Academic journal article Journal of Marital and Family Therapy

A Survey of Homework Use, Experience of Barriers to Homework, and Attitudes about the Barriers to Homework among Couples and Family Therapists

Academic journal article Journal of Marital and Family Therapy

A Survey of Homework Use, Experience of Barriers to Homework, and Attitudes about the Barriers to Homework among Couples and Family Therapists

Article excerpt

Homework is a therapeutic process that has strong theoretical and empirical basis, but existing research has focused on "compliance" rather than considering the broader and more clinically meaningful construct of "engagement." Absent in the literature is empirical study of the barriers to engagement or study of homework use among couple and family therapists (CFTs). The current study investigates the frequency and type of homework, as well as the influence of homework compliance, quality of compliance, and experience of barriers to compliance on CFTs' attitudes and beliefs toward barriers to homework completion for couples and families. Results indicated CFTs (N = 226 AAMFT Clinical members) use homework more often with couples than with families, and CFTs report greater homework compliance and quality of compliance for couples when compared to families. A path analysis examining compliance, quality of compliance, and barriers to compliance as predictors of attitudes/beliefs toward barriers revealed no significant findings. A discussion presents implications for future research and practice for homework in couple and family therapy.

Homework assignments are broadly defined as planned therapeutic activities that are discussed with therapists and completed by clients between scheduled sessions (Beck, 2005; Kazantzis & L'Abate, 2005). The process of integrating between-session tasks is well documented in the cognitive-behavioral therapy (CBT) literature as an efficacious clinical process tool with strong theoretical, practical, and empirical support for its use with clients (Beck, Rush, Shaw, & Emery, 1979; Dattilio & Padesky, 1990; Dattilio, 1998, 2005, 2010). According to CBT, homework tasks may be theorized as assisting with the reinforcement, shaping, maintenance, and complex reasoning in the generalization of skills learned in therapy to the clients' natural environment (Beck et al, 1979). The practical benefits of homework use include the ability for therapists to monitor and assess clients' progress toward treatment goals (Kazantzis & Lampropoulos, 2002) and to reduce the duration and expense of therapy by making use of time between sessions. Further, empirical support for homework has been demonstrated (Burns & Spangler, 2000; Persons, Burns, & Perloff, 1988); in a recent meta-analytic review of CBT studies, findings indicated that 62% of clients improved when therapy involved homework, compared to only 38% when therapy did not involve homework assignments (Kazantzis, Whittington, & Dattilio, 2010).

The theoretical and practical foundations in CBT for homework assignments are well documented for individual clients (Kellogg & Young, 2008; Zinbarg & Griffith, 2008) as well as for couples and families (Dattilio & Dickson, 2007; Epstein & Baucom, 2007; L'Abate & Cusinato, 2007; Linville & Hertlein, 2007). Unique to couple and family therapy, homework use provides focus and structure to multiple-family dynamics and increases the involvement of couple and family members in the process of treatment outside of the session (Dattilio & Dickson, 2007). However, homework has only been reviewed with increasing regularity in the literature as a therapeutic tool in couple and family therapy within the past decade (Dattilio & Dickson, 2007; Dattilio, L'Abate, & Deane, 2005; Kazantzis, Deane, Ronan, & L'Abate, 2005; L'Abate, 2003). As a result, empirical support for the actual use of homework in couple and family therapy is lacking (Dattilio & Dickson, 2007). Increased knowledge about the frequency and types of homework used by couple and family therapists would provide further support to the theoretical and clinical case contributions for practice in this area (Dattilio, 1998). The present study will address these gaps in the literature (Kazantzis & L'Abate, 2007).

In addition to evaluating the use of homework with couples and families, including frequency and type of homework assigned, it essential to gain a better understanding of the standard and quality of homework compliance among couples and families. …

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