Homework

One of the hallmark features of CT for depression is the use of homework (Beck et al., 1979). Cognitive therapists generally believe that what happens between treatment sessions is more important than what goes on within the session (Kazantzis & Deane, 1999; Kazantzis, Deane, Ronan, & L'Abate, 2005; Tompkins, 2004). Thus, whereas the sessions are essential for identifying problems and teaching strategies to deal with these problems, it is the implementation of these strategies in the patient's actual life that represents successful treatment. Certainly, most cognitive therapists would maintain that "insight" attained within a session is relatively meaningless, unless it can be translated into a concrete and specific implementation plan. Furthermore, it has been demonstrated that early completion of homework is a predictor of positive outcome in CT for depression (Startup & Edmonds, 1994), so it is critical to assign homework, to monitor it, and to evaluate its intended and actual outcomes. CT therapists purposely assign some homework in the first session (whether it be reading or other tasks described below), in part for the value of being able to assess the patient's ability to carry through on agreed assignments. This assessment also serves as a model for following up on assigned work, and may also lead to a discussion about how to maximize the chances of homework completion (Detweiler & Whisman, 1999).

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