In 30 years of reviewing treatment notes I can’t recall seeing a written homework assignment. But these were an integral part of the randomised controlled trials of CBT for depression and the anxiety disorders. Completion of homework has been found to effect outcome see Kazantis et al (2007) Using Homework Assignments in CBT Guilford Press.
According to the NHS workforce report there was a 65% increase in psychological therapists between 2019 and 2024.This expansion has come about despite any plausible evidence that CBT is delivered in routine practice. Looks suspiciously like jobs for the boys! What proportion of the 24,000 members of the British Association of Cognitive and Behavioural Therapies (BABCP) would testify to routinely giving clients written homework assignments?
It is worth recapping some of the benefits of a written homework assignment. It is a succinct summary of learning points from the treatment session, it ensures translation from the therapy room to the real-world, it provides continuity between sessions (sessions begin with a review of the set homework), it provides a personalising of therapy. In the absence of a written homework claims of fidelity to a NICE evidence-based treatment do not stand up in ‘court’.
Good to be back
Mike
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