A national survey of practicing psychologists’ use and attitudes toward homework in psychotherapy
Abstract
Homework assignments have been studied extensively in psychotherapy research, but there is little data on the way in which homework is transferred to clinical practice. A survey was conducted of 827 practicing psychologists nationwide regarding their use and attitudes toward homework. Overall, 68% of the present sample indicated that they "often" or "almost always" used homework assignments. Factor analysis revealed that practitioners have a range of attitudes that can be classified as reflecting the notion that homework has (a) a negative impact on in-session therapeutic work and (b) a positive effect on therapy outcomes. More positive attitudes were reported among those with a cognitive-behavioral theoretical orientation. Nevertheless, the use of homework among psychodynamic/analytic practitioners reported in the present sample was unexpected and suggests that theoretical and empirical work is required to examine homework's effects in a range of psychotherapy approaches.
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Similar techniques and exercises might be used in different therapeutic approaches although the specific language and the theoretical embedding might differ.
“This is consistent with general findings from the literature, showing that similar techniques and exercises might be used in different therapeutic approaches although the specific language and the theoretical embedding might differ (Kazantzis et al., 2005; Cuijpers et al., 2019; Banon et al., 2013).”
From TONI - One for all? Participatory development of a transtheoretic and transdiagnostic online intervention for blended care (2024) · cites this paper as Kazantzis et al., 2005
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Self-citationHomework in Cognitive Behavioral Supervision: Theoretical Background and Clinical Application
Praško, J. P., Krone, I., Burkauskas, J., Vaněk, J., Abeltiņa, M., Juškienė, A., Sollár, T., Bite, I., Šlepecký, M., & Ocisková, M. (2022) · Psychology Research and Behavior Management · doi:10.2147/prbm.s382246 · Cited by 10 · see citing works
“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.”
Therapists’ Views of Mechanisms of Change in Psychotherapy: A Mixed-Method Approach
Bitan, D. T., Shalev, S., & Abayed, S. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.565800 · Cited by 10 · see citing works
Negotiating Post-Consultation ‘Homework’ Tasks Between Counselors and Clients
Strong, T., & Massfeller, H. F. (2010) · International Journal for the Advancement of Counselling · doi:10.1007/s10447-009-9085-1 · Cited by 10 · see citing works
“Some of this relates to differences in theoretical orientations to practice ( Kazantzis et al. 2005; Ronan and Kazantzis 2006) among counselors, and, in particular, where counselors see the impetus for homework arising: from the client or the counselor (Brodley 2006).”
BackgroundKelly, P. J., Deane, F. P., Kazantzis, N., & Crowe, T. P. (2007) · Rehabilitation Counseling Bulletin · doi:10.1177/00343552070510010601 · Cited by 10 · see citing works
Self-citationHelbig-Lang, S., Hagestedt, D., Lang, T., & Petermann, F. (2012) · Zeitschrift für Psychiatrie, Psychologie und Psychotherapie · doi:10.1024/1661-4747/a000106 · Cited by 9 · see citing works
Provision of Care by “Real World” Telemental Health Providers
Bunnell, B. E., Kazantzis, N., Paige, S. R., Barrera, J. F., Thakkar, R. N., Turner, D., & Welch, B. M. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.653652 · Cited by 9 · see citing works
Self-citationKazantzis, N. (2024) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2024.03.002 · Cited by 10 · see citing works
Self-citationSession-by-session outcome monitoring in CAMHS: clinicians’ beliefs
James, K., Elgie, S., Adams, J., Henderson, T., & Salkovskis, P. M. (2015) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x15000653 · Cited by 8 · see citing works
On behalf of the GENKI Project, Hayasaka, Y., Furukawa, T. A., Sozu, T., Imai, H., Kawakami, N., & Horikoshi, M. (2015) · BMC Psychiatry · doi:10.1186/s12888-015-0687-3 · Cited by 7 · see citing works
“Homework is usually assigned in every session of CBT, asking patients to practice newly learned cognitive or behavioral skills and to generalise such skills to their daily situations in which their problems occur [13].”
BackgroundIntroduction and Historical Overview
Kazantzis, N., & L’Abate, L. (2006) · Springer eBooks · doi:10.1007/978-0-387-29681-4_1 · Cited by 8 · see citing works
Self-citationFacilitating Homework and Generalization of Skills to the Real World
Cummings, C. M., Kazantzis, N., & Kendall, P. C. (2014) · doi:10.1002/9781118500576.ch11 · Cited by 8 · see citing works
Self-citationDoes homework improve outcomes for individuals diagnosed with severe mental illness
Kelly, P. J., & Deane, F. P. (2007) · Research Online (University of Wollongong) · Cited by 8 · see citing works
Self-citationBetween-session homework in clinical training and practice: A transtheoretical perspective
Ryum, T., & Kazantzis, N. (2024) · Clinical Psychology in Europe · doi:10.32872/cpe.12607 · Cited by 7 · see citing works
“This notion is further supported by surveys of practicing therapists, indicating that BSH is commonly utilized by both cognitive-behavioral and psychodynamic therapists (Fehm & Kazantzis, 2004; Kazantzis & Dattilio, 2010; Kazantzis, Lampropoulos, et al., 2005).”
ResultSelf-citationFerrito, M., & Moore, E. (2017) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x17000150 · Cited by 5 · see citing works
“Between-session homework is a necessary element of CBT (Beck et al., 1979; Kazantzis et al., 2005), and is linked to improved clinical outcomes and development (Burns and NolenHoeksema, 1991; Kazantzis et al., 2000; Kazantzis and Lampropoulos, 2002; Kazantzis et al., 2004).”
BackgroundKazantzis, N., Dattilio, F. M., Shinkfield, G., & Petrik, A. M. (2022) · Scandinavian Journal of Psychology · doi:10.1111/sjop.12861 · Cited by 5 · see citing works
Self-citationHausaufgaben in der Paartherapie
Bodenmann, G., & Götz, C. (2012) · Zeitschrift für Psychiatrie Psychologie und Psychotherapie · doi:10.1024/1661-4747/a000105 · Cited by 4 · see citing works
Samantaray, N. N., Singh, P., & Sudhir, P. M. (2022) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2022.103069 · Cited by 4 · see citing works
‘Psychological treatment’ as an umbrella term for evidence-based psychotherapies?
Andersson, G., & Cuijpers, P. (2009) · Nordic Psychology · doi:10.1027/1901-2276.61.2.4 · Cited by 6 · see citing works
Homework in therapy: a case of it ain't what you do, it's the way that you do it?
Harris, D. L., & Hiskey, S. (2015) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x15000549 · Cited by 4 · see citing works
“However, homework between sessions is commonplace (Kazantzis et al. 2005), with 98% of therapists surveyed in a retrospective study reporting the regular use of it with clients (Kazantzis & Deane, 1999).”
BackgroundTrask, E. V., Barounis, K., Carlisle, B. L., Garland, A. F., & Aarons, G. A. (2018) · Administration and Policy in Mental Health and Mental Health Services Research · doi:10.1007/s10488-018-0867-9 · Cited by 4 · see citing works
“This is notably less than published rates of homework usage by psychologists (e.g., 68%; Kazantzis et al. 2005), but very similar to rates of homework usage by mental health case managers (40% of case managers reported using homework “often” or “almost always”; Kelly et al.”
ResultBunnell, B. E., Schuler, K. R., Ivanova, J., Flynn, L., Barrera, J. F., Niazi, J., Turner, D., & Welch, B. M. (2024) · JMIR Human Factors · doi:10.2196/56567 · Cited by 3 · see citing works
“Only 68% of general mental health care providers and approximately 55% of family care providers report using homework “often” to “almost always” [9,10].”
Development of a Scale: Barriers to CBT Homework Completion Scale
Callan, J. A. (2007) · D-Scholarship@Pitt (University of Pittsburgh) · Cited by 3 · see citing works
Magistrale, G., Hasson‐Ohayon, I., Lysaker, P. H., & Dimaggio, G. (2023) · Journal of Clinical Psychology · doi:10.1002/jclp.23600 · Cited by 3 · see citing works
Hausaufgaben in der Kinderpsychotherapie
Petermann, U., Petermann, F., & Röll, J. (2012) · Zeitschrift für Psychiatrie Psychologie und Psychotherapie · doi:10.1024/1661-4747/a000104 · Cited by 3 · see citing works
Challenges in Conducting ADHD Coaching with College Students: A Case Study
Prevatt, F. F., & Lee, J. (2009) · The ADHD Report · doi:10.1521/adhd.2009.17.4.4 · Cited by 3 · see citing works
Larsson, B. P. M. (2010) · Gothenburg University Publications Electronic Archive (Gothenburg University) · Cited by 3 · see citing works
LOU, V. W. Q., Au, J. W. N., & Choy, J. C. P. (2015) · Geriatrics and gerontology international/Geriatrics & gerontology international · doi:10.1111/ggi.12595 · Cited by 2 · see citing works
Fenski, F., Böttcher, J., & Hörz‐Sagstetter, S. (2023) · PPmP - Psychotherapie · Psychosomatik · Medizinische Psychologie · doi:10.1055/a-2050-3413 · Cited by 2 · see citing works
Yarwood, B., Angelakis, I., & Taylor, R. (2025) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x25000091 · Cited by 2 · see citing works
“Homework has been found to be a useful component of CBT, with homework compliance found to be a positive predictor of therapy outcome, and homework assignments producing significant positive effects on therapeutic outcomes (Kazantzis et al ., 2005).”
Client motivation, working alliance and the use of homework in psychotherapy
Franco, C. M. (2012) · ProQuest Demo Repository · Cited by 2 · see citing works
Behr, S., Fenski, F., Böttcher, J., Knaevelsrud, C., Hammelrath, L., Kovacs, G., Schirmer, W., Becker, P., & Schaeuffele, C. (2023) · doi:10.31234/osf.io/8xu5z · Cited by 2 · see citing works
Petrik, A. M., Dobson, K. S., Papadopoulos, O., & Kazantzis, N. (2023) · Clinical Psychologist · doi:10.1080/13284207.2023.2221782 · Cited by 1 · see citing works
Self-citationThapar, S., Quesada, D., & Knaüper, B. (2025) · JMIR Formative Research · doi:10.2196/69532 · Cited by 2 · see citing works
“Homework has long been considered central to the effectiveness of psychotherapy, with meta-analyses showing large effect sizes of homework quantity and quality on therapy effectiveness [5,6,27].”
Herman, K. G. (2013) · Cited by 1 · see citing works
Does Expectancy and Homework Compliance Predict Change in CBT?
Schroder, A. (2017) · Acta Psychopathologica · doi:10.4172/2469-6676.100133 · Cited by 1 · see citing works
Conklin, L. R. (2009) · OhioLink ETD Center (Ohio Library and Information Network) · Cited by 1 · see citing works
Petrik, A. M., & Kazantzis, N. (2015) · The Encyclopedia of Clinical Psychology · doi:10.1002/9781118625392.wbecp081 · Cited by 1 · see citing works
Self-citationOn the road to psychotherapy integration: A student's journey.
Lampropoulos, G. K. (2006) · Journal of Psychotherapy Integration · doi:10.1037/1053-0479.16.1.5 · Cited by 1 · see citing works
Self-citationThe Relation between Homework Compliance and Treatment Outcome for Individuals with Social Phobia
Edwards, S. M. (2022) · Digital Archive @ GSU · doi:10.57709/1951724 · Cited by 1 · see citing works
(2012) · Elsevier eBooks · doi:10.1016/b978-0-12-398455-5.00023-1 · Cited by 1 · see citing works
Case managers' use of homework assignments
Kelly, P. J., & Deane, F. P. (2005) · Research Online (University of Wollongong)
Self-citation
- Authors
- Kazantzis, N., Lampropoulos, G. K., & Deane, F. P.
- Affiliations
- Massey University (NZ)
- Ball State University (US)
- University of Wollongong (AU)
- Venue
- Journal of Consulting and Clinical Psychology
- Published
- 2005
- Volume
- 73
- Issue
- 4
- Pages
- 742-748
- ISSN
- 0022-006X (ISSN-L)
- 1939-2117
- OpenAlex
- W2109979704
- Cited by
- 112
- References
- 43
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 5 · 2023: 6 · 2022: 10 · 2021: 4 · 2020: 3 · 2019: 4 · 2018: 1 · 2017: 3 · 2016: 5 · 2015: 10 · 2014: 4 · 2013: 6 · 2012: 7
- FWCI
- 7.70
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Consulting and Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Research Online (University of Wollongong) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Social Psychology › Counseling Practices and Supervision
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- homework, psychotherapy, psychologists' attitudes, clinical practice, cognitive behavioral therapy, psychodynamic psychotherapy, therapeutic work, treatment outcomes, theoretical orientation
- MeSH terms
- Attitude of Health Personnel, Female, Humans, Male, Middle Aged, Patient Compliance, Practice, Psychological, Psychology, Psychotherapy, Surveys and Questionnaires, Reinforcement, Psychology, Treatment Outcome
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