Skip to Main Content
 

Global Search Box

 
 
 

ETD Abstract Container

Abstract Header

Client Engagement with Homework: A Study of Cognitive Therapy for Depression

Conklin, Laren Renee
http://rave.ohiolink.edu/etdc/view?acc_num=osu1365956558

Abstract Details

2013, Doctor of Philosophy, Ohio State University, Psychology.
Homework is considered an essential component of Cognitive Therapy (CT) for depression (Beck, Rush, Shaw, & Emery, 1979), and clients who engage in more homework tend to experience greater symptom improvement over the course of treatment (Kazantzis, Deane, & Ronan, 2000). However, less is known about how therapists can increase clients’ engagement in homework, especially early in treatment. In an initial step toward addressing these issues, the primary objectives of this study were to examine whether specific therapist behaviors serve as predictors of session-to-session homework engagement and to examine the relationship between homework engagement and concurrent depressive symptom changes. This study examined the first five sessions of 66 depressed clients participating in a course of CT. A team of trained undergraduates rated therapist behaviors using the Homework-Specific Therapist Behaviors scale (HSTB), which is composed of three subscales: Specificity, Motivation, and Problem-Solving. A second team rated the homework engagement variables, which included general homework engagement (time and effort put into homework and the frequency of therapy skill use to cope with feeling sad or upset) and CT-specific homework engagement (amount of cognitive, behavioral, and self-monitoring homework). Clients and therapists also provided ratings on general homework engagement. To examine therapist behaviors as predictors of session-to-session homework engagement, repeated measures regression analyses using the SAS Proc Mixed procedure (without specification of random effects) were utilized. Controlling for previous homework engagement reported during each session, HSTB subscale scores at each session were examined as predictors of homework engagement variables at the next session. Results indicated that the Specificity subscale was the strongest and most consistent predictor of homework engagement variables (in comparison with the Motivation and Problem-Solving subscales). When rated by therapists, higher general homework engagement was significantly related to greater depressive symptom improvements, but not when engagement was rated by observers or clients. Across all three informants, the frequency with which clients used therapy skills to cope was significantly related to greater depressive symptom improvements. When examining CT-specific homework engagement, cognitive homework engagement was significantly related to greater depressive symptom improvements, whereas self-monitoring homework was unexpectedly related to a smaller magnitude of session-to-session depressive symptom change from session-to-session. The results found with the HSTB Specificity subscale suggest that therapists who devote more time to helping clients really understand homework-relevant skills and know what the assignments they are to work on may be able to enhance clients’ engagement in homework in early sessions of CT.
Daniel Strunk, Ph.D. (Advisor)
Jennifer Cheavens, Ph.D. (Committee Member)
Mary Fristad, Ph.D. (Committee Member)
81 p.
Clinical Psychology
Homework; Cognitive Therapy; Depression

Recommended Citations

Citations

  • Conklin, L. R. (2013). Client Engagement with Homework: A Study of Cognitive Therapy for Depression [Doctoral dissertation, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1365956558

    APA Style (7th edition)

  • Conklin, Laren. Client Engagement with Homework: A Study of Cognitive Therapy for Depression. 2013. Ohio State University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1365956558.

    MLA Style (8th edition)

  • Conklin, Laren. "Client Engagement with Homework: A Study of Cognitive Therapy for Depression." Doctoral dissertation, Ohio State University, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=osu1365956558

    Chicago Manual of Style (17th edition)

osu1365956558
417
© 2013, all rights reserved.
This open access ETD is published by The Ohio State University and OhioLINK.