Mj. Bryant et al., Therapist skill and patient variables in homework compliance: Controlling an uncontrolled variable in cognitive therapy outcome research, COGN THER R, 23(4), 1999, pp. 381-399
Prior research suggests therapists' assignment of homework, and patients' c
ompliance with it, enhances the efficacy of cognitive therapy (CT). However
, factors contributing to homework compliance have received scant empirical
attention. This study examined specific demographic and clinical patient v
ariables (age, education, number of previous depressive episodes, depressio
n severity, and learned resourcefulness) and a variety of therapist skills
(general, CT-specific, and homework-focused) as they predicted homework com
pliance among 26 patients in a 20-session CT protocol for major depression.
Patients who were more compliant with homework exhibited significantly gre
ater treatment response on one depression measure but not another. Homework
compliance was most strongly predicted by therapists' reviewing homework a
ssigned previously, and by general therapeutic skills. Patients' age, educa
tion, depression severity, and learned resourcefulness were unrelated to co
mpliance; however, number of previous episodes was negatively related to co
mpliance.