Category: Dissemination / Implementation

Symposium

Factors Associated With Assignment of Therapeutic Homework in a Diverse Public Children's Mental Health System

Saturday, November 18
3:45 PM - 5:15 PM
Location: Aqua Salon A & B, Level 3, Aqua Level

Keywords: Community-Based Assessment / Intervention | Implementation | Evidence-Based Practice
Presentation Type: Symposium

Therapeutic homework is a fundamental skill-building component of the majority of evidence-based mental health treatments (Garland et al., 2008) and is associated with better treatment outcomes, less parenting stress, and a shorter duration of treatment (Kazantzis, Deane, & Ronan, 2000; Ros, Hernandez, Graziano, & Bagner, 2016, Stokes et al., 2016).  One study in a diverse usual care setting found that homework is assigned in very few treatment sessions (13% of sessions with children who have disruptive behavior disorders; Garland et al., 2010), which is lower than other published rates of homework usage (e.g., 57% of sessions; Kazantzis & Deane, 1999), likely because they did not measure use of homework in usual care. There is a dearth of research examining factors associated with clinician assignment of homework in diverse usual care settings.


Thus, this study’s aims were to: 1) Examine clinician rates of homework utilization in a diverse public mental health system serving children and families; 2) Identify barriers to homework utilization; and 3) Determine what factors predict clinicians’ assignment of homework.


An online survey was administered to 267 clinicians in a large diverse public mental health services. The survey consisted of 24 questions in the following areas: clinician demographics, barriers to homework use, and frequency of homework assignment during the last month.  Approximately 40% of clinicians reported assigning homework during most or all therapy sessions and only 12% said that their supervisors asked about their use of homework with clients during the majority of their supervision sessions. The most common barrier clinicians reported in using homework was clients not completing it.


Preliminary generalized estimating equation models suggest that clinicians who are younger, licensed, and identify as using a cognitive-behavioral orientation to treatment predicted greater assignment of homework.  Further, clinicians whose supervisors asked about their use of homework and whose clients who completed their homework more frequently, predicted greater assignment of homework.

Emily Trask

Senior Mental Health Researcher
University of California, San Diego

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