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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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“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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“E-mail: N.Kazantzis@latrobe.edu.au 119 Standard Papers rience of homework nonadherence as frequent in clinical practice; for example, a survey by Kazantzis, Lampropoulos, and Deane (2005) found that psychologists estimated that 20% of their patients had low adherence with homework.”
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“Additionally, therapists rated participants’ HW compliance by completing the HRS-II therapist version (Kazantzis et al., 2005).”
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“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).”
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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
“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
“Only 68% of general mental health care providers and approximately 55% of family care providers report using homework “often” to “almost always” [9,10].”
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“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
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
Petrik, A. M., Dobson, K. S., Papadopoulos, O., & Kazantzis, N. (2023) · Clinical Psychologist · doi:10.1080/13284207.2023.2221782 · Cited by 1
Self-citationThapar, S., Quesada, D., & Knaüper, B. (2025) · JMIR Formative Research · doi:10.2196/69532 · Cited by 2
“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
Does Expectancy and Homework Compliance Predict Change in CBT?
Schroder, A. (2017) · Acta Psychopathologica · doi:10.4172/2469-6676.100133 · Cited by 1
Conklin, L. R. (2009) · OhioLink ETD Center (Ohio Library and Information Network) · Cited by 1
Petrik, A. M., & Kazantzis, N. (2015) · The Encyclopedia of Clinical Psychology · doi:10.1002/9781118625392.wbecp081 · Cited by 1
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
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
(2012) · Elsevier eBooks · doi:10.1016/b978-0-12-398455-5.00023-1 · Cited by 1
Case managers' use of homework assignments
Kelly, P. J., & Deane, F. P. (2005) · Research Online (University of Wollongong)
Self-citation
Metadata
- 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 › Clinical 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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