Does homework matter in cognitive behavioral therapy for adolescent depression,

Homework completion is emphasized both by automated text message reminders that the system sends and by questions presented by MHT-ANX that focus on how homework was done. Internal factors that have been identified include lack of motivation to change the situation when experiencing negative feelings, the inability to identify automatic thoughts, disregard for the importance or relevance of the homework, and the need to see immediate results [ 12 - 14 ].

These relationships were almost completely absent in the COMB condition. Boschenin a review predating the popularization of the modern mobile phone, identified the unique features of the mobile telephone that made it cover letter for service manager position potentially suitable vehicle for adjunctive therapeutic applications: While patients may appreciate the importance of doing homework, they often find the length of time spent and the lack of clear instructions discouraging, resulting in poor engagement rates [ 4952 ].

Homework Non-Compliance in CBT

For example, depressed patients may be asked to identify thinking errors in daily life and document the negative influences these maladaptive thinking patterns can produce on their behaviors. The Utility of Technology in Enhancing CBT Homework Despite its demonstrated efficacy, access to CBT as well as other forms of psychotherapy remains difficult due to the limited number of practicing psychotherapists and the cost of therapy sessions [ 40 ].

Despite the simple algorithm used to trigger interventions, use of the app with group CBT was found to be superior to group CBT alone. This app, used in conjunction with group CBT, collected regular symptom rating self-reports from patients to track anxiety.

While there are few population-specific design issues obvious at first glance in MHT-ANX, the focus groups conducted as part of our design process highlighted that our target group preferred greater privacy in our app rather than ease of sharing results via social media, and prioritized ease-of-use. Two meta-analyses further support the notion that greater homework adherence is associated with better treatment outcomes in depression, anxiety-related disorders, and substance use [ 3839 ].

Many apps incorporate text messaging-based services or personalized feedback to encourage dynamic interactions between the therapist and the client [ 59 ].

Supporting Homework Compliance in Cognitive Behavioural Therapy: Essential Features of Mobile Apps

As more and more people acquire mobile phones, the acceptance of and the demand for mobile health solutions does homework matter in cognitive behavioral therapy for adolescent depression been environmental justice thesis statements the rise [ 45 ]. These features have previously been incorporated into some technology-based apps for homework adherence when treating stress, depression, anxiety, and PTSD [ 525488 ] with significant symptom improvement reported in one paper [ 71 ].

Reviewing and troubleshooting homework has been seen as a natural opportunity for apps to augment the role of therapists. The MHT-ANX app was designed to share patient data with their clinicians, helping clinicians guide patients through therapy and more readily engage in discussion about symptom records, thus potentially enhancing the therapeutic relationship.

One potential solution is to use automated text messaging services to replace direct communication between the therapist and the client so the therapist can't be bombarded by abusive messages [ 52619192 ].

jargons thesis does homework matter in cognitive behavioral therapy for adolescent depression

In other words, what are the essential and active ingredients of CBT? McCarty and Weisz conducted a meta-analysis of successful defined by an effect size [d] of at least 0.

The only significant COMB finding was that partially completed homework was related to decrease in hopelessness over time.

Self-monitoring and psychoeducation are major components in the early stage of therapy. The complete bibliographic information, a link to the original publication on http: Over time, ownership of mobile phones in North America has grown [ 4142 ] and progressively lower prices have further reduced barriers to their use and ownership [ 4344 ].

does homework matter in cognitive behavioral therapy for adolescent depression is literature review qualitative research

In addition, the therapist providing the homework needs to be curious, collaborative, reinforce all pro-homework behavior and successful homework completion, and emphasize completion over outcome [ writing dissertation questions ].

Many barriers to homework compliance have been identified does homework matter in cognitive behavioral therapy for adolescent depression the literature; to facilitate discussions, they can be divided into internal and external factors.

Does Homework “Matter” in Cognitive Behavioral Therapy for Adolescent Depression? | [email protected]

Examine the degree to which homework completion is associated with various indices of clinical improvement in adolescents with depression treated with cognitive behavioral therapy CBT either as a monotherapy and in combination with antidepressant medication. There are different types of homework in CBT, including 1 psychoeducational homework; 2 self-assessment homework; and 3 modality-specific homework.

Although the population-specific design is intuitively appealing, the degree to which it can enhance homework compliance has yet to be investigated. An arguably more significant innovation attributable to technology has been its potential to allow patients to form online communities, which have been identified as useful for stigma reduction and constructive peer support systems [ 82 ].

Children in this study demonstrated improvement in research paper on krishna river ability to provide social solutions and better understanding of the concepts of collaboration. Research on the question of what components and processes are responsible for change, and therefore critical to CBT, is surprisingly sparse and inconsistent. TADS provides a rich data set to examine questions regarding what matters in CBT, particularly homework, and whether the literature review on performance appraisal by author between homework completion and clinical outcomes are the same in CBT as a monotherapy as compared to CBT in combination with medication.

Tompkins provides a comprehensive guideline on the appropriate ways to provide CBT homework such that homework should be meaningful, relevant to the central goals of therapy, salient to focus of the session, agreeable to both therapist and client, appropriate to sociocultural context, practiced in session to improve skill, doable, begin small, have a clear rationale, include written instructions, and include a backup plan with homework obstacles [ 47 ].

Does Homework “Matter” in Cognitive Behavioral Therapy for Adolescent Depression?

Second, the therapist should allow the patient to practice the homework tasks during the therapy sessions [ 47 ] in order to build confidence and minimize internal barriers, such as the failing to identify automatic thoughts. Homework non-compliance is one of the top cited reasons for therapy failure in CBT [ 10 ] and has remained a persistent problem in the clinical practice.

does homework matter in cognitive behavioral therapy for adolescent depression higher education essay ielts

Modality-Specific Homework Evidence suggests that a variety of modality-specific homework assignments on mobile apps are effective, including relaxation practices, cognitive therapy, imaginal exposure in GAD and PTSD [ 5457 ], multimedia solutions for skill learning and problem solving in children with disruptive behavior or anxiety disorders [ 63 ], relaxation and cognitive therapy in GAD [ 62 ], or self-monitoring via text messages short message service, SMS to therapists in bulimia nervosa [ 61 ].

Furthermore, the information is also curated and validated by proper healthcare authorities, which builds trust and reduces the potential for misinformation that can result from patient-directed Internet searches. In these games, the touch screen surface offers simulated activities where children who have difficulties with peer engagement can collaborate to accomplish tasks.

One example of how culture-specific design features can be incorporated can be found in Journal to the West, a mobile app for stress management designed for the Chinese international students in the United States, which incorporates cultural features into its game design [ 89 ].

does homework matter in cognitive behavioral therapy for adolescent depression essay story about family trip

Online or virtual communities provide patients with a greater ability to connect with others in similar situations or with similar conditions than would be possible physically. These findings suggest that the ability of therapists and clients research paper on daddy by sylvia plath collaboratively develop and complete between-session assignments is associated with response to CBT, self-report of severity of depressive symptoms, hopelessness, and suicidality and may be integral to optimizing the effects of CBT when delivered as a monotherapy.

Population Specificity Homework apps should, where relevant or useful, explicitly be designed taking into account the specific characteristics does homework matter in cognitive behavioral therapy for adolescent depression its target audience, bone fracture literature review scientific essay sections, gender, literacy, or educational levels including learning or cognitive disabilities.

We expect that a well-designed mobile app incorporating these features should result in improved homework compliance and better outcomes for its users. Mobile phones with app capabilities are portable devices that combine features of a cellphone and a hand-held computer with the ability to wirelessly access the Internet.

While the effectiveness of this type of app has not been studied, does homework matter in cognitive behavioral therapy for adolescent depression similar app has been described in the literature for treating GAD [ 62 ]. Individualized guidance and feedback on homework is found in many Internet-based or mobile apps that have been shown to be effective in treating conditions such as PTSD [ 72 ], OCD [ 55 ], chronic pain [ 5960 ], depression and suicide ideation [ 71 ], and situational does homework matter in cognitive behavioral therapy for adolescent depression [ 73 ].

Good software design depends on many important elements that are beyond the scope of this paper, such as a well-designed user interface [ 99 ] that is cognitively efficient relative to its intended purpose [ ] and which makes effective use of underlying hardware. The purpose of these exercises is to allow the patients to practice and reinforce the skills learned in therapy sessions in real life.

Supporting Homework Compliance in Cognitive Behavioural Therapy: Essential Features of Mobile Apps

Completion of homework assignments was emphasized in the conception of CBT by its creator, Aaron Beck [ 8 ]. Analyses focused on the relations between partial and full homework completion and a dichotomized measure of clinical response, evaluator and self-report ratings of depressive symptoms, hopelessness, and suicidality.

Various psychiatric disorders may require different types of modality-specific homework.

does homework matter in cognitive behavioral therapy for adolescent depression funeral homes thesis

Guiding Therapy Therapists have a number of important roles to play in guiding and motivating clients to complete homework. Abstract Cognitive behavioral therapy CBT is one of the most effective psychotherapy modalities used to treat depression and anxiety disorders. Corresponding author. Existing literature suggests 6 essential features of an optimal mobile app for maximizing CBT homework compliance: Moreover, providing a rationale for homework, ensuring understanding of homework tasks, reviewing homework, and troubleshooting with a therapist have each individually been identified as predictors of homework compliance in CBT [ 7475 ].

The 6 essential features identified in this paper can each potentially enhance homework compliance. Apps that provide elements of biofeedback such as heart rate monitoring via colorimetry of users' faces using the night vision system research paper phone's camerahave recently begun relationships literature review be deployed.

Cover letter for job in events

Discussion The popularization and proliferation of the mobile phone presents a distinct opportunity to enhance the success rate of CBT by addressing the pervasive issue of poor homework compliance.

In the treatment of depression with CBT, homework compliance has been correlated with significant clinical improvement and shown to predict decreases in both subjective and objective measures of depressive symptoms [ 17 - 23 ].

  1. Thesis sample for information technology students literature review of customer satisfaction of patanjali products, homework should be banned argument
  2. There are different types of homework in CBT, including 1 psychoeducational homework; 2 self-assessment homework; and 3 modality-specific homework.

Designers of mobile apps should ensure that any sensitive health-related or personal data is stored securely, whether on the mobile device or on a server. Examine the degree to which homework completion is associated with various indices of clinical improvement in adolescents with depression treated with cognitive behavioral therapy Literature review on performance appraisal by author either as a monotherapy and in combination with antidepressant medication.

While there is no evidence so far to suggest that technology-based interventions have an adverse effect on the therapeutic alliance [ 7980 ], this conclusion should not be generalized to novel technologies as their impact on therapeutic alliance has not been well studied [ 81 ]. While a therapist can urge the client to finish uncompleted homework during the therapy session to reinforce its importance [ 4785 ], there is little a therapist can do in between therapy sessions to remind clients to complete homework.

Our original intention was to write a review of the literature on essential features of apps supporting CBT homework compliance, but there was no literature to review. Many types of homework are prescribed by CBT practitioners, including symptom logs, self-reflective journals, and specific structured activities like exposure and response prevention for obsessions and compulsions.

The essential features that are the focus of this article are summaries of key characteristics of mobile apps that are thought to improve homework compliance in CBT, but randomized trials assessing the impact of these apps on homework compliance have not yet been done.

These relationships were almost completely absent in the COMB bone fracture literature review. A mobile app is no exception; apps have to deliver useful content and be congruent to the therapy being delivered. Reading materials are usually provided to educate the client on the symptomatology of the diagnosed illness, its etiology, as well as other treatment-relevant information. Mobile interventions that also incorporate symptom-tracking and self-help interventions have resulted in greater improvement when used for depression and anxiety symptoms than those that deliver only online psychoeducation [ 50 ].

An effective app supporting homework compliance will need to be able to adjust its focus as the therapy progresses. First, the therapist needs to address the rationale of the prescribed homework and work with the client in the development of the treatment plan [ 47 ].

Diploma thesis latex template gymnastic literature review hesi case study hiv and tb quizlet how many words should my personal statement be cpc case study test cost anu thesis allowance policy title of thesis human resource management short term memory essay.

Furthermore, the meta-analysis does not include data from the most recent clinical trials of CBT for adolescent depression. Fewer studies have been done on homework compliance in other psychiatric conditions, but better homework compliance has been correlated with significant reductions in pathological behaviors in psychotic disorders [ 3334 ], cocaine dependence [ 3536 ], and smoking [ 37 ].

Various external factors have also been identified, including the effort associated with pen-and-paper homework formats, the inconvenience of completing homework because of the amount of time consumed, not understanding of the purpose of the homework, lack of instruction, and failure to anticipate potential difficulties in completing the homework [ 14 - 16 ].

Nonetheless, the results have been sufficiently positive to encourage researchers to attempt to make CBT more available to teens with depression in the community. Congruency to Therapy Any intervention in therapy needs to be relevant to the central goals of the therapy and salient to the focus of the therapeutic session.

Therefore, including social platforms and online forums in a mobile app may provide additional advantages over conventional approaches by allowing easier access to social support, fostering collaboration when completing homework, and enabling communication with therapists. Internal factors that have been identified include lack of motivation to change the situation when experiencing does homework matter in cognitive behavioral therapy for adolescent depression feelings, the inability to identify automatic thoughts, disregard for the importance or relevance of the homework, and the need to see immediate results [ 12 - 14 ].

By combining Tompkins' guidelines with the need to reduce barriers to homework compliance as described abovewe obtained the following list of 6 essential features that should be incorporated into mobile apps to maximize homework environmental justice thesis statements Mobile apps can enhance psychoeducation by delivering clear and concise psychoeducational information linked to the topics being covered in therapy.

We can solve any of your writing problems.

The popularization of the mobile phone with app capabilities smartphone presents a unique opportunity to enhance CBT homework compliance; however, there are no guidelines for designing mobile phone apps created for this purpose.

This article has been cited by other articles in PMC.

Article excerpt

Homework completion significantly predicted clinical improvement, decrease in self-reported hopelessness, suicidality, and depression—but not in evaluator-rated depressive symptoms—in adolescents treated with CBT only.

In contrast, a mobile app can, for example, provide ongoing graphical feedback on progress between sessions to motivate users [ 5286 ], or employ automatic text message reminders, which have been demonstrated to significantly improve treatment adherence in medical illnesses [ 87 ]. Therefore, the treatment modules delivered via mobile phones should meet the specific needs of therapy at each stage of therapy, while also providing psychoeducation resources and self-monitoring capabilities.

The only significant COMB finding was that partially completed homework was related to decrease in hopelessness over time.

does homework matter in cognitive behavioral therapy for adolescent depression curriculum vitae spanish translation

Internet-delivered CBT that includes a moderated discussion forum has been shown to significantly improve depression symptoms [ 83 ]. Which types are assigned will depend on the nature of the illness being treated, the stage of treatment, and the specific target [ 48 ].

Privacy and security issues are also real concerns for the users of technology [ 93 ], although no privacy breaches related to text messaging or data security have been reported in studies on mobile apps so automotive thesis title [ 8894 - 98 ].

  • Child care professional cover letter
  • Art of problem solving precalculus book how to write a business plan for a gas station, cover letter sample for geologist
  • Abstract Cognitive behavioral therapy CBT is one of the most effective psychotherapy modalities used to treat depression and anxiety disorders.
  • Sample cover letter for coop student how to write a cover letter for store manager position cover letter biology faculty position sample

However, as pointed out by Kennard et al. For example, as artificial intelligence [ ] or emotional sensing [ ] develops further, we would expect that software should be able to dynamically modify its approach to the user in response to users' evolving emotional states.

Therapy congruency focuses the features of the app on research paper on daddy by sylvia plath central goal of therapy and fostering learning eases engagement in therapy by reducing barriers.

defend your master thesis does homework matter in cognitive behavioral therapy for adolescent depression

While not yet formally assessed, reports from staff and early users suggest that MHT-ANX has been helpful for some patients with promoting homework compliance. The benefits of delivering psychoeducation via a mobile phone app are obvious: With the rise of mass-market mobile communication devices such as the iPhone or other kinds of mobile devices with app capabilities smartphonesnew solutions are being sought that will use these devices to provide therapy to patients in a more cost-effective manner.

The therapeutic alliance between the therapist and the client is the strongest predictor of therapeutic outcome [ 77 ] and has been suggested to predict level of does homework matter in cognitive behavioral therapy for adolescent depression compliance as well [ 78 ].