During an initial consultation with prospective Rational Emotive Behavior Therapy (REBT) clients, I discuss use of homework to strengthen psychoeducational lessons learned in sessions. For context, I stated in a blogpost entitled Homework:
This psychotherapeutic modality isn’t particularly difficult to learn, because there are essentially two major components: the ABC model and unconditional acceptance. Once clients have understanding of and belief in the method, they need to routinely practice REBT techniques.
Although people who contact me commonly express a misconception of how care for mental, emotional, and behavioral health should, must, or ought to be conducted – based largely on unhelpful representations of care from social media, I invite prospective clients to consider that I’m less interested in helping them feel better and more concerned with helping them get better.
Thus, as the late psychologist Albert Ellis who developed REBT stated, people “require work and practice, work and practice” to give up their biological and sociological tendencies to disturb themselves. Work and practice occurs in- and outside of sessions so that people can get better.
As one prominent REBT source expands upon this matter, “Strive to practice, practice, and practice some more REBT attitudes every day. Homework is the most important ingredient to therapeutic success.”
Once prospective clients agree to stipulations of practice, I find that people generally do well with demonstrating practice of REBT when in front of me. Nevertheless, homework completion appears to be one of the major hindrances to success with REBT among my clients.
Regarding this matter, page 158 of The REBT Therapist’s Pocket Companion (“Pocket Companion”) invites REBT practitioners to “provide clients with a powerful rationale for homework” exercises, because people who work and practice in this regard do better with REBT, thus they get better overall.
Noteworthy, REBT is a form of cognitive behavior therapy (CBT)—a psychotherapeutic modality that takes into account rehearsed skills as a matter of adapting healthier behavioral techniques. Regarding this approach to psychotherapy, one source states:
Homework non-compliance is one of the top cited reasons for therapy failure in CBT and has remained a persistent problem in the clinical practice. Surveys of practitioners have suggested rates of non-adherence in adult clients of approximately 20% to 50% while adherence rates in adolescents have been reported to be approximately 50%.
Statistically speaking, up to half of the people using a CBT approach to care for mental, emotional, and behavioral health will not benefit from the intervention if they don’t complete homework exercises. How’s that for powerful rationale?
But wait, there’s more! One study that assessed homework noncompliance reported, “The factors cited as affecting homework compliance were motivation, recall of the assignment, difficulty, putting off, understanding of the rationale, perceived benefits, insight, effort and relevance.”
Imagine investing money and time into the process of psychotherapy though not following through with half of the intervention, because of the aforementioned factors. That’s like paying full price for a plain hotdog and then tossing out the bun. According to another source:
The focal point of this issue lies in the evident reality that clients spend the majority of their time beyond the confines of therapy: in their residences, workplaces, or engaged in leisure activities; either in solitude or in the company of a partner, friends, colleagues, or children; engaging in routine tasks such as employment and recreational pursuits. For every hour dedicated to therapy, there exists ample scope for clients to advance the therapeutic process and strive toward ultimate treatment objectives in their daily routines, where challenges are most likely to persist.
Page 159 of the Pocket Companion invites REBT practitioners to encourage clients to “walk the rational talk, not just talk the rational talk.” This form of proverbial walking occurs outside of session and through completion of homework.
Additionally, page 160 of the Pocket Companion advocates use of a client-centered term for homework, as some people dislike the idea of homework from their days of education. For instance, a client may refer to homework as “skill-building.”
Also, page 161 of the Pocket Companion recommends negotiating homework with clients at each session. Homework is negotiated and not assigned, and without an assignment per session clients may miss out on invaluable opportunities to hone skills of REBT.
Similarly, page 162 of the Pocket Companion suggests making homework relevant to information covered in sessions. As a matter of preference, page 163 invites REBT practitioners to familiarize themselves with various self-help books which may assist clients with their practice of REBT.
Still, page 164 of the Pocket Companion advises that such books are an “important prelude to action, not a substitute for it.” Thus, homework is necessary so that clients may fully benefit from the psychotherapeutic experience.
Importantly, page 165 of the Pocket Companion encourages use of a client homework log for tracking exercises, and page 166 advocates use of varying self-help forms for expediency. In the same way, page 167 advises use of client training in regard to homework self-help forms.
Additionally, when clients make errors on their self-help forms, it may be helpful to clearly correct these errors without use of discouragement, pet page 168. As well, page 169 of the Pocket Companion advocates challenging, though not overwhelming, homework exercises.
Helpfully, I negotiate with clients when and how homework exercises are to be completed, per page 170, and together we troubleshoot possible obstacles to homework completion, per page 171. This collaborative approach contributes to the rationale for doing homework in the first place.
Page 172 of the Pocket Companion invites REBT practitioners to discuss emotional engagement and not solely client intellectual capacity when conducting homework. Otherwise, clients may derive little benefit from these exercises.
As well, it’s important to ensure that clients have the necessary skills to complete homework tasks, per page 173. Equally, page 174 of the Pocket Companion advocates commitment to homework rather than merely “trying” these exercises. This is an incredibly essential point.
In the earlier stages of my development as an REBT practitioner, I waited until the last few minutes of session to negotiate homework. However, per page 175 of the Pocket Companion, giving oneself plenty of time to discuss homework tasks contributes to client follow-through.
Likewise, page 176 invites REBT practitioners to review homework exercises at the beginning of the following session. When otherwise becoming sidetracked by supplementary topics, clients may learn that homework is unimportant. Therefore, I review the tasks as soon as possible.
In the same way, I elicit from clients what parts of homework exercises were helpful, unhelpful, or had no effect at all, per page 177 of the Pocket Companion. As such, clients learn about the rationale behind completion of homework tasks.
Ultimately, work and practice within a session is nowhere as substantial as the work and practice that can be done outside of a session. Thus, the artificial nature of a therapy session is in no way comparable to the realistic environments in which people live.
Therefore, in the interest of psychotherapeutic success, the rationale for homework lies in the fact that those who complete homework exercises give themselves an opportunity to get better within settings which provide ample opportunity for realistic work and practice.
If you’re looking for a provider who works to help you understand how thinking impacts physical, mental, emotional, and behavioral elements of your life—helping you to sharpen your critical thinking skills, I invite you to reach out today by using the contact widget on my website.
As a psychotherapist, I’m pleased to help people with an assortment of issues ranging from anger (hostility, rage, and aggression) to relational issues, adjustment matters, trauma experience, justice involvement, attention-deficit hyperactivity disorder, anxiety and depression, and other mood or personality-related matters.
At Hollings Therapy, LLC, serving all of Texas, I aim to treat clients with dignity and respect while offering a multi-lensed approach to the practice of psychotherapy and life coaching. My mission includes: Prioritizing the cognitive and emotive needs of clients, an overall reduction in client suffering, and supporting sustainable growth for the clients I serve. Rather than simply helping you to feel better, I want to help you get better!
Deric Hollings, LPC, LCSW
References:
AEI. (n.d.). About Albert Ellis, Ph.D. Albert Ellis Institute. Retrieved from https://albertellis.org/about-albert-ellis-phd/
Dryden, W. and Neenan, M. (2003). The REBT Therapist’s Pocket Companion. Albert Ellis Institute. ISBN 0-917476-26-3. Library of Congress Control Number: 20031044378
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