I often tell therapists and patients that the way people get better is to make small changes in their thinking and behavior every day. That’s why it’s important for patients to do homework – just talking to a therapist for an hour a week is unlikely to be of much help to most people with psychiatric disorders. Homework frequently involves having patients change their distorted thinking so they see reality more clearly, doing “experiments” to change their behavior in small ways to see what happens, and implementing solutions to problems they’ve discussed in session.

I set up homework assignments very carefully and make sure patients are overwhelmingly likely to do them. When an Australian graduate student contacted me a few weeks ago about the role of homework in cognitive therapy, I told him that I think the reason some patients fail to do homework is because of mistakes their therapist makes. Read more