The use of homework in behavior therapy for anxiety disorders.

Abstract

In this article, the authors discuss the role of homework in behavior therapyfor the anxiety disorders. First, the authors describe the essential componentsof behavior therapy that include exposure to feared consequences andcessation of all avoidance behaviors. Then, the authors briesy review theliterature on the relationship between homework compliance and treatmentoutcome. Next, the authors discuss the way that homework is used in termsof self-monitoring and exposure exercises during the course of treatment.Finally, the authors discuss the practicalities of encouraging homeworkcompliance and managing noncompliance.Behavior therapy is an empirically based treatment approach that hasdemonstrated efÞcacy across the anxiety disorders (see Hersen & Bellack,1999, for discussions of behavior therapy in panic disorder, obsessiveÐcompulsive disorder, social phobia and posttraumatic stress disorder, or forspeciÞc treatment manuals including suggestions for homework assign-ments see Oxford University Press/Graywind Publications manuals). Inaddition to the empirical stance taken by researchers of behavior therapy,clinicians and patients are also encouraged to take the stance of scientistsin the context of treatment. SpeciÞcally, treatment involves testing beliefsthat they have about particular situations during treatment sessions and ontheir own through the use of homework assignments.Behavior therapy for the anxiety disorders focuses primarily on havingpatients confront situations that that they are avoiding. Avoidance can beovert (e.g., a person with social phobia who refuses to do any public