Homework (mutually agreed tasks for the patient to complete outside the therapy session) is an
important component of Cognitive Behavioral Therapy (CBT). CBT homework disconfirms
negative thoughts and beliefs; focuses subjective accounts to more objective detailed accounts;
allows therapist and patient to review the past weeks activities; and helps the therapist to relate
the session to specific tasks (Beck et al., 1979). Compliance with homework has been shown to
improve the clinical results of CBT (Persons et al., 1988). At the present time there is no
consensus as to the average rate of adherence in completing homework assignments (Detweiler
& Whisman, 1999).
The identification and reliable measurement of barriers affecting completion of
homework assignments may improve the potency of CBT, thereby producing further reductions
in depressive symptoms and improvement in ultimate clinical outcome. It may also assist
researchers to identify factors related to variance in treatment outcome, thereby strengthening the
generalizability of investigational findings for the clinical community.
A two-phase study was conducted to develop an instrument that may assist CBT patients,
therapists, and researchers to ascertain the barriers that may be preventing completion of
homework assignments. Phase I involved the interview of 20 depressed patients and 20
therapists to elicit perceived barriers to homework completion in order to develop an item pool
for the draft instrument. In Phase II, the draft instrument was administered to 56 subjects on 2
separate occasions.
Factor Analysis revealed a 2-factor solution of Patient Factors and Therapist/Task
Factors. Internal Consistency demonstrated Alpha Coefficients of the Subscale and Entire
scales that ranged from .80 to .95. Test-Re-Test correlations demonstrated Pearson correlations
of .72 to .95. The only consistent demographic predictors of levels of Barriers to CBT
Homework Completion Scale scores were race and marital status. The Patient subscale was able
to satisfactorily classify patients (75 to 79 %) with low and high adherence to homework
assignments. There were no consistent predictors of assignment compliance. The Barriers to
CBT Homework Completion Scale scores did correlate significantly with Assignment
Compliance (.32 to .46). Sample size most likely limited the ability to fully evaluate the
psychometric properties of this draft instrument. Future studies will expand upon this pilot study
of the Barriers to CBT Homework Completion Scale.
| Identifer | oai:union.ndltd.org:PITT/oai:PITTETD:etd-05082007-211141 |
| Date | 07 June 2007 |
| Creators | Callan, Judith |
| Contributors | Michael Thase M.D., Ellen Olshansky DNSc, RN, FAAN, Susan Sereika PhD, Clement Stone PhD, Jacqueline Dunbar-Jacob PhD, RN, FAAN |
| Publisher | University of Pittsburgh |
| Source Sets | University of Pittsburgh |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.pitt.edu/ETD/available/etd-05082007-211141/ |
| Rights | unrestricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Pittsburgh or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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