One element of cognitive behavioural therapy (CBT) that’s a crucial part of treatment, but which won’t necessarily feature in other types of therapy, is completing ‘homework’ in between sessions. This might bring up disagreeable memories of school days, but the homework you do in CBT is very different! There’s no right or wrong, and no good or bad marks. If the word holds unpleasant connotations for you, you can choose to call it something else – some patients prefer ‘tasks’ or ‘activities’, for example.
Homework is important because CBT is based on learning new skills and techniques, and you need to practice these in the real world to make good progress. If you were having piano lessons, you wouldn’t spend an hour with the teacher, then do nothing until the next week, and expect to see a difference in your playing!
You and your therapist will discuss, agree and set your homework together, and they’ll check that you understand it and whether there are any obstacles that might prevent you from doing it.
The kind of tasks that might be set in the early stages of your treatment include:
- Keeping a diary of your symptoms and experiences, so you and your therapist can keep track of your difficulties and progress.
- Thinking about the goals you’d like to achieve through your treatment.
- Writing examples of situations you’ve experienced as part of your problem, for your CBT formulation.
Later on, the activities you carry out might involve:
- Practicing techniques you’ve learned during the session, in order to embed them.
- Completing a behavioural experiment – where you do something differently from usual in order to learn something new.
- Challenging any negative or unhelpful thoughts you have.
During the next session you and your therapist will discuss how the homework went, and what you’ve learned from it. Remember, there’s no such thing as ‘failing’; even if something doesn’t go as well as you hoped there’ll still be useful insights for you to take away and build on.
You may end up doing the same activity for a number of weeks, if there’s a skill you need to strengthen, for example, or you might set a different task each time. What could feel like a big chore at the beginning of therapy might become second nature as you keep doing it. We know that the more work CBT patients do outside the sessions, and the more they engage with their homework, the greater the impact this has on their recovery.
Some people do struggle with completing their homework. If they’re depressed, for instance, they might feel a lack of motivation, while somebody with anxiety might feel under pressure to do it perfectly. Others might struggle with getting the time to do it, or find it too distressing. If this happens to you, try thinking back over the benefits of working on your skills between sessions, as well as the reasons you agreed to do the specific task – and please do discuss this with your therapist.
You can find out more about what to expect from online CBT here.