in that they require work and active reflection on the part of the client in order to answer the questions. The most effective techniques to motivate clients are the ones which require the clients to do active work and are not closed-ended questions. The more you can allow a client to engage in self-reflection, research shows client motivation and propensity to change increases.

One of the biggest frustrations that therapists experience is a client who is seemingly not putting in the work or reportedly making progress and change. It's very common for a therapist to assume that a client is unwilling to change and is purposefully resistant to the process. Often, this is not the case and the client's stagnation can be better explained through a theoretical lens. For example, using the Transtheoretical Model of Change, we can identify that client barriers to progress come in the form of fear of failure, anxiety, and perceived low self-esteem, rather than willful ignorance.

Honest, direct conversations with clients allow them to see themselves through your perspective, and vice versa. Typically, research shows that clients who have a high sense of self-efficacy have a higher propensity to engage in change making behaviors. Therapists can increase client self-efficacy by continuing to engage clients in

Self-reflection.

Wrapping up…

The bottom line is that when clients do their homework things progress quicker, but when clients DON’T do their homework, we get new insights to resistances and what is actually going on inside. Thank you to all the fantastic therapists that contributed to this article! With great insight comes improved well-being.

You can find the original article published here: https://www.psychreg.org/therapists-weigh-how-motivate-clients-who-dont-do-their-therapy-homework/

Feel free to download the interactive PDF but don't forget to share the link to our page!!

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Homework in Cognitive Behavioral Supervision: Theoretical Background and Clinical Application

1 Department of Psychiatry, University Hospital Olomouc, Faculty of Medicine, Palacky University in Olomouc, Olomouc, The Czech Republic

2 Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, The Slovak Republic

3 Department of Psychotherapy, Institute for Postgraduate Training in Health Care, Prague, The Czech Republic

4 Jessenia Inc. - Rehabilitation Hospital Beroun, Akeso Holding, Beroun, The Czech Republic

Ilona Krone

5 Riga`s Stradins University, Riga, Latvia

Julius Burkauskas

6 Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania

Jakub Vanek

Marija abeltina.

7 University of Latvia, Latvian Association of CBT, Riga, Latvia

Alicja Juskiene

Tomas sollar, milos slepecky, marie ociskova.

The homework aims to generalize the patient’s knowledge and encourage practicing skills learned during therapy sessions. Encouraging and facilitating homework is an important part of supervisees in their supervision, and problems with using homework in therapy are a common supervision agenda. Supervisees are encouraged to conceptualize the patient’s lack of homework and promote awareness of their own beliefs and responses to non-cooperation. The supervision focuses on homework twice – first as a part of the supervised therapy and second as a part of the supervision itself. Homework assigned in supervision usually deals with mapping problems, monitoring certain behaviors (mostly communication with the patient), or implementing new behaviors in therapy.

Introduction

The development of competent clinical supervision is crucial to effectively training new CBT therapists and supervisors and maintaining high therapy standards throughout their careers. 1 Clinical supervision is a basis for CBT training, but there are only a few empirical evaluations on the effect of supervision on therapists’ competencies. Wilson et al 2 in their systematic review and meta-analysis, synthesized the experience and impact of supervision for trainee therapists from 15 qualitative studies. Although supervision leads to feelings of distress and self-doubts, it can effectively support supervisees in personal and professional development. It could similarly harm supervisees’ well-being, clinical work and clients’ experiences. Alfonsson et al 3 published a study to evaluate the effects of standardized supervision on rater-assessed competency in six CBT therapists under protocol-based clinical supervision. This is one of the first investigations showing that supervision affects cognitive behavioral competencies. Although several works have studied the effectiveness of supervision on the therapist’s competence and for the therapist’s work with patients in qualitative studies, 3–7 there is still a lack of studies that dealt with the importance of homework in supervision.

Homework is a vital element of cognitive behavioral therapy (CBT) which distinguishes it from many other psychotherapeutic approaches. 8–10 Patients usually participate in therapy by completing homework assignments and taking responsibility for their course.

Assigning and discussing homework is one of the basic competencies of a cognitive-behavioral therapist and a supervisor in the context of counselling, psychology, therapy, and social work. The manuscript aims to refer to homework in several settings: homework in therapy, supervision of homework in therapy, using the homework by the supervisor for the supervisee, and homework in the training of supervisors.

Homework in Therapy

While specific recommendations for the practical usage of homework have been clearly articulated since the early days of CBT, 11 , 12 practitioners state that they do not follow these recommendations. 13–15 For example, many physicians admit that they forget homework or do not focus on standard specifications when, where, how often, and how long the task should last. Often reported non-cooperation in homework assignments may be due to the practice recommendations being too strict or because students think the amount of homework they can assign is limited. 16

The Sense of Homework in the Therapy

Patients verify methods and skills they learned during the session in real situations and the natural environment. 9 , 17 Through homework, patients also test hypotheses that emerged during the session with the therapist (for example, “If I went out on the street alone, I would be so weak that I would pass out or lose control completely”). Homework help that the important part of the therapy takes place between sessions and allows the patients to become independent and manage their problems even after the end of therapy. 10 , 18 Patients learn how to raise hypotheses and test them in real-life situations. Through completing homework persistently during the therapy, patients gain skills on how to plan their activities and gain new skills, and they also collect a rich source of therapeutic diaries. The investigations advocate that adding homework to CBT increases its efficacy and that patients who constantly complete homework have better outcomes. The outcomes of four meta-analyses highlight the value of homework in CBT:

• Kazantzis et al 10 inspected 14 studies that compared results for patients allocated to CBT without or with homework. The average patient in the homework group reported better results than about 70% of controls.
• Outcomes from 16 studies 17 and an updated analysis of 23 studies 19 discovered that higher compliance led to better treatment results among patients who received homework projects during therapy.
• Kazantzis et al 20 studied the relationships between quantity (15 studies) and quality (3 studies) of the homework to treatment results. The effect sizes were medium to large, and these effects remained fairly constant in a 12-month follow-up.

Therapists strategically create homework to reduce patients’ psychopathology and encourage them to practice skills learned during therapy sessions; nevertheless, non-adherence (between 20% and 50%) remains one of the most cited reasons for decreased CBT efficacy. 21 Several reasons for non-adherence to homework might be pointed out –the therapist does not regularly discuss homework with the patient, the patient no longer considers it important and stop doing it. 9 , 22 Discussing homework also allows the therapist to strengthen the patient’s belief in their ability to achieve certain goals. 23 The fact that the patient has completed the assignment must be properly acknowledged, and then therapists discuss the quality of homework separately. 24 Good questions might be, “How did you do your homework? Were there any difficulties in fulfilling them? What kind?” Furthermore: “How can you handle these problems next time? What did you learn while completing your homework? Can it help you cope with other issues?”

How to Increase the Effectiveness of Homework in the Therapy

Homework is the most effective, and it is most likely to succeed if: 19 , 25

• Follows logically from the topics discussed during the session and uses the methods that the patient learned during the session;
• they are clearly and concretely defined, so it is easy to determine whether or to what extent the patient has been successful in fulfilling them (eg, “Leaving the house alone for at least 30 minutes every day”, not “Starting to go out alone”);
• the patient clearly understands their meaning (“To verify your belief that you will faint on the street” or “See for yourself whether your anxiety will continue to rise, remain the same or subside after a certain time”), and they believe they can achieve the goals;
• homework is formulated so that failure is impossible because, in any case, the patient will learn something useful that will help them in therapy;
• the therapist anticipates and discusses obstacles that could hinder the fulfilment of homework and plans procedures to overcome them.

An important aspect of CBT is the patient’s independence. 10 , 18 Homework is typically determined by consensus. To increase the likelihood that the patient will complete the homework, the patient and the therapist should document their assignments in writing. Additionally, it is very convenient for the patient to record the homework, typically pre-prepared. 24 These records serve as a basis for discussing homework in the next session and also allow the therapist to assess the changes achieved during therapy (“A month ago, you were able to go out alone for only half an hour and your anxiety level previously reached level ‘9’, while now you were alone outside for more than an hour and your anxiety do not exceed ‘5’ rated subjectively”).

Because the goal of therapy is to help the patient experience success, the patient’s assigned homework must be feasible. 18 , 26 On the other hand, patients should improve their ability to cope with problems and unpleasant conditions during therapy, they need to exert significant effort to overcome certain unpleasant feelings and emotions. 19 , 20

Even if therapists follow all these rules, they will unavoidably find that sometimes the patient does not complete assigned homework. 20 , 23 In this case, it is required to find out why this happened:

• whether the patient understood what the task was and what it meant
• whether mastering this exercise is important and motivated
• whether unforeseen circumstances prevented them from fulfilling it
• whether the assigned exercise was not very demanding for them in their current mental state

Therefore, therapists do not consider the non-fulfilment of homework a priori as a manifestation of resistance or lack of moral qualities on the patient’s part, then as a problem that must be solved together.

However, if, despite a thorough discussion of homework and agreement on its completion, the patient repeatedly does not even attempt to complete it, does not bring records and fails to justify non-compliance, it is necessary to return to the problem analysis and goal-setting. We need to clarify with the patient whether the problem they are currently dealing with in therapy is really the most important for them, whether the goal they seek to achieve is sufficiently desirable, and whether the therapist offers to achieve is acceptable. 9 , 20

Most practicing CBT therapists report that they use homework and consider homework important for many problems 14 and believe in the role of homework in improving therapeutic outcomes. 24 , 27 Encouraging and facilitating homework is a basic skill of a CBT therapist; therefore, it is an important part of supervision. 19 , 20 , 26 Homework needs to be carefully assigned and discussed ( Box 1 ).

Case Vignette – Discussion About Not Completing Homework with an Anxious Patient

Kazantzis et al 28 advise examining the therapeutic relationship, which significantly impacts therapy adherence, to better comprehend non-cooperation with homework assignments. Data illustrating the therapist’s homework competence and the therapy outcome 29 , 30 show that the therapist is primarily responsible for their patients’ adhering to or failing to do homework. CBT therapists exhibit many interrelated automatic thoughts, assumptions, and behaviors during sessions that affect homework use in therapy. 8 , 15 In training, common negative attitudes for therapists include: “Homework will make patients feel like school and resent!” “They will feel too controlled and limited!”; “Homework will increase some ps’ sense of vulnerability!”; or “Homework will be even more stressful for stressed patients!” Another widespread belief is that the “structure” of CBT, whose homework is important, reduces spontaneity and worsens the therapeutic relationship. 15

In addition, there is some scientific support for these views of therapists’ attitudes toward homework concerning the therapeutic process. 31 The result of these attitudes is either a complete avoidance of homework assignments in a way that is not effective and consequently maintains these beliefs. 8 For example, common behaviors require supervision, such as rapidly discussing directions at the end of a session, neglecting to repeat homework, or failing to justify while designing homework. 9 The CBT Homework Project proposed a practice model 29 that emphasizes the importance of therapist beliefs, therapist empowerment, cognitive conceptualization, and the therapeutic relationship in enhancing homework practice. 23

Theoretical and empirical support for homework assignments in CBT leads most practicing CBT therapists to at least accept in principle that regular and systematic homework assignments will benefit their patients. 8 As a result, CBT therapists favour assigning homework in therapy. However, many beginning therapists encounter problems when they start designing homework (ie, selecting tasks and discussing them with the patient), assigning homework (ie, collaborating on practical aspects of completing homework), and repeating homework in sessions. 32 Incorporating homework into therapy is often superficial, hasty, poorly done, or forgotten. 16 Therefore, problems with using homework in therapy are a common supervision agenda of practicing CBT therapists.

Personal Training and Self-Reflection of the Therapist as a Supervision Intervention

CBT training students are encouraged to conceptualize the patient’s lack of homework and promote awareness of their own beliefs and responses to non-cooperation in the CBT conceptual framework. 8 Suppose the therapist fails to develop this awareness. In that case, errors in clinical judgment may occur, adversely affecting the therapeutic relationship and course of therapy. 33 Self-exercise (practicing CBT techniques and interventions as a therapist) and self-reflection (ie, process reflection) are concepts developed by Bennett-Levy et al, 34 to operationalize a useful understanding of own processes in working with patients. CBT training students are asked to become accustomed to using self-exercise and self-reflection. In a few qualitative studies, self-exercise and self-reflection have proven to improve the therapist’s self-concept, ie, self-confidence, perceived competence in one’s abilities and belief in the effectiveness of the CBT model. 34–36 Calvert et al 37 study checked the use of meta-communication in supervision from supervisees’ perspectives using the Metacommunication in Supervision Questionnaire (MSQ). There were differences in the reported frequency with which the different types of meta-communication were used. It appears that meta-communication around difficult or uncomfortable feelings in the supervisory relationship occurs less often than other components of meta-communication. 1

Below are examples of self-exercise and self-reflective exercises. The following self-assessment is developed to shape thinking before a preliminary meeting with a supervisor. Earlier knowledge has shown that supervisees and supervisors do not always share common ideas about supervision. Therefore, the supervisee could finish this self-assessment as a homework exercise before supervision. A supervisee might want to identify conversation matters that may enable a supervisor to better comprehend their requirements and needs.

Before Starting

Questions regarding previous and desired experience in supervision.

What background information do you think your supervisor requires to understand you at the start? (This may include a curriculum vitae noting appropriate previous experience). What would be the best method to convey these details? Is there any distinction between what you desire from this placement and what you feel you need? What background details about this placement and this supervisor do you have? How does this make you feel? Exists any more information that you need? What do you want and expect your supervisor to concentrate on during supervision? What roles do you want your supervisor to play with respect to you and your work? What supervisory media do you want to experience (for example, taped, “live”, or reported)? What do you intend to do about your feelings? Consider how you feel about your supervisor evaluating your work at the end of the positioning process.

More Specific Questions

• What specific activities during supervision do you recall as being helpful?
• What conditions would be most convenient for you?
• What would you personally anticipate getting from being supervised?
• However, what would you want to receive from supervision prepared that will not be on offer?
• What could you do about this?

Several possible tough issues can appear in supervision. The following list includes concerns the supervisee might consider ( Table 1 ).

Difficulties in Previous Supervisions (Adapted According to Scaife 2019 38 )

In the next step:

• Recognize the two issues which seem to be the most important ones for you.
• What steps can be taken now to minimize the chances that these two concerns will seriously disrupt your cooperation?

Reflection on the Strengths

What are the top three strengths you want your supervisor to uncover as you enter this supervisory relationship?

List 3 points for your development that may or might not be obvious to your supervisor.

Reflection on Difficulties

Therapists regularly discover face-to-face contact with people labelled by society as coming from a specific sub-group.

Which sub-groups make you feel uneasy for whatever reason? Do you want to address this during supervision? 38

Examples of Self-Assessment in the Supervision Process

Exploring sources of stress from clinical work.

Check all that resonate for you. 39

❑ Perfectionism ❑ Fear of failure ❑ Self-doubt ❑ Need for approval ❑ Emotional depletion ❑ Unhealthy lifestyle

Which of them seems to have the greatest impact on your stress levels?

What supervisor has most regularly identified as weak points in your clinical work?

Processing Mistakes

When mistakes are processed in ways that lead to reflection, flexibility, and adjustments in how you function, it can result in learning and growth.

Consider a patient you are now working with (or have recently worked with) with whom you have experienced a therapeutic failure.

Answer the following questions while keeping this experience in mind:

• What are the signs of a therapeutic failure? How can you be certain that what you are doing is not beneficial on some level? What benefits might your patient derive from failure? When did things begin to deteriorate? Which initiatives have been most effective so far, and which have been least effective? How have you been careless?
• Examine your intervention choices as well as how they were carried out:
• What concerns or considerations did you overlook? What is impeding your ability to be more effective? How has your empathy and compassion for this individual been harmed? How can you use this experience to help you grow?

Reflection of Therapeutics Mastery Skills

Favorite techniques.

• Explain three things you have put off in your career or life because they appear risky—you have something to lose and gain.
• Which therapeutic strategies or interventions stimulate you the most?
• What would you call your “hidden weapon”?
• What kind of patients or presenting difficulties interest you the most?
• What would it take to incorporate more of the pleasure and satisfaction you receive when applying the strategies mentioned earlier into other aspects of your work? 39

The following examples from clinical supervision demonstrate how self-exercise and self-reflection can help participants understand their belief system’s impact on homework in CBT.

Supervision of Homework in Therapy

Supervision is classically mandatory for students in cognitive behavioral training and plays a crucial part in therapist development. 2 The typical structure of continuous supervision of one patient includes discussing questionnaires or scales used to measure the severity of the problem (like the Beck depression inventory), homework, events in therapy since the last session, and then discussing the agenda of the current supervision meeting (what will be done in the session, which problem will be addressed), work on a selected issue or problems, homework assignment, session summary and its evaluation by the supervisor. The supervision focuses on homework twice – first as a part of the supervised therapy and second as a part of the supervision itself ( Box 2 ).

Case Vignette – Discussion About Patient´s Homework During Supervision

Whether and how the patient completes homework is a common supervisory issue ( Box 3 ). The therapist often complains that the patient refuses to do homework or rarely does it. 8 , 16

Recording of Paul’s Automatic Thoughts

The picture describes the vicious circle of countertransference reaction, where automatic thoughts lead to developing negative emotions, bodily reactions and behaviors. Any vicious circle components can alert the therapists that their countertransference reaction is taking place.

Case Vignette –Discussion of Setting Homework During Supervision

Homework in Supervision

Homework assignments are a common part of supervisory work. These may involve the patient’s management (eg noticing on their recording how often the therapist strengthens the patient and how and if it is rare to clarify where reinforcement would be appropriate), working on oneself (eg clarifying experiences and attitudes that lead to countertransference in a particular patient, awareness of which other patients may also occur) and theoretical study (the supervisor may advise the therapist to read a professional text that can help better understand and work with the patient). 40

The supervisor helps define a specific engagement, discusses specific therapeutic methods, touches on what methods the therapist has used and what else they may consider the role, for the most part, the implementation of strategies whose ability to use in therapy under supervision will be planned, as part of homework.

Homework assigned in supervision usually deals with mapping problems (supplementing the conceptualization of the case, evaluation, vicious circle of the problem with the patient, etc.), monitoring certain behaviors (mostly communication with the patient), or implementing new, behaviors in therapy (usually using therapeutic strategies). 12 Homework teaches the supervisee to work on self-reflection outside the supervision meetings. 41 Discussing the homework properly at the beginning of the session is important. The mentioned home exercises usually concern the work with the supervised case report of the patient. The basic questions concern homework results, discussing the obstacles in solving them and what the supervisee learned in homework. 8 The discussion gives the supervisor case management information and can point to important practice moments.

Homework Assignment

Before the end of the session, the supervisor and the supervisee agree on a homework assignment. It is optimal when homework arises from a problem addressed in the session’s main part. 8 At the beginning of supervision, proposals for homework assignments usually come from the supervisor and are discussed and recorded in writing. 40 During supervision, the supervisee creates homework assignments, and the content is discussed with the supervisee.

The Meaning of Homework

Homework must make sense for the supervisee; otherwise, he will have no motivation to do it. However, it is also important to make sense of the patient or patients and develop the therapist’s skills and competencies. It is desirable to discuss the meaning of homework in supervision.

Possible Difficulties When Completing Homework

It is advantageous to discuss the anticipated difficulties in completing homework. This has the advantage that the supervisee can prepare for possible difficulties, consider overcoming them and consult with the supervisor. Discussing difficulties helps the supervisee model and later develops the skill to discuss the patient’s homework difficulties.

The Impact of the Therapist’s Belief System

In some therapists, there can be reasons for a more complex level of conceptualization. 42 That is important when the therapist repeats certain mistakes even though they have repeatedly discussed them with the supervisor. At a directly accessible level, the situation with the patient can be described using a vicious circle. The deeper “hidden” level refers to the core beliefs and conditional rules activated in a specific situation with the patient. 40 , 43 A supervisor can use the “falling arrow” technique to map core beliefs and conditional assumptions. 43

One such way is the Therapeutic Belief System (TBS). 44 TBS is a theoretical model useful for understanding the specific beliefs, assumptions, and behaviors that therapists and patients commonly experience that could potentially affect the course of therapy. In line with the cognitive model, TBS provides a framework for identifying therapists’ and patients’ beliefs about themselves, each other, the treatment process, the emotions these beliefs can evoke, and typical behavioral reactions. For example, a therapist may see a patient as an “aggressor”, a “helpless victim”, or a “collaborator”. The participant’s own beliefs may supplement these beliefs about himself, such as “victim”, “co-worker”, “carer”, or “rescuer”. Homework assignments may be perceived by both the therapist and the patient as “hopeless”, “productive”, or simply maintaining the status quo and lead to a different emotional and behavioral response. 8 Thus, TBS can be introduced into supervision to guide the supervisee to consider whether he or she identifies with any of the therapists’ typical beliefs and behaviors outlined in the model. A simple awareness of such patterns can be a useful orientation when considering the role of attitudes and beliefs in integrating homework ( Box 4 ).

Case Vignette – Discussion About Supervisee Homework

The scheme broadly refers to mental structures that integrate and give meaning to events. 45 Schemes can be positive, negative or neutral. In CBT as a treatment for psychological disorders, we focus on dysfunctional patterns often associated with specific diagnostic presentations (for example, emotional vulnerability patterns are common in anxiety disorders). Schema is generally defined as a ubiquitous topic of cognitive functions, emotions, physiological feelings about oneself, and relations with others. 33

Therapists’ schemes run in specific therapies and do not usually signal mental health problems. 8 Therapists’ schemes are influenced by the following factors: training experiences, such as supervision and training phase, therapy model, peer group, clinical experience, and personal experience. 13 , 40 Once identified, the therapist’s scheme can be used in supervision as a starting point to discuss some of the practitioner’s views that may interfere with therapy. 8 Completing structured questionnaires can identify participants’ schemes, basic beliefs, and assumptions. Some examples of useful questionnaires are the Dysfunctional Attitudes Scale, 46 the Personal Faith Questionnaire, 47 the Young Schema Questionnaire 48 and the Therapists’ Schema Questionnaire. 49 Leahy’s Therapists’ Scheme Questionnaire is a relatively straightforward screening technique for identifying therapeutic patterns that could affect a therapeutic relationship. It consists of 46 assumptions related to the 14 most common therapeutic regimens.

Certain schemes are particularly common in CBT supervisees. These include “demanding standards”, “excessive self-sacrifice”, and “special superior person”. 49 Training therapists who identify with the “demanding standards” scheme have a somewhat obsessive, perfectionist, and controlling approach to therapy. These therapists usually have high expectations for keeping a patient’s homework and may not realize that non-compliance with homework is often part of the learning process. Therapists may expect that there is a “right” way to complete a homework assignment, leading to feelings of frustration when assignments produce different results. This may signify insecurity and a notion that if things break from the planned structure, the therapist will be exposed as “incompetent”. Many therapists identify with the “excessive self-sacrifice” pattern, the most commonly observed pattern in both novice and experienced therapists. 33 Leahy 49 proposes that these therapists overstate the importance of their patient relationships. They may fear leaving or feel guilty that they are or feel better than the patient. As a result, the therapist may engage in therapy-defeating behaviors, such as making the homework assignment to the patient’s various needs, having difficulty with appropriate assertiveness in discussing persistent patient non-cooperation, and having a tendency to avoid techniques. Such as exposure or opening of painful memories for fear that the patient will be upset.

Novice therapists who identify with the “special superior person” scheme see the therapeutic situation as an opportunity to achieve excellent results and have high-performance expectations. There may be a tendency for the patient to idealize or, conversely, to devalue or distance himself from patients who do not improve or do their homework. The presence of a “special superior” scheme can be seen as overcompensation in response to “demanding standards” and “excessive self-sacrifice”, which have the thematic connotations of “not being good enough”. The supervision session sets the supervisee in a situation where the supervisor supervises homework through videotaped therapeutic sessions utilizing a cognitive therapy scale (CTS). 50 Feelings of superiority and exceptionality can, in some cases, be a way of dealing with the feelings of inferiority that they experience, that their use of homework is judged in this way.

In addition to recognizing the general responses to the scheme that most training students encounter, the supervisor should help the supervisor become aware of his or her idiosyncratic beliefs and coping styles, which some patients may trigger ( Box 5 ). The supervisor should encourage the supervisee to pay special attention to the “overlapping patterns” in which the therapist’s scheme and the patient’s scheme overlap, leading to the over-identification of the therapist with the patient. 33

Case Vignette – The Supervisor Advises the Therapist to Work with Core Beliefs and Conditional Rules

Homework in Supervisor Training

For supervisors, their supervisors’ training is important. An important part of this training is the practice of self-reflection, which should be requested directly in the meeting and as homework. It can be a task to capture situations in supervision in which they do not feel comfortable using the vicious circle, cognitive restructuring of automatic negative thoughts in these situations, capturing thoughts, emotions, bodily sensations and behaviors in situations where they are aware that they are experiencing countertransference reactions to the supervised therapist. It is also important that in their homework, they reflect on their concentration level during supervision sessions and consider what supervision skills they have used or what they have learned for the next session. A typical complex homework in supervision training is a video recording of supervision sessions and their analysis. The recorded supervision and analysis are then analyzed in the next supervision training meeting.

This article is designed as an overview of views and experiences. Its important element is work samples. This is also a limitation of this article. Assignment of homework in supervision and therapist and supervisor training lacks scientific information about its effectiveness. Nevertheless, assigning homework is an important part of cognitive behavioral therapy. We know quite well about its meaning in prescribing for patients. Less is known about their meaning and effectiveness in supervision. The supervisee encounters problems completing homework assignments for her patients that she brings to the supervisee. Why the patient does not complete the homework may be his problem, but his therapist may also have a part in it his requirements, which include how the homework is assigned, its suitability for the given patient, timing, and complexity. Homework can also belong to the training of supervisors and the supervision of supervision. Here, we do not know any research evidence about their effectiveness in using the most important part of supervision, the patient; however, they are experienced by supervisors and supervisees as useful and meaningful.

Homework in supervision and supervision requires further reflection on their meaning and subsequent research, which should examine their significance for the supervisee’s competence (supervisee) and the ultimate impact on the patient himself.

Homework presents one of the cornerstones of cognitive-behavioral therapy, CB supervision and the training of CBT supervisors. If applied consistently and collaboratively, homework enhances therapeutic outcomes and increases the patient’s self-confidence. Setting and maintaining a fruitful working alliance for homework can be challenging – issues with homework present one of the common reasons to seek a supervisory consultation. Supervision then focuses on examining the specific case and experienced problems, factors in the interaction between the therapist and their patient, and the therapist’s automatic thoughts, schemas, and behaviors that might maintain the issue. There are several ways to address this topic in supervision. Homework is usually part of supervision because of its usefulness. The supervised therapist may be given similar tasks as the patient receives in therapy: to describe the automatic thoughts that occur to him while guiding the patient, to test them and look for a more rational response, to conduct behavioral experiments, to clarify the core beliefs and conditioned assumptions that influence the formation of the therapeutic relationship, experiments with adequate communication with the patient and others. A therapist’s self-experience through practice can help them improve their therapeutic work.

Acknowledgments

This paper was supported by the research grant VEGA no. APVV-15-0502 Psychological, psychophysiological and anthropometric correlates of cardiovascular diseases.

The authors report no conflicts of interest in this work.

The importance of homework in therapy

by Elyssa Barbash | Jul 25, 2018 | change , growth , Self-improvement , success , Therapy , Uncategorized , worry | 0 comments

Not all therapists assign homework, but many do – even if they don’t call it “homework.” Homework in therapy is not meant to be busy work. This is not school, after all. But rather, any assignments given during the course of therapy are intended to supplement and benefit the therapeutic process.

There has been significant research conducted on the use of homework in therapy. Findings consistently indicate that homework maximizes the benefit of therapy and allows clients to realize gains in their life.

At the beginning of therapy, homework is a topic that I review with all of my patients. However, there still comes the times where I have to re-review the importance of homework with my patients after they share they have not completed their work!

Purpose of Homework

Homework in therapy is intended to allow the person to implement the strategies that are being learned in therapy so that they can actualize the changes and gains they are seeking to make in their life. I like to put it this way: therapy sessions do not consume a very large portion of your life. At most, we are talking about 45 to 50 minutes out of your week that you are in a therapy session. While the therapy session lays the foundation for the changes to occur in your life, the actual therapy session is such a small portion of your time and is a false reality.

The place is where you will actually see the gains and progress being made is in your every day life.

This is where homework comes in. To maximize the value of therapy, homework helps you to implement the strategies being learned in your life so you can actually see changes. Homework is usually skills oriented, though not always. When it is skills oriented, it teaches the person how to deal with their problems on their own and not have to rely on their therapist. (Bonus: Any ethical therapist will approach treatment in this way. However, not all therapies are intended to be skills building so this is not to say that those therapist to don’t assign homework are unethical!).

Benefits of Homework

Remember, this is not school. Homework being assigned is not being given to you to keep you busy. If your therapist assigned the homework, it is with the best intentions that what they are asking you to do is going to help you. It is also likely to lead to shortened treatment times, which means overall reduced costs related to treatment and less time dedicated to the therapy process in the long run.  

A Strong Indication of your commitment to Therapy, and to yourself

Finally, completing your homework is an indication of your commitment to therapy, which is a greater indication of your commitment to yourself. When you do not follow through and complete your homework, the message that you are sending is that you really don’t care. And a therapist cannot truly help you if you do not care.

So the next time you want to skip that homework assignment your therapist gave you, remember what the true purpose of it is and how much you want that change in your life.

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Contact us today to schedule an appointment. Whatever the reason, give us a call.  Remember, there are many reasons why people seek therapy. Professional mental health assistance can greatly benefit you in many ways, including making important changes in your life.

We are committed to providing therapy and counseling services in a comfortable, relaxing, encouraging, and non-judgmental environment to yield the most realistic and best outcomes.   Give us a call or email us today to schedule an appointment.

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• Aug 9, 2019

Did my therapist just give me homework?

Homework isn’t just something you deal with in school - it’s also a great tool that therapists use to help you work on a particular issue in between your sessions. If your therapist assigned a project or task for you to complete before your meeting, view it as a positive step in your overall outcome for therapy. Why? Homework serves as a way to build upon topics discussed within your hourly sessions so that you’ll be better able to develop behaviors that improve your mental health.

To help get the most out of your talk therapy, approach it as a collaborative effort and follow your agreed-upon plan for treatment. Your therapist might end your sessions with a task to work on or think about before your next meeting - these are activities or projects that have a specific purpose in mind. Some examples include: writing in a journal, practicing a dialogue technique, or making a list of things that make you feel stuck. It’s a very constructive way to get the most out of your working relationship, recognizing the fact that one hour a week is just the starting point to helping you meet your therapy goals.

When tasked with helping you break through a particular issue, some homework might require courage, but they’re designed to facilitate your growth. For example, someone who experiences social anxiety might be assigned the goal of talking to one new person at work that week. Provided by a skilled therapist and within the context of personal development, the benefit here is that whatever interaction happens - and how it makes you feel - can be processed and discussed in your next therapy session. Perhaps it can build greater confidence in the future and soften the social anxiety, or it might serve as a skill-building tool as you work with your therapist to brainstorm other ways of breaking the ice if the first was less than successful.

Much like any teacher, a therapist uses homework to improve your experience and help you get the most out of the working relationship between the two of you. Being patient, open, and willing to participate in the process is the hallmark of a positive therapeutic alliance and will only improve your chances that you’ll have a good outcome.

As you approach your homework with an open mind, be sure to communicate with your therapist about how the assignments are working for you. You might find that the between-sessions work is meaningful and useful. You might even come up with a suggestion for something else that you’d like to try in addition, and with your therapist’s support, perhaps even try something you’d be afraid to try on your own.

Even though there’s no A, Honor Roll or Spring Break after your therapy homework, it’s a valuable tool that many skilled therapists use and you’re wise to approach it with an open mind. As you build skills and begin to explore trouble spots, spending the time in between sessions to work on your therapy goals is the kind of collaborative effort that will fortify your mental health and help you feel empowered.

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Do You Need a Homework Therapist?

By Natalie Proulx

• April 5, 2018

How do you feel about homework? Do you find it helps you learn more? Is it ever enjoyable, or does it only stress you out? Why?

In “ Homework Therapists’ Job: Help Solve Math Problems, and Emotional Ones ,” Kyle Spencer writes:

On a recent Sunday, Bari Hillman, who works during the week as a clinical psychologist at a New York mental health clinic, was perched at a clear, plastic desk inside a 16-year-old’s Manhattan bedroom, her shoeless feet resting on a fluffy white rug. Dr. Hillman was helping a private school sophomore manage her outsize worry over a long-term writing project. The student had taped the project outline on the wall above the desk, at Dr. Hillman’s prodding. It was designed to serve both as a reminder that the project was due, and an empowering indicator of progress. Dr. Hillman mused about the way worry can morph into unhealthy avoidance, the cathartic power of deep breathing and the soothing nature of to-do lists. Dr. Hillman, 30, represents a new niche in the $100 billion tutoring industry. Neither a traditional tutor nor a straight-up therapist, she is an amalgam of the two. “Homework therapists,” as they are now sometimes called, administer academic help and emotional support as needed. Via Skype, email and text, and during pricey one-on-one sessions, they soothe cranky students, hoping to steer them back to the path of achievement. The service is not cheap. Parents in New York generally pay between $200 and $600 for regularly scheduled in-person sessions that range from 50 to 75 minutes. This on top of the hefty fees New York mothers and fathers already pay to help their children get ahead, or just stay on pace, from coaching for kindergarten gifted and talented tests, to subject tutoring, SAT prep and help with writing their college essays. Tutors make themselves available for last-minute interventions before midterms or when writing projects are due. They respond to texts and emails and often send their own, nudging students to finish a homework assignment or stay positive before and during a big exam. Some have teenagers create playlists on Spotify that express their feelings about homework. Others hand out blobs of scented putty, known as therapy dough, that is designed to calm. Others use meditation and mindfulness to refocus their charges on the hunt for a 4.0 and higher SAT scores.

Students: Read the entire article, then tell us:

— Do you ever feel overwhelmed by homework and studying? If so, what strategies do you have for dealing with the pressure? Are there any ideas from the article that you could use when doing homework in the future?

— What do you think contributes to many students’ feelings of stress and anxiety around homework?

— Do you think homework therapy is a good idea? Or does it coddle students too much, preventing them from developing into fully functional, responsible and independent young adults? Why do you think so?

— Would you benefit from having a homework therapist? Why or why not?

— Who do you think should teach students effective organizational, time management and stress management skills? Teachers, parents, therapists or tutors? Or should students be expected to learn them on their own? Why?

Students 13 and older are invited to comment. All comments are moderated by the Learning Network staff, but please keep in mind that once your comment is accepted, it will be made public.

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Trains Moscow to Elektrostal: Times, Prices and Tickets

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Moscow to Elektrostal by train

The journey from Moscow to Elektrostal by train is 32.44 mi and takes 2 hr 7 min. There are 71 connections per day, with the first departure at 12:15 AM and the last at 11:46 PM. It is possible to travel from Moscow to Elektrostal by train for as little as or as much as . The best price for this journey is .

Get from Moscow to Elektrostal with Virail

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How can I find the cheapest train tickets to get from Moscow to Elektrostal?

Prices will vary when you travel from Moscow to Elektrostal. On average, though, you'll pay about for a train ticket. You can find train tickets for prices as low as , but it may require some flexibility with your travel plans. If you're looking for a low price, you may need to prepare to spend more time in transit. You can also often find cheaper train tickets at particular times of day, or on certain days of the week. Of course, ticket prices often change during the year, too; expect to pay more in peak season. For the lowest prices, it's usually best to make your reservation in advance. Be careful, though, as many providers do not offer refunds or exchanges on their cheapest train tickets. Unfortunately, no price was found for your trip from Moscow to Elektrostal. Selecting a new departure or arrival city, without dramatically changing your itinerary could help you find price results. Prices will vary when you travel from Moscow to Elektrostal. On average, though, you'll pay about for a train ticket. If you're looking for a low price, you may need to prepare to spend more time in transit. You can also often find cheaper train tickets at particular times of day, or on certain days of the week. Of course, ticket prices often change during the year, too; expect to pay more in peak season. For the lowest prices, it's usually best to make your reservation in advance. Be careful, though, as many providers do not offer refunds or exchanges on their cheapest train tickets.

How long does it take to get from Moscow to Elektrostal by train?

The journey between Moscow and Elektrostal by train is approximately 32.44 mi. It will take you more or less 2 hr 7 min to complete this journey. This average figure does not take into account any delays that might arise on your route in exceptional circumstances. If you are planning to make a connection or operating on a tight schedule, give yourself plenty of time. The distance between Moscow and Elektrostal is around 32.44 mi. Depending on the exact route and provider you travel with, your journey time can vary. On average, this journey will take approximately 2 hr 7 min. However, the fastest routes between Moscow and Elektrostal take 1 hr 3 min. If a fast journey is a priority for you when traveling, look out for express services that may get you there faster. Some flexibility may be necessary when booking. Often, these services only leave at particular times of day - or even on certain days of the week. You may also find a faster journey by taking an indirect route and connecting in another station along the way.

How many journeys from Moscow to Elektrostal are there every day?

On average, there are 71 daily departures from Moscow to Elektrostal. However, there may be more or less on different days. Providers' timetables can change on certain days of the week or public holidays, and many also vary at particular times of year. Some providers change their schedules during the summer season, for example. At very busy times, there may be up to departures each day. The providers that travel along this route include , and each operates according to their own specific schedules. As a traveler, you may prefer a direct journey, or you may not mind making changes and connections. If you have heavy suitcases, a direct journey could be best; otherwise, you might be able to save money and enjoy more flexibility by making a change along the way. Every day, there are an average of 18 departures from Moscow which travel directly to Elektrostal. There are 53 journeys with one change or more. Unfortunately, no connection was found for your trip from Moscow to Elektrostal. Selecting a new departure or arrival city, without dramatically changing your itinerary could help you find connections.

Book in advance and save

If you're looking for the best deal for your trip from Moscow to Elektrostal, booking train tickets in advance is a great way to save money, but keep in mind that advance tickets are usually not available until 3 months before your travel date.

Stay flexible with your travel time and explore off-peak journeys

Planning your trips around off-peak travel times not only means that you'll be able to avoid the crowds, but can also end up saving you money. Being flexible with your schedule and considering alternative routes or times will significantly impact the amount of money you spend on getting from Moscow to Elektrostal.

Always check special offers

Checking on the latest deals can help save a lot of money, making it worth taking the time to browse and compare prices. So make sure you get the best deal on your ticket and take advantage of special fares for children, youth and seniors as well as discounts for groups.

Unlock the potential of slower trains or connecting trains

If you're planning a trip with some flexible time, why not opt for the scenic route? Taking slower trains or connecting trains that make more stops may save you money on your ticket – definitely worth considering if it fits in your schedule.

Best time to book cheap train tickets from Moscow to Elektrostal

The cheapest Moscow - Elektrostal train tickets can be found for as low as $36.80 if you’re lucky, or $56.77 on average. The most expensive ticket can cost as much as $81.46.

Find the best day to travel to Elektrostal by train

When travelling to Elektrostal by train, if you want to avoid crowds you can check how frequently our customers are travelling in the next 30-days using the graph below. On average, the peak hours to travel are between 6:30am and 9am in the morning, or between 4pm and 7pm in the evening. Please keep this in mind when travelling to your point of departure as you may need some extra time to arrive, particularly in big cities!

Moscow to Elektrostal CO2 Emissions by Train

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Empowering Progress: Effective Therapy Homework for Depression

The role of therapy homework.

Therapy homework plays a vital role in the treatment of depression, providing individuals with an opportunity to actively engage in their healing process. By completing assignments outside of therapy sessions, individuals can reinforce the concepts learned in therapy, apply new skills, and make progress towards their treatment goals. In this section, we will explore the importance of therapy homework and how it can specifically help with depression.

Understanding the Importance of Homework in Therapy

Homework assignments serve as an extension of therapy and allow individuals to continue their progress beyond the confines of the therapy room. It provides an opportunity for individuals to practice and integrate new insights, coping strategies, and techniques into their daily lives. Through regular engagement with therapy homework, individuals can reinforce the therapeutic work, develop new habits, and enhance their overall well-being.

Therapy homework offers several benefits for individuals with depression. It allows for increased self-awareness, as individuals are encouraged to reflect on their thoughts, emotions, and behaviors. This self-reflection promotes a deeper understanding of oneself and the factors contributing to their depression, enabling individuals to identify patterns and make positive changes.

Additionally, therapy homework empowers individuals by giving them a sense of control and agency in their recovery journey. It fosters a sense of ownership and responsibility for one’s mental health, promoting active participation and engagement in the therapeutic process.

How Therapy Homework Can Help with Depression

Therapy homework can be particularly effective in addressing various aspects of depression. It can help individuals challenge negative thought patterns and develop more adaptive and positive thinking. Cognitive Behavioral Therapy (CBT) worksheets, for example, provide structured exercises to identify and reframe negative thoughts. These worksheets, along with journaling and thought records, allow individuals to track their thoughts and emotions, identify cognitive distortions, and develop healthier thinking patterns.

Behavioral activation exercises are another valuable component of therapy homework for depression. They involve engaging in activities that provide a sense of accomplishment, pleasure, or mastery, even when motivation is low. By gradually increasing participation in enjoyable and fulfilling activities, individuals can combat the inertia often associated with depression and experience an improvement in mood.

By consistently engaging in therapy homework, individuals with depression can experience a sense of progress, growth, and empowerment. However, it’s essential to collaborate with a therapist to develop a personalized homework plan that aligns with individual goals, needs, and preferences. This collaboration ensures that the homework assignments are tailored to the specific challenges and circumstances faced by each individual.

In the following sections, we will explore different types of therapy homework for depression and provide tips for developing a personalized homework plan that maximizes the benefits of therapy.

Types of Therapy Homework for Depression

When it comes to managing depression through therapy,  various types of homework assignments  can be incorporated to enhance the therapeutic process. These assignments aim to reinforce the skills and techniques learned in therapy sessions and provide individuals with opportunities for self-reflection and growth. Here are three common types of therapy homework for depression:

Cognitive Behavioral Therapy (CBT) Worksheets

Cognitive Behavioral Therapy (CBT) is a widely used approach for treating depression. CBT worksheets are valuable homework tools that help individuals identify and challenge negative thought patterns and beliefs. These worksheets typically involve exercises such as identifying automatic negative thoughts, examining evidence for and against these thoughts, and developing more balanced and realistic thinking patterns. CBT worksheets can be used to address distorted thinking commonly associated with depression, such as overgeneralization, personalization, and catastrophizing.

Journaling and Thought Records

Journaling and thought records are effective homework assignments for promoting self-awareness and monitoring thoughts and emotions related to depression. By encouraging individuals to write down their thoughts and feelings, these assignments provide an opportunity to identify negative thinking patterns and emotions that contribute to depressive symptoms. Thought records, in particular, involve documenting a specific negative thought, examining evidence for and against it, and generating alternative, more positive thoughts. Journaling and thought records can be powerful tools for increasing self-reflection and challenging negative self-perceptions.

Behavior Activation Exercises

Behavior activation is a key component of therapy for depression . Homework assignments focused on behavior activation aim to increase engagement in pleasurable and meaningful activities, even when motivation is low. These assignments may involve creating a schedule of daily activities, setting achievable goals, and gradually increasing involvement in enjoyable activities. By actively participating in positive experiences, individuals with depression can counteract the cycle of withdrawal and isolation often associated with the condition.

By incorporating these types of therapy homework into the treatment plan, individuals with depression can actively engage in their own healing process. It is important for therapists to collaborate with their clients, identifying specific goals and areas of focus, to tailor the homework assignments to each individual’s needs and preferences. Consistency, tracking progress, and seeking support are essential for making therapy homework a meaningful and effective part of the journey towards overcoming depression.

For more information on therapy homework assignments and ideas for other areas of focus, visit our articles on  therapy homework assignments  and  therapy homework ideas .

Developing a Personalized Homework Plan

To make the most out of therapy homework for depression, it’s essential to collaborate with your therapist and develop a personalized plan. This plan should be tailored to your specific needs, goals, and areas of focus. By working together with your therapist, you can create a realistic and manageable homework plan that complements your therapy sessions.

Collaborating with Your Therapist

The first step in developing a personalized homework plan is to collaborate with your therapist. Through open and honest communication, express your goals, challenges, and preferences. Your therapist will use their expertise to guide you in selecting appropriate homework assignments that align with your therapy objectives.

Your therapist may suggest specific therapy techniques or resources that can be incorporated into your homework plan. These may include  cognitive behavioral therapy (CBT) worksheets ,  journaling ,  thought records ,  behavior activation exercises , or other relevant tools. By discussing your preferences and comfort level, you can ensure that the chosen homework assignments resonate with you.

Identifying Goals and Areas of Focus

During therapy sessions, you and your therapist will identify specific goals and areas of focus. These goals may include developing coping skills, challenging negative thought patterns, improving self-esteem, or enhancing communication skills. By identifying these goals, you can create homework assignments that directly address the areas you want to work on.

For example, if one of your goals is to challenge negative thought patterns, your therapist may suggest completing CBT worksheets that help you identify and reframe negative thoughts. By integrating these worksheets into your homework plan, you can reinforce the skills learned during therapy sessions and continue working on them independently.

Creating a Realistic and Manageable Plan

When creating your homework plan, it’s crucial to ensure that it is realistic and manageable. Your therapist will help you set realistic expectations and establish a schedule that fits your lifestyle. It’s important to strike a balance between challenging yourself and avoiding overwhelming tasks.

By breaking down larger goals into smaller, achievable tasks, you can maintain motivation and progress steadily. Your therapist may also suggest incorporating self-care activities, relaxation exercises, or mindfulness practices into your homework plan to foster emotional well-being and resilience.

To help you stay organized and track your progress, consider using a journal or a digital tool specifically designed for therapy homework. These tools can help you monitor your assignments, record your thoughts and emotions, and reflect on your progress over time.

Remember, the success of your therapy homework plan depends on your consistency, commitment, and willingness to actively engage in the process. By collaborating with your therapist, identifying goals, and creating a realistic plan, you can maximize the benefits of therapy homework for depression.

Tips for Effective Therapy Homework

To make the most out of therapy homework and enhance the effectiveness of your treatment for depression , it’s important to keep a few key tips in mind. These tips will help you stay on track and maximize the benefits of your therapy sessions.

Consistency and Commitment

Consistency is key when it comes to therapy homework. Make a commitment to regularly engage in your assigned exercises or activities. Set aside dedicated time each day or week to work on your homework. Treat it as a priority and integrate it into your routine. By being consistent and committed, you’ll reinforce the therapeutic progress and build momentum towards achieving your goals.

Tracking Progress and Making Adjustments

Keep track of your progress as you engage in therapy homework. Maintain a record of your experiences, observations, and any changes you notice. This tracking will help you identify patterns and trends, providing valuable insights into your journey. It can be helpful to use a journal or a tracking app to record your thoughts and progress. Regularly review your records with your therapist to assess your growth, make adjustments, and refine your homework plan if necessary.

Seeking Support and Accountability

Seek support and accountability to stay motivated and committed to your therapy homework. Share your goals and progress with a trusted friend, family member, or support group. Consider joining a therapy or coaching community where you can connect with others who are also working on their mental health. Engaging in discussions, sharing experiences, and receiving encouragement from others can provide a sense of support and accountability that keeps you motivated and engaged.

Remember, therapy homework is an integral part of the treatment process for depression. By following these tips for effective therapy homework, you can enhance your progress and experience the full benefits of your therapeutic journey. Stay consistent, track your progress, and seek support to make the most out of your therapy experience.

For more information and resources on therapy homework for various topics, visit our  therapy homework assignments  page.

Overcoming Challenges with Therapy Homework

While therapy homework can be an effective tool for managing depression, it’s important to acknowledge and address the challenges that may arise during the process. Here are some common challenges individuals may encounter when completing therapy homework and strategies for overcoming them.

Addressing Resistance and Motivation Issues

Resistance and lack of motivation can hinder progress when it comes to therapy homework. It’s not uncommon to feel resistant or unmotivated, especially when dealing with the symptoms of depression. However, it’s important to remember that therapy homework plays a significant role in your overall treatment and recovery.

To address resistance and motivation issues, consider the following strategies:

• Explore the underlying reasons : Reflect on why you may be resistant or lacking motivation. Are there specific barriers or fears that need to be addressed? Share your concerns with your therapist to gain a deeper understanding and explore possible solutions.
• Break tasks into smaller steps : Overwhelming tasks can lead to resistance. Break down your therapy homework into smaller, more manageable steps. This can help make the tasks feel less daunting and increase motivation.
• Find intrinsic motivation : Connect with the deeper reasons behind why you want to engage in therapy homework. Remind yourself of the potential benefits, such as improved coping skills or increased self-awareness. Focusing on these intrinsic motivations can help reignite your motivation.

Dealing with Time Constraints

Finding time to complete therapy homework can be challenging, especially when juggling other responsibilities and commitments. However, dedicating time to your therapy homework is essential for making progress in your treatment.

To overcome time constraints, consider the following strategies:

• Prioritize and schedule : Prioritize your therapy homework by scheduling specific times in your daily or weekly routine dedicated solely to completing the tasks. Treat these scheduled times as non-negotiable commitments to yourself and your well-being.
• Break tasks into shorter sessions : If the length of the tasks feels overwhelming, break them into shorter sessions spread out over several days. This can help you fit therapy homework into your schedule more easily.
• Utilize downtime : Identify pockets of time throughout your day that can be used to complete smaller tasks. For example, you can work on journaling exercises during your morning commute or listen to guided meditation during your lunch break.

Modifying Homework to Fit Individual Needs

Therapy homework is not one-size-fits-all, and it’s important to tailor it to your individual needs and preferences. If you find that certain exercises or assignments are not resonating with you or are not producing the desired outcomes, it may be necessary to modify them.

Consider the following strategies for modifying therapy homework:

• Communicate with your therapist : Discuss any challenges or concerns you have with your therapist. They can help modify the homework assignments to better suit your needs and provide alternative options if necessary.
• Explore alternative techniques or activities : If a particular exercise is not effective for you, discuss alternative techniques or activities with your therapist. They may be able to suggest different approaches that align better with your preferences and goals.
• Experiment and adapt : Be open to experimenting with different approaches and techniques. Therapy homework is a collaborative process, and it may take some trial and error to find what works best for you. With the guidance of your therapist, adapt and modify the homework assignments to suit your unique circumstances.

By addressing resistance and motivation issues, managing time constraints, and modifying therapy homework to fit your individual needs, you can overcome challenges and make the most of your treatment. Remember to communicate openly with your therapist, as they are there to support you in your journey toward healing and recovery.

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