Improving therapeutic use of homework: Suggestions from mental health clinicians

Background. The majority of mental health clinicians report the use of homework to support their case management, but practitioner surveys indicate that homework is not routinely used. Aims. To examine barriers that mental health case managers experience in implementing homework and to identify strategies to promote successful homework administration. Method. One hundred thirty-four surveys were completed by mental health case managers. The survey examined their use of homework for individuals diagnosed with a severe mental health problem. It also asked them to identify barriers to regularly implement homework and describe strategies to promote more regular use of homework. Results. On average, homework was used at 50% of clinical contacts. The primary reasons for not using homework included allocating insufficient time at appointments, perceived client resistance for using homework and concerns that the client was too unwell. Strategies used to overcome these difficulties included prioritising the use of homework and ensuring that homework assignments were achievable. Conclusions. Clinicians are able to identify a range of practical strategies to promote the use of homework. Discussion focuses on the application of the suggested strategies to promote regular use of homework. This includes discussion of possible training approaches to enhance systematic homework administration.