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Health Hazards of Homework

March 18, 2014 | Julie Greicius Pediatrics .

A new study by the Stanford Graduate School of Education and colleagues found that students in high-performing schools who did excessive hours of homework “experienced greater behavioral engagement in school but also more academic stress, physical health problems, and lack of balance in their lives.”

Those health problems ranged from stress, headaches, exhaustion, sleep deprivation, weight loss and stomach problems, to psycho-social effects like dropping activities, not seeing friends or family, and not pursuing hobbies they enjoy.

In the Stanford Report story about the research, Denise Pope , a senior lecturer at the Stanford Graduate School of Education and a co-author of the  study published in the  Journal of Experimental Education , says, “Our findings on the effects of homework challenge the traditional assumption that homework is inherently good.”

The study was based on survey data from a sample of 4,317 students from 10 high-performing high schools in California communities in which median household income exceeded $90,000. Of the students surveyed, homework volume averaged about 3.1 hours each night.

“It is time to re-evaluate how the school environment is preparing our high school student for today’s workplace,” says Neville Golden, MD , chief of adolescent medicine at Stanford Medicine Children’s Health and a professor at the School of Medicine. “This landmark study shows that excessive homework is counterproductive, leading to sleep deprivation, school stress and other health problems. Parents can best support their children in these demanding academic environments by advocating for them through direct communication with teachers and school administrators about homework load.”

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Is it time to get rid of homework? Mental health experts weigh in.

It's no secret that kids hate homework. And as students grapple with an ongoing pandemic that has had a wide range of mental health impacts, is it time schools start listening to their pleas about workloads?

Some teachers are turning to social media to take a stand against homework. 

Tiktok user @misguided.teacher says he doesn't assign it because the "whole premise of homework is flawed."

For starters, he says, he can't grade work on "even playing fields" when students' home environments can be vastly different.

"Even students who go home to a peaceful house, do they really want to spend their time on busy work? Because typically that's what a lot of homework is, it's busy work," he says in the video that has garnered 1.6 million likes. "You only get one year to be 7, you only got one year to be 10, you only get one year to be 16, 18."

Mental health experts agree heavy workloads have the potential do more harm than good for students, especially when taking into account the impacts of the pandemic. But they also say the answer may not be to eliminate homework altogether.

Emmy Kang, mental health counselor at Humantold , says studies have shown heavy workloads can be "detrimental" for students and cause a "big impact on their mental, physical and emotional health."

"More than half of students say that homework is their primary source of stress, and we know what stress can do on our bodies," she says, adding that staying up late to finish assignments also leads to disrupted sleep and exhaustion.

Cynthia Catchings, a licensed clinical social worker and therapist at Talkspace , says heavy workloads can also cause serious mental health problems in the long run, like anxiety and depression. 

And for all the distress homework  can cause, it's not as useful as many may think, says Dr. Nicholas Kardaras, a psychologist and CEO of Omega Recovery treatment center.

"The research shows that there's really limited benefit of homework for elementary age students, that really the school work should be contained in the classroom," he says.

For older students, Kang says, homework benefits plateau at about two hours per night. 

"Most students, especially at these high achieving schools, they're doing a minimum of three hours, and it's taking away time from their friends, from their families, their extracurricular activities. And these are all very important things for a person's mental and emotional health."

Catchings, who also taught third to 12th graders for 12 years, says she's seen the positive effects of a no-homework policy while working with students abroad.

"Not having homework was something that I always admired from the French students (and) the French schools, because that was helping the students to really have the time off and really disconnect from school," she says.

The answer may not be to eliminate homework completely but to be more mindful of the type of work students take home, suggests Kang, who was a high school teacher for 10 years.

"I don't think (we) should scrap homework; I think we should scrap meaningless, purposeless busy work-type homework. That's something that needs to be scrapped entirely," she says, encouraging teachers to be thoughtful and consider the amount of time it would take for students to complete assignments.

The pandemic made the conversation around homework more crucial 

Mindfulness surrounding homework is especially important in the context of the past two years. Many students will be struggling with mental health issues that were brought on or worsened by the pandemic , making heavy workloads even harder to balance.

"COVID was just a disaster in terms of the lack of structure. Everything just deteriorated," Kardaras says, pointing to an increase in cognitive issues and decrease in attention spans among students. "School acts as an anchor for a lot of children, as a stabilizing force, and that disappeared."

But even if students transition back to the structure of in-person classes, Kardaras suspects students may still struggle after two school years of shifted schedules and disrupted sleeping habits.

"We've seen adults struggling to go back to in-person work environments from remote work environments. That effect is amplified with children because children have less resources to be able to cope with those transitions than adults do," he explains.

'Get organized' ahead of back-to-school

In order to make the transition back to in-person school easier, Kang encourages students to "get good sleep, exercise regularly (and) eat a healthy diet."

To help manage workloads, she suggests students "get organized."

"There's so much mental clutter up there when you're disorganized. ... Sitting down and planning out their study schedules can really help manage their time," she says.

Breaking up assignments can also make things easier to tackle.

"I know that heavy workloads can be stressful, but if you sit down and you break down that studying into smaller chunks, they're much more manageable."

If workloads are still too much, Kang encourages students to advocate for themselves.

"They should tell their teachers when a homework assignment just took too much time or if it was too difficult for them to do on their own," she says. "It's good to speak up and ask those questions. Respectfully, of course, because these are your teachers. But still, I think sometimes teachers themselves need this feedback from their students."

More: Some teachers let their students sleep in class. Here's what mental health experts say.

More: Some parents are slipping young kids in for the COVID-19 vaccine, but doctors discourage the move as 'risky'

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More than two hours of homework may be counterproductive, research suggests.

A Stanford education researcher found that too much homework can negatively affect kids, especially their lives away from school, where family, friends and activities matter.   "Our findings on the effects of homework challenge the traditional assumption that homework is inherently good," wrote Denise Pope , a senior lecturer at the Stanford Graduate School of Education and a co-author of a study published in the Journal of Experimental Education .   The researchers used survey data to examine perceptions about homework, student well-being and behavioral engagement in a sample of 4,317 students from 10 high-performing high schools in upper-middle-class California communities. Along with the survey data, Pope and her colleagues used open-ended answers to explore the students' views on homework.   Median household income exceeded $90,000 in these communities, and 93 percent of the students went on to college, either two-year or four-year.   Students in these schools average about 3.1 hours of homework each night.   "The findings address how current homework practices in privileged, high-performing schools sustain students' advantage in competitive climates yet hinder learning, full engagement and well-being," Pope wrote.   Pope and her colleagues found that too much homework can diminish its effectiveness and even be counterproductive. They cite prior research indicating that homework benefits plateau at about two hours per night, and that 90 minutes to two and a half hours is optimal for high school.   Their study found that too much homework is associated with:   • Greater stress : 56 percent of the students considered homework a primary source of stress, according to the survey data. Forty-three percent viewed tests as a primary stressor, while 33 percent put the pressure to get good grades in that category. Less than 1 percent of the students said homework was not a stressor.   • Reductions in health : In their open-ended answers, many students said their homework load led to sleep deprivation and other health problems. The researchers asked students whether they experienced health issues such as headaches, exhaustion, sleep deprivation, weight loss and stomach problems.   • Less time for friends, family and extracurricular pursuits : Both the survey data and student responses indicate that spending too much time on homework meant that students were "not meeting their developmental needs or cultivating other critical life skills," according to the researchers. Students were more likely to drop activities, not see friends or family, and not pursue hobbies they enjoy.   A balancing act   The results offer empirical evidence that many students struggle to find balance between homework, extracurricular activities and social time, the researchers said. Many students felt forced or obligated to choose homework over developing other talents or skills.   Also, there was no relationship between the time spent on homework and how much the student enjoyed it. The research quoted students as saying they often do homework they see as "pointless" or "mindless" in order to keep their grades up.   "This kind of busy work, by its very nature, discourages learning and instead promotes doing homework simply to get points," said Pope, who is also a co-founder of Challenge Success , a nonprofit organization affiliated with the GSE that conducts research and works with schools and parents to improve students' educational experiences..   Pope said the research calls into question the value of assigning large amounts of homework in high-performing schools. Homework should not be simply assigned as a routine practice, she said.   "Rather, any homework assigned should have a purpose and benefit, and it should be designed to cultivate learning and development," wrote Pope.   High-performing paradox   In places where students attend high-performing schools, too much homework can reduce their time to foster skills in the area of personal responsibility, the researchers concluded. "Young people are spending more time alone," they wrote, "which means less time for family and fewer opportunities to engage in their communities."   Student perspectives   The researchers say that while their open-ended or "self-reporting" methodology to gauge student concerns about homework may have limitations – some might regard it as an opportunity for "typical adolescent complaining" – it was important to learn firsthand what the students believe.   The paper was co-authored by Mollie Galloway from Lewis and Clark College and Jerusha Conner from Villanova University.

Clifton B. Parker is a writer at the Stanford News Service .

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Stanford research shows pitfalls of homework

A Stanford researcher found that students in high-achieving communities who spend too much time on homework experience more stress, physical health problems, a lack of balance and even alienation from society. More than two hours of homework a night may be counterproductive, according to the study.

Education scholar Denise Pope has found that too much homework has negative effects on student well-being and behavioral engagement. (Image credit: L.A. Cicero)

A Stanford researcher found that too much homework can negatively affect kids, especially their lives away from school, where family, friends and activities matter.

“Our findings on the effects of homework challenge the traditional assumption that homework is inherently good,” wrote Denise Pope , a senior lecturer at the Stanford Graduate School of Education and a co-author of a study published in the Journal of Experimental Education .

The researchers used survey data to examine perceptions about homework, student well-being and behavioral engagement in a sample of 4,317 students from 10 high-performing high schools in upper-middle-class California communities. Along with the survey data, Pope and her colleagues used open-ended answers to explore the students’ views on homework.

Median household income exceeded $90,000 in these communities, and 93 percent of the students went on to college, either two-year or four-year.

Students in these schools average about 3.1 hours of homework each night.

“The findings address how current homework practices in privileged, high-performing schools sustain students’ advantage in competitive climates yet hinder learning, full engagement and well-being,” Pope wrote.

Pope and her colleagues found that too much homework can diminish its effectiveness and even be counterproductive. They cite prior research indicating that homework benefits plateau at about two hours per night, and that 90 minutes to two and a half hours is optimal for high school.

Their study found that too much homework is associated with:

• Greater stress: 56 percent of the students considered homework a primary source of stress, according to the survey data. Forty-three percent viewed tests as a primary stressor, while 33 percent put the pressure to get good grades in that category. Less than 1 percent of the students said homework was not a stressor.

• Reductions in health: In their open-ended answers, many students said their homework load led to sleep deprivation and other health problems. The researchers asked students whether they experienced health issues such as headaches, exhaustion, sleep deprivation, weight loss and stomach problems.

• Less time for friends, family and extracurricular pursuits: Both the survey data and student responses indicate that spending too much time on homework meant that students were “not meeting their developmental needs or cultivating other critical life skills,” according to the researchers. Students were more likely to drop activities, not see friends or family, and not pursue hobbies they enjoy.

A balancing act

The results offer empirical evidence that many students struggle to find balance between homework, extracurricular activities and social time, the researchers said. Many students felt forced or obligated to choose homework over developing other talents or skills.

Also, there was no relationship between the time spent on homework and how much the student enjoyed it. The research quoted students as saying they often do homework they see as “pointless” or “mindless” in order to keep their grades up.

“This kind of busy work, by its very nature, discourages learning and instead promotes doing homework simply to get points,” Pope said.

She said the research calls into question the value of assigning large amounts of homework in high-performing schools. Homework should not be simply assigned as a routine practice, she said.

“Rather, any homework assigned should have a purpose and benefit, and it should be designed to cultivate learning and development,” wrote Pope.

High-performing paradox

In places where students attend high-performing schools, too much homework can reduce their time to foster skills in the area of personal responsibility, the researchers concluded. “Young people are spending more time alone,” they wrote, “which means less time for family and fewer opportunities to engage in their communities.”

Student perspectives

The researchers say that while their open-ended or “self-reporting” methodology to gauge student concerns about homework may have limitations – some might regard it as an opportunity for “typical adolescent complaining” – it was important to learn firsthand what the students believe.

The paper was co-authored by Mollie Galloway from Lewis and Clark College and Jerusha Conner from Villanova University.

Homework Struggles May Not Be a Behavior Problem

Exploring some options to understand and help..

Posted August 2, 2022 | Reviewed by Abigail Fagan

• Mental health challenges and neurodevelopmental differences directly affect children's ability to do homework.
• Understanding what difficulties are getting in the way—beyond the usual explanation of a behavior problem—is key.
• Sleep and mental health needs can take priority over homework completion.

Chelsea was in 10th grade the first time I told her directly to stop doing her homework and get some sleep. I had been working with her since she was in middle school, treating her anxiety disorder. She deeply feared disappointing anyone—especially her teachers—and spent hours trying to finish homework perfectly. The more tired and anxious she got, the harder it got for her to finish the assignments.

One night Chelsea called me in despair, feeling hopeless. She was exhausted and couldn’t think straight. She felt like a failure and that she was a burden to everyone because she couldn’t finish her homework.

She was shocked when I told her that my prescription for her was to go to sleep now—not to figure out how to finish her work. I told her to leave her homework incomplete and go to sleep. We briefly discussed how we would figure it out the next day, with her mom and her teachers. At that moment, it clicked for her that it was futile to keep working—because nothing was getting done.

This was an inflection point for her awareness of when she was emotionally over-cooked and when she needed to stop and take a break or get some sleep. We repeated versions of this phone call several times over the course of her high school and college years, but she got much better at being able to do this for herself most of the time.

When Mental Health Symptoms Interfere with Homework

Kids with mental health or neurodevelopmental challenges often struggle mightily with homework. Challenges can come up in every step of the homework process, including, but not limited to:

• Remembering and tracking assignments and materials
• Getting the mental energy/organization to start homework
• Filtering distractions enough to persist with assignments
• Understanding unspoken or implied parts of the homework
• Remembering to bring finished homework to class
• Being in class long enough to know the material
• Tolerating the fear of not knowing or failing
• Not giving up the assignment because of a panic attack
• Tolerating frustration—such as not understanding—without emotional dysregulation
• Being able to ask for help—from a peer or a teacher and not being afraid to reach out

This list is hardly comprehensive. ADHD , autism spectrum disorder, social anxiety , generalized anxiety, panic disorder, depression , dysregulation, and a range of other neurodevelopmental and mental health challenges cause numerous learning differences and symptoms that can specifically and frequently interfere with getting homework done.

The Usual Diagnosis for Homework Problems is "Not Trying Hard Enough"

Unfortunately, when kids frequently struggle to meet homework demands, teachers and parents typically default to one explanation of the problem: The child is making a choice not to do their homework. That is the default “diagnosis” in classrooms and living rooms. And once this framework is drawn, the student is often seen as not trying hard enough, disrespectful, manipulative, or just plain lazy.

The fundamental disconnect here is that the diagnosis of homework struggles as a behavioral choice is, in fact, only one explanation, while there are so many other diagnoses and differences that impair children's ability to consistently do their homework. If we are trying to create solutions based on only one understanding of the problem, the solutions will not work. More devastatingly, the wrong solutions can worsen the child’s mental health and their long-term engagement with school and learning.

To be clear, we aren’t talking about children who sometimes struggle with or skip homework—kids who can change and adapt their behaviors and patterns in response to the outcomes of that struggle. For this discussion, we are talking about children with mental health and/or neurodevelopmental symptoms and challenges that create chronic difficulties with meeting homework demands.

How Can You Help a Child Who Struggles with Homework?

How can you help your child who is struggling to meet homework demands because of their ADHD, depression, anxiety, OCD , school avoidance, or any other neurodevelopmental or mental health differences? Let’s break this down into two broad areas—things you can do at home, and things you can do in communication with the school.

Helping at Home

The following suggestions for managing school demands at home can feel counterintuitive to parents—because we usually focus on helping our kids to complete their tasks. But mental health needs jump the line ahead of task completion. And starting at home will be key to developing an idea of what needs to change at school.

• Set an end time in the evening after which no more homework will be attempted. Kids need time to decompress and they need sleep—and pushing homework too close to or past bedtime doesn’t serve their educational needs. Even if your child hasn’t been able to approach the homework at all, even if they have avoided and argued the whole evening, it is still important for everyone to have a predictable time to shut down the whole process.
• If there are arguments almost every night about homework, if your child isn’t starting homework or finishing it, reframe it from failure into information. It’s data to put into problem-solving. We need to consider other possible explanations besides “behavioral choice” when trying to understand the problem and create effective solutions. What problems are getting in the way of our child’s meeting homework demands that their peers are meeting most of the time?
• Try not to argue about homework. If you can check your own anxiety and frustration, it can be more productive to ally with your child and be curious with them. Kids usually can’t tell you a clear “why” but maybe they can tell you how they are feeling and what they are thinking. And if your child can’t talk about it or just keeps saying “I don't know,” try not to push. Come back another time. Rushing, forcing, yelling, and threatening will predictably not help kids do homework.

Helping at School

The second area to explore when your neurodiverse child struggles frequently with homework is building communication and connections with school and teachers. Some places to focus on include the following.

• Label your child’s diagnoses and break down specific symptoms for the teachers and school team. Nonjudgmental, but specific language is essential for teachers to understand your child’s struggles. Breaking their challenges down into the problems specific to homework can help with building solutions. As your child gets older, help them identify their difficulties and communicate them to teachers.
• Let teachers and the school team know that your child’s mental health needs—including sleep—take priority over finishing homework. If your child is always struggling to complete homework and get enough sleep, or if completing homework is leading to emotional meltdowns every night, adjusting their homework demands will be more successful than continuing to push them into sleep deprivation or meltdowns.
• Request a child study team evaluation to determine if your child qualifies for services under special education law such as an IEP, or accommodations through section 504—and be sure that homework adjustments are included in any plan. Or if such a plan is already in place, be clear that modification of homework expectations needs to be part of it.

The Long-Term Story

I still work with Chelsea and she recently mentioned how those conversations so many years ago are still part of how she approaches work tasks or other demands that are spiking her anxiety when she finds herself in a vortex of distress. She stops what she is doing and prioritizes reducing her anxiety—whether it’s a break during her day or an ending to the task for the evening. She sees that this is crucial to managing her anxiety in her life and still succeeding at what she is doing.

Task completion at all costs is not a solution for kids with emotional needs. Her story (and the story of many of my patients) make this crystal clear.

Candida Fink, M.D. , is board certified in child/adolescent and general psychiatry. She practices in New York and has co-authored two books— The Ups and Downs of Raising a Bipolar Child and Bipolar Disorder for Dummies.

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Barriers Associated with the Implementation of Homework in Youth Mental Health Treatment and Potential Mobile Health Solutions

Brian e. bunnell.

1 Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA

2 Biomedical Informatics Center, College of Medicine, Medical University of South Carolina, Charleston, SC, USA

Lynne S. Nemeth

3 Department of Nursing, College of Nursing, Medical University of South Carolina, Charleston, SC, USA

Leslie A. Lenert

Nikolaos kazantzis.

4 Cognitive Behavior Therapy Research Unit and School of Psychological Sciences, Monash University, Clayton, VIC, Australia

Esther Deblinger

5 Child Abuse Research Education & Service (CARES) Institute, Rowan University School of Osteopathic Medicine, Stratford, New Jersey, USA

Kristen A. Higgins

Kenneth j. ruggiero.

6 Technology Applications Center for Healthful Lifestyles, College of Nursing, Medical University of South Carolina, Charleston, SC, USA

Author Contributions

Associated Data

Background:.

Homework, or between-session practice of skills learned during therapy, is integral to effective youth mental health TREATMENTS. However, homework is often under-utilized by providers and patients due to many barriers, which might be mitigated via m Health solutions.

Semi-structured qualitative interviews were conducted with nationally certified trainers in Trauma Focused Cognitive Behavioral Therapy (TF-CBT; n =21) and youth TF-CBT patients ages 8–17 ( n =15) and their caregivers ( n =12) to examine barriers to the successful implementation of homework in youth mental health treatment and potential m Health solutions to those barriers.

The results indicated that many providers struggle to consistently develop, assign, and assess homework exercises with their patients. Patients are often difficult to engage and either avoid or have difficulty remembering to practice exercises, especially given their busy/chaotic home lives. Trainers and families had positive views and useful suggestions for m Health solutions to these barriers in terms of functionality (e.g., reminders, tracking, pre-made homework exercises, rewards) and user interface (e.g., easy navigation, clear instructions, engaging activities).

Conclusions:

This study adds to the literature on homework barriers and potential m Health solutions to those barriers, which is largely based on recommendations from experts in the field. The results aligned well with this literature, providing additional support for existing recommendations, particularly as they relate to treatment with youth and caregivers.

Introduction

Homework, or between-session practice of skills learned during therapy, is one of the most integral, yet underutilized components of high-quality, evidence-based mental health care ( Kazantzis & Deane, 1999 ). Homework activities (e.g., self-monitoring, relaxation, exposure, parent behavior management) are assigned by providers in-session and completed by patients between sessions with the goal of “practicing” therapeutic skills in the environment where they will be most needed ( Kazantzis, Deane, Ronan, & L’Abate, 2005 ). There are numerous benefits to the implementation of homework during mental health treatment ( Kazantzis et al., 2016 ; Kazantzis, Deane, & Ronan, 2004 ). Homework enables the generalization of skills and behaviors learned during therapy, facilitates treatment processes, provides continuity between sessions, allows providers to better grasp patients’ learning, and strengthens that learning, leading to improved maintenance of treatment gains ( Hudson & Kendall, 2002 ; Scheel, Hanson, & Razzhavaikina, 2004 ). Meta-analytic and systematic reviews have shown that homework use by providers and adherence by patients predict increased treatment engagement, decreased treatment dropout, and medium-to-large effects on improvements in clinical outcomes for use (Cohen’s d =.48–.77) and adherence ( d =.45–.54) ( Hudson & Kendall, 2002 ; Kazantzis, Deane, & Ronan, 2000 ; Kazantzis & Lampropoulos, 2002 ; Kazantzis, Whittington, & Dattilio, 2010 ; Mausbach, Moore, Roesch, Cardenas, & Patterson, 2010 ; Scheel et al., 2004 ; Sukhodolsky, Kassinove, & Gorman, 2004 ). Simply put, 68% vs . 32% of patients can be expected to improve when therapy involves homework ( Kazantzis et al., 2010 ).

Despite its many benefits, homework is implemented with variable effectiveness in mental health treatment. Only 68% of general mental health providers and ~55% of family providers report using homework “often” to “almost always” ( Dattilio, Kazantzis, Shinkfield, & Carr, 2011 ; Kazantzis, Lampropoulos, & Deane, 2005 ). Further, providers report using homework in an average of 57% of sessions, although this rate is higher for CBT practitioners (66%) vs . non-CBT practitioners (48%). Moreover, only 25% of providers report using expert recommended systematic procedures for recommending homework (i.e., specifying frequency, duration, and location; writing down homework assignments for patients) ( Kazantzis & Deane, 1999 ). A national survey revealed that 93% or general mental health providers estimate rates of patient adherence to homework to be low to moderate ( Kazantzis, Lampropoulos, et al., 2005 ), and research studies report low to moderate rates of youth/caregiver adherence during treatment (i.e., ~39–63%; ( Berkovits, O’Brien, Carter, & Eyberg, 2010 ; Clarke et al., 1992 ; Danko, Brown, Van Schoick, & Budd, 2016 ; Dattilio et al., 2011 ; Gaynor, Lawrence, & Nelson-Gray, 2006 ; Helbig & Fehm, 2004 ; Lyon & Budd, 2010 ; Simons et al., 2012 ).

Numerous barriers to the successful implementation of homework during mental health treatment have largely been suggested by experts in the field, rather than specifically measured ( Dattilio et al., 2011 ), and have generally been classified as occurring on the provider-, patient-, task-, and environmental-level ( Kazantzis & Shinkfield, 2007 ). Provider-level barriers can relate to the therapeutic relationship and the degree to which a collaborative approach is used, provider beliefs about homework and the patient’s adherence, and providers’ ability to effectively design homework tasks ( Callan et al., 2012 ; Coon, Rabinowitz, Thompson, & Gallagher-Thompson, 2005 ; Friedberg & Mcclure, 2005 ; Garland & Scott, 2002 ; Kazantzis & Shinkfield, 2007 ). Patient-level barriers can include patient avoidance and symptomatology, negative beliefs toward the task, not understanding the rationale or how to do the task, forgetting, and beliefs about their ability to complete homework tasks. ( Bru, Solholm, & Idsoe, 2013 ; Callan et al., 2012 ; Dattilio et al., 2011 ; Friedberg & Mcclure, 2005 ; Garland & Scott, 2002 ; Hudson & Kendall, 2005 ; Kazantzis & Shinkfield, 2007 ; Leahy, 2002 ). Relatedly, core beliefs central to the patients’ psychopathology can be activated during homework–thereby triggering withdrawal and avoidance patterns ( Kazantzis & Shinkfield, 2007 ). Task-level barriers include poor match between tasks and therapy goals, tasks that are perceived as vague or unclear, tasks that are perceived as too difficult or demanding in terms of time or effort, tasks being viewed as boring, and general aversiveness of the idea of completing homework ( Bru et al., 2013 ; Callan et al., 2012 ; Dattilio et al., 2011 ; Friedberg & Mcclure, 2005 ; Garland & Scott, 2002 ; Hudson & Kendall, 2005 ). Environmental factors have been noted to include practical obstacles, lack of family/caregiver support, dysfunctional home environments, lack of time due to busy schedules, and lack of reward or reinforcement ( Callan et al., 2012 ; Dattilio et al., 2011 ; Hudson & Kendall, 2005 ).

The advancement and ubiquitousness of technologies such as m Health resources (e.g., mobile- and web-based apps) provide a tremendous opportunity to overcome barriers to homework use and adherence and resultantly, improve the quality of mental health treatment. m Health solutions to improve access and quality of care, have been widely investigated, are effective in facilitating behavior change, practical, desired by patients and providers, and available at low cost ( Amstadter, Broman-Fulks, Zinzow, Ruggiero, & Cercone, 2009 ; Boschen & Casey, 2008 ; Donker et al., 2013 ; Ehrenreich, Righter, Rocke, Dixon, & Himelhoch, 2011 ; Hanson et al., 2014 ; Heron & Smyth, 2010 ; Krebs & Duncan, 2015 ; Luxton, McCann, Bush, Mishkind, & Reger, 2011 ; Ruggiero, Saunders, Davidson, Cook, & Hanson, 2017 ). Existing m Health resources include features that can support homework implementation (e.g., voice and SMS reminders and feedback, self-monitoring and assessment, and modules and activities that can be used to facilitate between-session practice; Bakker, Kazantzis, Rickwood, & Rickard, 2016 ; Tang & Kreindler, 2017 ), but these resources were not designed with the express intention of addressing barriers to homework implementation, particularly for youth and family patient populations.

The extant literature on barriers to homework implementation is limited in that it is largely based on expert recommendations. Therefore, the first aim of this study was to explore provider, youth, and caregiver patient perspectives on barriers to the successful implementation of homework during youth mental health treatment. Further, m Health solutions to those barriers have not been explored, especially for youth and family patients. Thus, the second and third aims of this study were to obtain suggestions for m Health solutions to homework barriers and explore perceptions on the benefits and challenges associated with those m Health solutions.

Institutional Review Board approval was obtained prior to enrolling any participants in the study. The approach for this study was based on the constructivist grounded theory, which acknowledges the researcher’s prior knowledge and influence in the process and supports and guides conceptual framework development to understand interrelations between constructs ( Charmaz, 2006 ). This qualitative study used a thematic analysis of semi-structured interviews in a sample of nationally certified trainers in Trauma-Focused Cognitive Behavioral Therapy (TFCBT; Cohen, Mannarino, & Deblinger, 2017 ), youth who had engaged in TF-CBT, and their caregivers. The initial goal was to conduct interviews with 15–20 interviewees in each group to achieve theoretical saturation (i.e., no new information was derived), consistent with a prior study by members of the research team which used similar semi-structured interviews with national TF-CBT trainers ( Hanson et al., 2014 ), and recommendations by Morse (2000) given the relatively narrow scope and clear nature of the study. Interviews were conducted until interviewers and the study lead determined that no new pertinent information was being obtained.

Participants

National trainers..

Twenty-one national trainers in TF-CBT were interviewed. National trainers are mental health providers who completed a 15-month TF-CBT Train-the-Trainer program led by the TF-CBT developers. Trainers work extensively with numerous community mental health providers to problem-solve common barriers to clinical practice and thus, provide a unique perspective on the barriers to successful homework implementation and possible m Health solutions to those barriers. An e-mail invitation was sent to a list of approved TF-CBT trainers. Twenty-four trainers responded to this e-mail, 22 of whom agreed to participate in an interview, one of whom was unreachable after initial scheduling. Interviews were completed with a total of 21 trainers, who received a $25 gift card in compensation for their time.

Trainers had been treating children for an average of 23.29 years ( SD =8.80) and had been training providers for an average of 14.95 years ( SD =8.98). In the year prior to the interview, they led an average of 17 provider trainings ( SD =21.67) and trained roughly 345 providers ( SD =339.90). All trainers were licensed, and the majority were Clinical Psychologists (47.6%) and Social Workers (33.3%). The average age of trainers was 47.48 years ( SD =13.63) and the majority were female (71.4%), white (95.2%), and non-Hispanic/Latino (85.7%; see Table 1 ).

Trainer Demographics

Twelve families were interviewed for this study. Families were included if they had one or more youth between the ages of 8 and 17 years-of-age and a caregiver who had engaged in at least four sessions for TF-CBT. These criteria were chosen because TF-CBT is typically recommended for youth between the ages of 8 and 17 years-of-age and it was estimated that four sessions would have likely allowed for adequate time for patients to have received homework assignments, consistent with the authors’ experience and prior TF-CBT literature ( Deblinger, Pollio, & Dorsey, 2016 ; Scheeringa, Weems, Cohen, Amaya-Jackson, & Guthrie, 2011 ). Families were recruited via advertisements online and at local community mental health clinics, and from a participant pool from a prior study ( Davidson et al., 2019 ). Twenty-nine families initially expressed interest in participating in the study. Six families were ineligible because they had not received TF-CBT and contact was lost with six families after their initial contact. Seventeen families were scheduled for an interview, five of which were unreachable after initially being scheduled, and interviews were completed with 12 families. Written informed consent from caregivers and assent from youth above the age of 15 were obtained in-person for four families and via a telemedicine-based teleconsent platform (i.e., https://musc.doxy.me ) for eight families. Families received a $30 gift card in compensation for their time.

A total of 15 youth who had engaged in TF-CBT, and their caregivers ( n =12; three families had two youth who had received treatment) were interviewed. Six youth were still in treatment at the time of their interview and nine had finished treatment an average of 49 weeks ( SD =42.32) prior to the interview. The average age of youth was 13.20 years ( SD =3.19), roughly half were female (53.3%), the majority were white (80%), and all were non-Hispanic/Latino. The average age of caregivers was 44.83 years ( SD =7.90), 66.7% were female, and all were White and non-Hispanic/Latino. Youth and caregivers rated their comfort with technology, in general, on a 10-point Likert scale (i.e., 1–10) with higher scores representing higher levels of comfort. Youth reported being very comfortable with technology (M=9.62, SD =1.12), as did their caregivers (M=7.83, SD =2.63; see Table 2 ).

Family Demographics

Trauma-Focused Cognitive Behavioral Therapy

TF-CBT is a well-established and widely disseminated mental health treatment ( Cohen et al., 2017 ; Deblinger, Mannarino, Cohen, Runyon, & Steer, 2011 ; Silverman et al., 2008 ; Wethington et al., 2008 ). It is a conjoint youth-caregiver mental health treatment typically conducted over ~12, 90-minute sessions that address nine major treatment components (i.e., P sychoeducation; P arenting Skills; R elaxation Skills; A ffective Expression and Modulation Skills; C ognitive Coping and Processing Skills; T rauma Narration and Processing; I n Vivo Exposure; C onjoint Child Parent Activities; and E nhancing Future Safety and Development). TF-CBT also addresses a broad range of symptom domains including trauma- and stress-related disorders, disruptive behavior disorders/behaviors, depression/depressive symptoms, and anxiety disorders ( Cohen et al., 2017 ). TF-CBT was chosen as a model treatment for this study because of its broad symptom focus, inclusion of treatment components used in a variety of youth mental health treatments, and involvement of youth and their caregivers, offering potential to improve the applicability of the study’s results to a range of youth mental health treatment approaches.

Procedures for Data Collection

Interviews were conducted via telephone for trainers, and either in-person or via telephone for families based on their preference. A postdoctoral fellow and masters-level research assistant conducted the interviews, which were audio-recorded and transcribed using a professional transcription service. Interviews included three major components. The first component included demographic questions. The second included a brief orientation to the goal of the study, which was to develop a new technology-based resource to help providers and patients during the implementation of homework during mental health treatment. The third component included questions that aimed to assess perspectives on barriers to homework implementation, elicit suggestions for m Health solutions to those barriers, and examine perceptions on the benefits and challenges associated with m Health solutions to homework barriers. The average duration of interviews was 41 minutes for trainers and 37 minutes for families. See Supplementary Materials for complete interviews.

Data Analysis

Transcribed interviews were coded using NVivo qualitative analysis software. NVivo was used to identify common themes (nodes) as they related to (1) patient-, provider-, task-, and environmental-barriers to homework implementation, (2) suggestions for m Health solutions to homework barriers, and (3) benefits and challenges associated with m Health homework solutions. Initial and secondary coding passes were conducted to identify and refine theme classifications as they emerged and impose a data-derived hierarchy to the nodes identified. Focused coding was used to refine the coding and ensure that data were coded completely with minimal redundancy ( Miles & Huberman, 1994 ). Themes were initially proposed by the first author and reviewed by an expert in qualitative and mixed methods research (the second author) and an internationally recognized expert in the implementation of homework and related barriers during CBT (the fourth author). Divergent perspectives on theme descriptions ( n =2) and classifications ( n =1) were compared until agreement was reached.

Results are organized by the main topics explored in this study, including: 1) barriers to the successful implementation of homework, coded on provider, patient, task, and environmental levels; 2) potential m Health solutions to those homework barriers; and 3) perceived benefits and challenges of those potential m Health solutions. Results within each of these topics are presented first from the perspectives of trainers and second from the perspectives of families.

Barriers to the Successful Implementation of Homework

Trainer perspectives..

As displayed in Table 3 , trainers identified several barriers to homework implementation on the provider-, patient-, task-, and environmental-level.

Trainer Perspectives on Homework Barriers

Provider-Level Barriers.

Many trainers felt that providers tend to have difficulty engaging patients in assigned tasks, leading some providers to become discouraged by low levels of engagement. As stated by one trainer,

“I think they recognize that [homework assignments] do have value, but in terms of what I feel, a lot of clinicians are not having success with families completing homework, so it’s diminishing the sense of value…something they’ve tried to put into place and they are not feeling there’s any success in it.”

Trainers also noted that many providers do not see homework as an integral part of therapy. One trainer commented,

“I think there are a lot of concrete barriers, but to me probably the biggest barrier will be the–I think that still to this day [providers] like to think that therapy happens in that one hour.”

Other interrelated difficulties faced by providers related to their capacity to effectively and consistently develop, assess, and assign meaningful and patient-centered homework exercises.

As stated by one trainer,

“I see a lot of that just shooting from the hip, kind of off the cuff, ‘let’s do this,’ but yet, it’s not backed by anything concrete or tangible…I think probably one of the biggest pieces again is the failure on the clinician’s part to follow that up and too often review it at the end of the session.”

Another said,

“I think clinicians don’t always appreciate how hard it is to actually do homework that requires you to make some behavioral change.”

Barriers also related to providers’ time and resources for implementing homework, as conveyed by one trainer’s comment,

“I mean, these people…every minute of every day is filled up with doing, billing, writing, charting, going to meetings, getting supervision, and seeing patients, and then they go home exhausted.”

Patient-Level Barriers.

Many trainers stated that, similar to some providers, patients often do not see homework as an important part of therapy. Put by one trainer,

“I think that some [patients] just feel that coming to the session is enough and that should resolve everything, and that you know, doing homework is just kind of an extra thing…I don’t really need to do it to benefit from the therapy.”

Perhaps relatedly, trainers also noted that patients generally forget to do homework assignments, and often forget why, how, when, and where assignments should be done.

Task-Level Barriers.

Task-level barriers noted by trainers included assignments not always aligning with patient values or treatment goals and that the term ‘homework’ being aversive to patients of all ages. One trainer commented,

“I think it has to be something that [patients] see the value in. And again, we go back to that engagement and them trusting you as well as you explaining to them why this could be helpful…If it didn’t help, we need to change it.”

Another trainer laughed while stating,

“when we use the word homework, we might as well just throw a stink bomb in the room.”

Environmental-Level Barriers.

Finally, on the environmental-level, many trainers suggested that patients’ home lives are busy and chaotic, leaving little-to-no time for homework.

Explained by one trainer,

“I think that for parents…they have many other things in their life; work, parenting, partnerships that they are working on, just day to day chores or things that they have to do in terms of their family or other responsibilities. So, [homework] often feels like, I think for families, to add another thing…it just feels like a lot.”

Associated barriers included limited caregiver involvement and reinforcement for completing homework assignments. One trainer commented,

“So, let’s not forget that the parents need to be encouraged and checked on to make sure the kid is doing it. They have to work at it – It’s not going to just happen. So, helping the parents to see that they’re going to need to work to make sure the kids do it, because again, the kids would rather eat ice-cream than do the work. I mean change is hard.”

Another stated,

“I would say, lack of reinforcement for homework, so maybe for getting what you assign for homework and not reviewing it or the kiddo or the family learning pretty quickly, you know, why do it, because there’s not a lot of support around it. You know, if [patients] don’t get reinforced, whether tangibly or verbally, they may not continue that.”

Family Perspectives.

Families identified several barriers to homework implementation on the patient-, task-, and environmental-level which were similar to many of those noted by national trainers (see Table 4 ).

Family Perspectives on Homework Barriers

Families believed that patients often avoid homework as a result of their symptoms. In other words, the patient’s unhelpful coping strategies are being triggered.

One caregiver commented,

“Sometimes people don’t even want to dig into their feelings even to do the assignment either, you know. It stirs up things. You know, when you’re dealing with feelings, sometimes you don’t want to experience that feeling…you shut down. You don’t want to feel that at that time.”

“When you already have a child that has ADHD or behavior problems, it’s hard to get them motivated and to get them to do these exercises at home.”

Families also felt that patients simply forget to complete homework or bring it to their next session. One child stated,

“That’s my problem, she’ll give me homework, we met once a week, basically, and I would forget it because I’ve got a lot going on, and when I come in and she’s like, ‘Did you do your homework,’ I’m like, ‘Oh man’.”

Similar to trainers, families felt that patients often forget why, how, when and where assignments should be done. As stated by one caregiver,

“I think sometimes it can also be just, like maybe not fully understanding what is being asked of them to do. I know the therapist will ask them in the office, ‘do you understand?’ and of course the kids always go, ‘yes I do, can I go home now’?”

With respect to task-level barriers, most families viewed homework assignments as boring. General consensus from families was that patients–particularly youth– would more often than not just rather be doing something more interesting.

On the environmental level, all families noted that the home-life of patients is busy and chaotic, leaving little perceived time for homework. Everyday responsibilities such as schoolwork, employment, household chores, and familial responsibilities often take precedence. One caregiver stated,

“Well I think it sounds good in the office and then you get home and you just get quite busy and it gets pushed aside.”

Another commented,

“But I know what he’s saying…sometimes seven-and-a-half hours at school and then sometimes his therapy would be an hour-and-a-half. And thank goodness, his teacher was so flexible that on days he has therapy he did not have homework [for school], but he was just so emotionally and physically drained. When he got home, all he wanted to do was just rest or play. Because that’s the therapy, it can be just exhausting.”

Families also believed that that there is often a lack of reinforcement for completing homework assignments.

m Health Solutions to Homework Barriers

Trainer suggestions..

Trainers provided several suggestions for m Health solutions to homework barriers ( Table 5 ). Most trainers felt that reminders and schedules to help patients remember to complete homework assignments would be a crucial feature. One trainer suggested, “Maybe some kind of reminder feature, something that would kind of record into their daily calendars that they use, or an alarm, or something like a daily reminder…set to the times they are most likely to do the homework.”

Trainer Suggestions for m Health Solutions to Homework Barriers

Trainers also suggested including reports or activity summaries of homework completion along with behavior and symptom tracking tools. One trainer thoughtfully commented, “If the homework app can somehow help to provide some data on the actual implementation of certain skills during the week that would be very valuable because I think the constructive feedback and the positive feedback that’s offered by therapists about performance of those skills between sessions can be really valuable.”

Trainers suggested including a variety of interactive, fun, and rewarding activities that engage children and caregivers. For example, one trainer stated,

“I think the more interactive you can make it between parent and child and the more of a game you can make it…kids are more likely to do that and to kind of use those skills.” All trainers ( n =21) felt that a text message-based system for reminding patients to complete homework assignments would be beneficial.

Family Suggestions.

Families suggested that the main function of the resource should serve to provide reminders (e.g., text messages or push notifications) for patients to complete homework assignments as well as instructions for how and when they should be completed. Another common suggestion was to include a reward system within the resource to reinforce engagement with homework assignments. Some suggestions for this reward system included coins, experience points, levels, and customizable avatar characters. One child thoughtfully related,

“there could be a digital reward system like stars or gems or something. Then it could be redeemed or something in the therapist’s office. Like I remember it was a while ago, I remember my therapist said if I was able to do something that I was having trouble with, we would have like brownies or something the next visit.”

Families also recommended that the resource include interactive and fun activities. The most common suggestion was to “gamify” homework assignments to make them more fun and interesting to patients. For example, a caregiver noted,

“I think that if you are able to play a game or level up after you did your activity…I don’t think you would have a problem with them doing the activity. They would be so excited to be able to play the game.”

Families providers also recommended reports and activity summaries so that progress could be tracked and reported to providers to be reviewed during the next treatment session ( Table 6 ). All families ( n =12) felt that a text message-based system for reminding patients to complete homework assignments would be beneficial.

Family Suggestions for m Health Solutions to Homework Barriers

Benefits and Challenges of m Health Solutions to Homework Barriers

The majority of trainers responded that an m Health solution to homework barriers would increase provider use of ( n =20; 95.2%) and family adherence to ( n =21; 100%) homework during mental health treatment. The majority of trainers also responded that such a resource would positively affect the therapeutic relationship ( n =15; 71.4%), increase treatment efficiency ( n =18; 85.7%), and improve treatment effectiveness ( n =18; 85.7%). Neutral responses were provided by all trainers who did not respond affirmatively to these questions (i.e., no negative responses were provided). Trainers also commented on the potential clinical utility of an m Health homework resource in that it would help providers with tracking and assigning homework and patients with skill development while promoting high levels of engagement in youth patients. Access, comfort with technology, and convenience were also noted benefits (See Table 7 ). One trainer commented,

Trainer Perspectives on Benefits and Challenges relating to m Health Solutions to Homework Barriers No. of Trainers

“I feel like so many people now enjoy so much more doing things on electronics and so definitely in sessions with kids I’m often recommending having a clinician use apps…sometimes technology is the way to really hook families in and engage them.”

“You know everybody has a phone and if we can have some apps where…I mean it’s so exciting to me what you are talking about. I can’t think of a better idea, I really can’t. I mean people always have their phones on them even if you are really, really poor, people tend to have a phone.”

Challenges identified by trainers centered around confidentiality, access and comfort with technology, and potential negative impacts on the therapeutic process. For example, one trainer stated,

“I do not know if people worry about if somebody else saw the app and wondered, ‘oh you are in therapy, oh what happened to you?’ So, some things around privacy issues and confidentiality, but those will be pretty easy to fix.”

The majority of families believed that the an m Health homework resource would make practicing therapy skills at home more fun or interesting ( n =11; 91.7%), would help families practice skills more often ( n =12; 100%), would positively affect the therapeutic relationship ( n =12; 100%), and would improve treatment effectiveness ( n =11; 91.7%). Neutral responses were provided by all families who did not respond affirmatively to these questions (i.e., no negative responses were provided). Families also suggested that an m Health homework resource would have excellent clinical utility, helping to improve communication between providers and families, make treatment and homework more rewarding, encourage more engagement from youth One caregiver commented,

“I think it would encourage the kids to get [homework] done even before the parents. The kids would want to do it on the phone, they love messing with phones.”

“I think by having the reminders, as well as having something there that’s interactive for the kids and the caregivers both. I think it would be a huge help.”

Similar to trainers, challenges noted by families related to confidentiality and some families not having access to the technology or the internet. Additional family perspectives on benefits and challenges are provided in Table 8 .

Family Perspectives on Benefits and Challenges relating to m Health Solutions to Homework Barriers

The aims of this study were to assess barriers to the successful implementation of homework during youth mental health treatment, obtain suggestions for m Health solutions to those barriers, and explore perceptions on the benefits and challenges associated with m Health solutions to homework barriers through semi-structured qualitative interviews with relevant stakeholders. National trainers in TF-CBT provided a unique perspective on the common challenges met by mental health providers and their patients as well as potential solutions to those challenges, particularly given their extensive experience problem-solving common clinical challenges with community mental health providers. Interviews with youth TF-CBT patients and their caregivers provided important perspectives from those most affected by homework barriers in mental health treatment.

Perspectives on Barriers to the Successful Implementation of Homework

Trainer and family perspectives on the various barriers to the successful implementation of homework during mental health treatment aligned well with the heuristic proposed by Kazantzis and Shinkfield (2007) , which classifies barriers as occurring on the provider-, patient-, task-, and environmental-levels. Most of the provider-level barriers noted by trainers were consistent with expert recommendations from the research literature, such as providers’ beliefs relating to homework and patient engagement in homework ( Coon et al., 2005 ; Friedberg & Mcclure, 2005 ; Garland & Scott, 2002 ), difficulty designing homework activities and individualizing them to specific patients ( Kazantzis & Shinkfield, 2007 ), forgetting about homework and running out of time during the session ( Friedberg & Mcclure, 2005 ), difficulty with consistency and not wanting to put too many demands on patients ( Coon et al., 2005 ), and difficulty effectively assessing patient barriers ( Kazantzis & Shinkfield, 2007 ). Experts have proposed a model for practice that directly addresses many of these provider-level barriers by proposing an ideal process for facilitating engagement in homework ( Kazantzis, MacEwan, & Dattilio, 2005 ).

Trainer and family perspectives on the most common patient-level homework barriers were similar and were also consistent with the extant literature. These included patients’ avoidance or symptoms ( Coon et al., 2005 ; Dattilio et al., 2011 ; Friedberg & Mcclure, 2005 ; Garland & Scott, 2002 ; Hudson & Kendall, 2005 ; Leahy, 2002 ), forgetting to complete assignments ( Coon et al., 2005 ; Hudson & Kendall, 2005 ), not understanding when, where, or how to do assignments or the rationale ( Dattilio et al., 2011 ; Friedberg & Mcclure, 2005 ; Garland & Scott, 2002 ), and beliefs about homework tasks and their ability to complete them ( Dattilio et al., 2011 ; Kazantzis & Shinkfield, 2007 ). Interestingly, whereas the most commonly endorsed patient-level barrier by trainers was patients not seeing homework as an integral part of therapy or important, the most commonly endorsed barriers by families included avoidance or symptoms, forgetfulness, and lack of understanding about assignments, reflecting differing views on the more significant barriers faced by patients. This discrepancy in the trainers/providers vs . families’ perspectives regarding between session assignments suggests the importance of therapists’ focusing more time on explaining assignments, discussing potential challenges, emphasizing the benefits of completing assignments in overcoming symptoms/difficulties and ultimately inspiring follow through.

Task-level barriers reported by both trainers and families included assignments not aligning with patient values or treatment goals ( Coon et al., 2005 ; Dattilio et al., 2011 ; Hudson & Kendall, 2005 ). Many trainers reported that the word “homework” is an aversive term to patients, particularly to youth patients. Perhaps relatedly, many families reported that children view homework assignments are boring. Negative associations with homework may be addressed by referring to “homework” as practice assignments, experiments, exercises, or action plans, as recommended by a recent Beck Institute blog post by Drs. Judith Beck and Francine Broder ( Beck & Broder, 2016 ).

Finally, environment-level barriers noted by trainers and families included the home lives of patients being busy and chaotic – leaving little time to complete homework assignments; a lack of caregiver involvement in the case of youth; and a lack of reward or reinforcement for completing homework assignments, all of which have been previously noted ( Bru et al., 2013 ; Coon et al., 2005 ; Dattilio et al., 2011 ; Kazantzis & Shinkfield, 2007 ). In sum, trainer and family perspectives on barriers to the successful implementation of homework were largely consistent with those suggested by experts. Further, there was a general agreement between trainers and families with respect to those barriers. It is important to note the interrelatedness of several barriers within various levels. For example, patients not understanding the importance of homework or seeing it as an integral part of therapy could very much reflect a mismatch in alliance, tasks needed to achieve therapy goals, or a poor therapist rationale and opportunity for client feedback and discussion. Further, a patient’s understanding of the rationale for homework might be dependent on the provider’s skill in its explanation.

Trainers and families provided numerous suggestions for m Health solutions to homework barriers. These functionality and content suggestions included: reminders and schedules to overcome barriers to forgetting; behavior and symptom tracking and reports or activity summaries to assist providers in assessing homework completion; a variety of homework activities to choose from to help providers struggling with developing activities; resources for caregivers to improve caregiver support; and an integrated reward system to make completing homework rewarding and reinforcing for patients. Other suggested features related more to user interface and user experience. For example, interviewees felt that the m Health resource should allow easy navigation to relevant resources; include clear instructions via video, text, and audio to help patients understand and remember how to do assignments; include interactive and fun activities to help make the assignments less boring and less like “homework;” and be patient-centered and developmentally appropriate. Trainers and families also felt that a text message-based system for reminding patients to complete homework assignments would be beneficial, indicating that this approach would provide a good alternative to a purely app-based resource.

As outlined in recent reviews, there are several studies on m Health resources that include the functionality and content features suggested in this study and can also be used to facilitate homework implementation ( Bakker et al., 2016 ; Tang & Kreindler, 2017 ). For example, a number of m Health resources can be used for self-monitoring and symptom tracking, and many have engaging activities that can be used to support between-session learning and skill development in the areas of relaxation, cognitive therapy, imaginal exposure, and parent behavioral management ( Bunnell et al., 2019 ; Jungbluth & Shirk, 2013 ; Kristjánsdóttir et al., 2013 ; Newman, Przeworski, Consoli, & Barr Taylor, 2014 ; Reger et al., 2013 ; Shapiro et al., 2010 ; Whiteside, Ale, Vickers Douglas, Tiede, & Dammann, 2014 ). SMS- and app-based reminders and feedback on progress can also be used to encourage continued engagement in skills practice ( Aguilera & Muñoz, 2011 ; Harrison et al., 2011 ; Reger et al., 2013 ; Wiederhold, Boyd, Sulea, Gaggioli, & Riva, 2014 ). However, as stated previously, most of these resources were not designed with the express intention of addressing barriers to homework implementation, particularly for youth and family patient populations, leaving room for future work in this area.

Trainers and families expressed very positive views on m Health solutions to homework barriers. Trainers felt that m Health would increase provider use and family adherence to homework, positively affect the therapeutic relationship, and increase treatment efficiency and effectiveness. Families felt that it would make practicing therapy skills at home more fun or interesting, help families practice skills more often, positively affect the therapeutic relationship, and improve treatment effectiveness. A potential benefit commonly noted by trainers and families was a high likelihood that youth would engage with the resource given their generally strong interest in technology, and that this would help to reinforce the practice of skills learned during therapy. A particular benefit noted was increased access to helpful resources between-sessions. Trainers and families expressed concerns about issues relating to confidentiality. While they did not view this as a fatal flaw of the resource, they suggested implementing appropriate safeguards to protect patient privacy and clearly explaining data protection to encourage use.

Limitations

There are several limitations to this study. Regarding generalizability of results, the selection of trainers and families interviewed was based on experience with TF-CBT, a specific treatment protocol for childhood trauma. Although interview questions were kept general during interviews, referring to mental health treatment rather than solely to TF-CBT, the views expressed by interviewees may relate more to TF-CBT than other child mental health treatments. However, a strength of this research is that TF-CBT has a broad symptom focus (e.g., PTSD, anxiety, depression, anger, disruptive behavior) and includes treatment components used in numerous youth mental health treatments (e.g., psychoeducation, relaxation, cognitive coping, affective modulation, exposure), which suggests that results would be applicable to a range of child mental health treatments. Additionally, national trainers in TF-CBT have consistent exposure to working closely with community mental health providers and regularly help them to problem-solve common barriers in clinical practice. This added insight into difficulties experienced by numerous mental health providers rather than asking individual providers about their experience. This is a strength of this study but also a potential limitation as not directly measured, thus an assumption. The views of trainers may not be completely representative of the every-day challenges to homework implementation experienced by community mental health providers. Given the small samples size and lack of diversity, the results should be interpreted with caution as they may not reflect the experiences or views of therapists and patients who utilize homework across different treatment approaches, therapy settings, and populations.

With respect to interview questions and results, they tended to focus on barriers and challenges and provided less of an opportunity for trainers and family members to share factors that may have led to successes with homework assignments. Such information could also importantly support the development and presentation of m health solutions by therapists. Relatedly, families were asked about barriers faced by youth and caregivers, and not by providers, which would have provided interesting data on family perspectives on providers’ limitations. Although comfort with technology in general was assessed in youth and caregivers, it was not specified as comfort with m Health, and ratings were not collected from trainers. As such, a potential limitation of this study is that participants’ comfort specifically with mHealth was unknown. Furthermore, this study focused specifically on m Health without a comparison to other low-tech solutions, which might have resulted in inflated levels of interest in m health solutions to homework barriers. A final limitation is that interviews were coded by the first author, and there is potential for variability in coding that was not accounted for (i.e., the same themes might have been classified in different ways). Despite this limitation, themes were reviewed and by an internationally recognized expert in the implementation of homework and related barriers during CBT (the fourth author) and compared until agreement was reached, supporting the derived themes.

Conclusions

This study provides important new information on barriers to the successful implementation of homework during youth mental health treatment, based on perspectives of providers, youth, and caregivers with that treatment experience. This study adds to the literature on these barriers, which has been based largely on recommendations from experts in the field. The results of this study aligned well with this literature, providing additional support for these recommendations. Valuable insights on potential m Health solutions to these homework barriers were also provided. These data are being used to inform the development of an m Health resource that aims to address homework barriers in hopes of improving provider use and patient adherence to homework during youth mental health treatment, with the ultimate goal of improving the quality of care received by patients in community mental health settings.

Supplementary Material

10608_2020_10090_moesm1_esm, acknowledgments.

Compliance with Ethical Standards

Funding. Dr. Bunnell was supported by the National Institute of Mental Health (grant numbers F32 MH108250 and K23 MH118482).

Disclosure of Potential Conflicts of Interest

Conflict of Interest. The authors declare that they have no conflict of interest.

Research Involving Human Participants and/or Animals

Statement of Human Rights.

Ethics approval. All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional Review Board at the Medical University of South Carolina (Pro00047774) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Statement on the Welfare of Animals

Ethical approval. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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School Stress Takes A Toll On Health, Teens And Parents Say

Patti Neighmond

Colleen Frainey, 16, of Tualatin, Ore., cut back on advanced placement classes in her junior year because the stress was making her physically ill. Toni Greaves for NPR hide caption

Colleen Frainey, 16, of Tualatin, Ore., cut back on advanced placement classes in her junior year because the stress was making her physically ill.

When high school junior Nora Huynh got her report card, she was devastated to see that she didn't get a perfect 4.0.

Nora "had a total meltdown, cried for hours," her mother, Jennie Huynh of Alameda, Calif., says. "I couldn't believe her reaction."

Nora is doing college-level work, her mother says, but many of her friends are taking enough advanced classes to boost their grade-point averages above 4.0. "It breaks my heart to see her upset when she's doing so awesome and going above and beyond."

And the pressure is taking a physical toll, too. At age 16, Nora is tired, is increasingly irritated with her siblings and often suffers headaches, her mother says.

Teens Talk Stress

When NPR asked on Facebook if stress is an issue for teenagers, they spoke loud and clear:

• "Academic stress has been a part of my life ever since I can remember," wrote Bretta McCall, 16, of Seattle. "This year I spend about 12 hours a day on schoolwork. I'm home right now because I was feeling so sick from stress I couldn't be at school. So as you can tell, it's a big part of my life!"
• "At the time of writing this, my weekend assignments include two papers, a PowerPoint to go with a 10-minute presentation, studying for a test and two quizzes, and an entire chapter (approximately 40 pages) of notes in a college textbook," wrote Connor West of New Jersey.
• "It's a problem that's basically brushed off by most people," wrote Kelly Farrell in Delaware. "There's this mentality of, 'You're doing well, so why are you complaining?' " She says she started experiencing symptoms of stress in middle school, and was diagnosed with panic disorder and generalized anxiety disorder in high school.
• "Parents are the worst about all of this," writes Colin Hughes of Illinois. "All I hear is, 'Work harder, you're a smart kid, I know you have it in you, and if you want to go to college you need to work harder.' It's a pain."

Parents are right to be worried about stress and their children's health, says Mary Alvord , a clinical psychologist in Maryland and public education coordinator for the American Psychological Association.

"A little stress is a good thing," Alvord says. "It can motivate students to be organized. But too much stress can backfire."

Almost 40 percent of parents say their high-schooler is experiencing a lot of stress from school, according to a new NPR poll conducted with the Robert Wood Johnson Foundation and the Harvard School of Public Health. In most cases, that stress is from academics, not social issues or bullying, the poll found. (See the full results here .)

Homework was a leading cause of stress, with 24 percent of parents saying it's an issue.

Teenagers say they're suffering, too. A survey by the American Psychological Association found that nearly half of all teens — 45 percent — said they were stressed by school pressures.

Chronic stress can cause a sense of panic and paralysis, Alvord says. The child feels stuck, which only adds to the feeling of stress.

Parents can help put the child's distress in perspective, particularly when they get into what Alvord calls catastrophic "what if" thinking: "What if I get a bad grade, then what if that means I fail the course, then I'll never get into college."

Then move beyond talking and do something about it.

Colleen pets her horse, Bishop. They had been missing out on rides together because of homework. Toni Greaves for NPR hide caption

Colleen pets her horse, Bishop. They had been missing out on rides together because of homework.

That's what 16-year-old Colleen Frainey of Tualatin, Ore., did. As a sophomore last year, she was taking all advanced courses. The pressure was making her sick. "I didn't feel good, and when I didn't feel good I felt like I couldn't do my work, which would stress me out more," she says.

Mom Abigail Frainey says, "It was more than we could handle as a family."

With encouragement from her parents, Colleen dropped one of her advanced courses. The family's decision generated disbelief from other parents. "Why would I let her take the easy way out?" Abigail Frainey heard.

But she says dialing down on academics was absolutely the right decision for her child. Colleen no longer suffers headaches or stomachaches. She's still in honors courses, but the workload this year is manageable.

Even better, Colleen now has time to do things she never would have considered last year, like going out to dinner with the family on a weeknight, or going to the barn to ride her horse, Bishop.

Psychologist Alvord says a balanced life should be the goal for all families. If a child is having trouble getting things done, parents can help plan the week, deciding what's important and what's optional. "Just basic time management — that will help reduce the stress."

• Children's Health

Opinion | Social-Emotional Learning

If we’re serious about student well-being, we must change the systems students learn in, here are five steps high schools can take to support students' mental health., by tim klein and belle liang     oct 14, 2022.

Shutterstock / SvetaZi

Educators and parents started this school year with bated breath. Last year’s stress led to record levels of teacher burnout and mental health challenges for students.

Even before the pandemic, a mental health crisis among high schoolers loomed. According to a survey administered by the Centers for Disease Control and Prevention in 2019, 37 percent of high school students said they experienced persistent sadness or hopelessness and 19 percent reported suicidality. In response, more than half of all U.S. states mandated that schools have a mental health curriculum or include mental health in their standards .

As mental health professionals and co-authors of a book about the pressure and stress facing high school students, we’ve spent our entire careers supporting students’ mental health. Traditionally, mental health interventions are individualized and they focus on helping students manage and change their behaviors to cope with challenges they’re facing. But while working with schools and colleges across the globe as we conducted research for our book , we realized that most interventions don’t address systemic issues causing mental health problems in the first place.

It’s time we acknowledge that our education systems are directly contributing to the youth mental health crisis. And if we are serious about student well-being, we must change the systems they learn in.

Here are five bold steps that high schools can take to boost mental health.

Limit Homework or Make it Optional

Imagine applying for a job, and the hiring manager informs you that in addition to a full workday in the office, you’ll be assigned three more hours of work every night. Does this sound like a healthy work-life balance? Most adults would consider this expectation ridiculous and unsustainable. Yet, this is the workload most schools place on high school students.

Research shows that excessive homework leads to increased stress, physical health problems and a lack of balance in students' lives. And studies have shown that more than two hours of daily homework can be counterproductive , yet many teachers assign more.

Homework proponents argue that homework improves academic performance. Indeed, a meta-analysis of research on this issue found a correlation between homework and achievement. But correlation isn’t causation. Does homework cause achievement or do high achievers do more homework? While it’s likely that homework completion signals student engagement, which in turn leads to academic achievement, there’s little evidence to suggest that homework itself improves engagement in learning.

Another common argument is that homework helps students develop skills related to problem-solving, time-management and self-direction. But these skills can be explicitly taught during the school day rather than after school.

Limiting homework or moving to an optional homework policy not only supports student well-being, but it can also create a more equitable learning environment. According to the American Psychological Association, students from more affluent families are more likely to have access to resources such as devices, internet, dedicated work space and the support necessary to complete their work successfully—and homework can highlight those inequities .

Whether a school limits homework or makes it optional, it’s critical to remember that more important than the amount of homework assigned, is designing the type of activities that engage students in learning. When students are intrinsically motivated to do their homework, they are more engaged in the work, which in turn is associated with academic achievement.

Cap the Number of APs Students Can Take

Advanced Placement courses give students a taste of college-level work and, in theory, allow them to earn college credits early. Getting good grades on AP exams is associated with higher GPAs in high school and success in college, but the research tends to be correlational rather than causational.

In 2008, a little over 180,000 students took three or more AP exams. By 2018, that number had ballooned to almost 350,000 students .

However, this expansion has come at the expense of student well-being.

Over the years, we’ve heard many students express that they feel pressure to take as many AP classes as possible, which overloads them with work. That’s troubling because studies show that students who take AP classes and exams are twice as likely to report adverse physical and emotional health .

AP courses and exams also raise complex issues of equity. In 2019, two out of three Harvard freshmen reported taking AP Calculus in high school, according to Jeff Selingo, author of “ Who Gets In and Why: A Year Inside College Admissions ,” yet only half of all high schools in the country offer the course. And opportunity gaps exist for advanced coursework such as AP courses and dual enrollment, with inequitable distribution of funding and support impacting which students are enrolling and experiencing success. According to the Center for American Progress, “National data from the Civil Rights Data Collection show that students who are Black, Indigenous, and other non-Black people of color (BIPOC) are not enrolled in AP courses at rates comparable to their white and Asian peers and experience less success when they are—and the analysis for this report finds this to be true even when they attend schools with similar levels of AP course availability.”

Limiting the number of AP courses students take can protect mental health and create a more equitable experience for students.

Eliminate Class Rankings

In a study we conducted about mental health problems among high school girls, we found that a primary driver of stress was their perception of school as a hypercompetitive, zero-sum game where pervasive peer pressure to perform reigns supreme.

Class rankings fuel these cutthroat environments. They send a toxic message to young people: success requires doing better than your peers.

Ranking systems help highly selective colleges decide which students to admit or reject for admission. The purpose of high school is to develop students to their own full potential, rather than causing them to fixate on measuring up to others. Research shows that ranking systems undercut students’ learning and damage social relationships by turning peers into opponents.

Eliminating class rankings sends a powerful message to students that they are more than a number.

Become an Admission Test Objector

COVID-19 ushered in the era of test-optional admissions. De-centering standardized tests in the college application process is unequivocally a good thing. Standardized tests don’t predict student success in college , they only widen the achievement gap between privileged and underprivileged students and damage students' mental health .

Going “test optional” is an excellent first step, but it's not enough.

Even as more colleges have made tests optional, affluent students submit test scores at a higher rate than their lower-income peers and are admitted at higher rates , suggesting that testing still gives them an edge.

High schools must adhere to standardized test mandates, but they don’t have to endorse them. They can become test objectors by publicly proclaiming that these tests hold no inherent value. They can stop teaching to the test and educate parents on why they are doing so. Counseling departments can inform colleges that their school is a test objector so admission teams won’t penalize students.

Of course, students and families will still find ways to wield these tests as a competitive advantage. Over time, the more schools and educators unite to denounce these tests, the less power they will hold over students and families.

Big change starts with small steps.

Stand For What You Value

Critics may argue that such policies might hurt student outcomes. How will colleges evaluate school rigor if we limit AP courses and homework? How will students demonstrate their merits without class rankings and standardized test scores?

The truth is, the best school systems in the world succeed without homework, standardized test scores or an obsession with rigorous courses. And many U.S. schools have found creative and empowering ways to showcase student merit beyond rankings and test scores.

If we aren’t willing to change policies and practices that have been shown to harm students’ well-being, we have to ask ourselves: Do we really value mental health?

Thankfully, it doesn’t have to be an either/or scenario: We can design school systems that help students thrive academically and psychologically.

Belle Liang and Tim Klein are mental health professionals and co-authors of “How To Navigate Life: The New Science of Finding Your Way in School, Career and Life.”

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Is Homework Necessary? Education Inequity and Its Impact on Students

The Problem with Homework: It Highlights Inequalities

How much homework is too much homework, when does homework actually help, negative effects of homework for students, how teachers can help.

Schools are getting rid of homework from Essex, Mass., to Los Angeles, Calif. Although the no-homework trend may sound alarming, especially to parents dreaming of their child’s acceptance to Harvard, Stanford or Yale, there is mounting evidence that eliminating homework in grade school may actually have great benefits , especially with regard to educational equity.

In fact, while the push to eliminate homework may come as a surprise to many adults, the debate is not new . Parents and educators have been talking about this subject for the last century, so that the educational pendulum continues to swing back and forth between the need for homework and the need to eliminate homework.

One of the most pressing talking points around homework is how it disproportionately affects students from less affluent families. The American Psychological Association (APA) explained:

“Kids from wealthier homes are more likely to have resources such as computers, internet connections, dedicated areas to do schoolwork and parents who tend to be more educated and more available to help them with tricky assignments. Kids from disadvantaged homes are more likely to work at afterschool jobs, or to be home without supervision in the evenings while their parents work multiple jobs.”

[RELATED] How to Advance Your Career: A Guide for Educators >> 

While students growing up in more affluent areas are likely playing sports, participating in other recreational activities after school, or receiving additional tutoring, children in disadvantaged areas are more likely headed to work after school, taking care of siblings while their parents work or dealing with an unstable home life. Adding homework into the mix is one more thing to deal with — and if the student is struggling, the task of completing homework can be too much to consider at the end of an already long school day.

While all students may groan at the mention of homework, it may be more than just a nuisance for poor and disadvantaged children, instead becoming another burden to carry and contend with.

Beyond the logistical issues, homework can negatively impact physical health and stress — and once again this may be a more significant problem among economically disadvantaged youth who typically already have a higher stress level than peers from more financially stable families .

Yet, today, it is not just the disadvantaged who suffer from the stressors that homework inflicts. A 2014 CNN article, “Is Homework Making Your Child Sick?” , covered the issue of extreme pressure placed on children of the affluent. The article looked at the results of a study surveying more than 4,300 students from 10 high-performing public and private high schools in upper-middle-class California communities.

“Their findings were troubling: Research showed that excessive homework is associated with high stress levels, physical health problems and lack of balance in children’s lives; 56% of the students in the study cited homework as a primary stressor in their lives,” according to the CNN story. “That children growing up in poverty are at-risk for a number of ailments is both intuitive and well-supported by research. More difficult to believe is the growing consensus that children on the other end of the spectrum, children raised in affluence, may also be at risk.”

When it comes to health and stress it is clear that excessive homework, for children at both ends of the spectrum, can be damaging. Which begs the question, how much homework is too much?

The National Education Association and the National Parent Teacher Association recommend that students spend 10 minutes per grade level per night on homework . That means that first graders should spend 10 minutes on homework, second graders 20 minutes and so on. But a study published by The American Journal of Family Therapy found that students are getting much more than that.

While 10 minutes per day doesn’t sound like much, that quickly adds up to an hour per night by sixth grade. The National Center for Education Statistics found that high school students get an average of 6.8 hours of homework per week, a figure that is much too high according to the Organization for Economic Cooperation and Development (OECD). It is also to be noted that this figure does not take into consideration the needs of underprivileged student populations.

In a study conducted by the OECD it was found that “after around four hours of homework per week, the additional time invested in homework has a negligible impact on performance .” That means that by asking our children to put in an hour or more per day of dedicated homework time, we are not only not helping them, but — according to the aforementioned studies — we are hurting them, both physically and emotionally.

What’s more is that homework is, as the name implies, to be completed at home, after a full day of learning that is typically six to seven hours long with breaks and lunch included. However, a study by the APA on how people develop expertise found that elite musicians, scientists and athletes do their most productive work for about only four hours per day. Similarly, companies like Tower Paddle Boards are experimenting with a five-hour workday, under the assumption that people are not able to be truly productive for much longer than that. CEO Stephan Aarstol told CNBC that he believes most Americans only get about two to three hours of work done in an eight-hour day.

In the scope of world history, homework is a fairly new construct in the U.S. Students of all ages have been receiving work to complete at home for centuries, but it was educational reformer Horace Mann who first brought the concept to America from Prussia. 

Since then, homework’s popularity has ebbed and flowed in the court of public opinion. In the 1930s, it was considered child labor (as, ironically, it compromised children’s ability to do chores at home). Then, in the 1950s, implementing mandatory homework was hailed as a way to ensure America’s youth were always one step ahead of Soviet children during the Cold War. Homework was formally mandated as a tool for boosting educational quality in 1986 by the U.S. Department of Education, and has remained in common practice ever since.  

School work assigned and completed outside of school hours is not without its benefits. Numerous studies have shown that regular homework has a hand in improving student performance and connecting students to their learning. When reviewing these studies, take them with a grain of salt; there are strong arguments for both sides, and only you will know which solution is best for your students or school. 

Homework improves student achievement.

• Source: The High School Journal, “ When is Homework Worth the Time?: Evaluating the Association between Homework and Achievement in High School Science and Math ,” 2012. 
• Source: IZA.org, “ Does High School Homework Increase Academic Achievement? ,” 2014. **Note: Study sample comprised only high school boys. 

Homework helps reinforce classroom learning.

• Source: “ Debunk This: People Remember 10 Percent of What They Read ,” 2015.

Homework helps students develop good study habits and life skills.

• Sources: The Repository @ St. Cloud State, “ Types of Homework and Their Effect on Student Achievement ,” 2017; Journal of Advanced Academics, “ Developing Self-Regulation Skills: The Important Role of Homework ,” 2011.
• Source: Journal of Advanced Academics, “ Developing Self-Regulation Skills: The Important Role of Homework ,” 2011.

Homework allows parents to be involved with their children’s learning.

• Parents can see what their children are learning and working on in school every day. 
• Parents can participate in their children’s learning by guiding them through homework assignments and reinforcing positive study and research habits.
• Homework observation and participation can help parents understand their children’s academic strengths and weaknesses, and even identify possible learning difficulties.
• Source: Phys.org, “ Sociologist Upends Notions about Parental Help with Homework ,” 2018.

While some amount of homework may help students connect to their learning and enhance their in-class performance, too much homework can have damaging effects. 

Students with too much homework have elevated stress levels. 

• Source: USA Today, “ Is It Time to Get Rid of Homework? Mental Health Experts Weigh In ,” 2021.
• Source: Stanford University, “ Stanford Research Shows Pitfalls of Homework ,” 2014.

Students with too much homework may be tempted to cheat. 

• Source: The Chronicle of Higher Education, “ High-Tech Cheating Abounds, and Professors Bear Some Blame ,” 2010.
• Source: The American Journal of Family Therapy, “ Homework and Family Stress: With Consideration of Parents’ Self Confidence, Educational Level, and Cultural Background ,” 2015.

Homework highlights digital inequity. 

• Sources: NEAToday.org, “ The Homework Gap: The ‘Cruelest Part of the Digital Divide’ ,” 2016; CNET.com, “ The Digital Divide Has Left Millions of School Kids Behind ,” 2021.
• Source: Investopedia, “ Digital Divide ,” 2022; International Journal of Education and Social Science, “ Getting the Homework Done: Social Class and Parents’ Relationship to Homework ,” 2015.
• Source: World Economic Forum, “ COVID-19 exposed the digital divide. Here’s how we can close it ,” 2021.

Homework does not help younger students.

• Source: Review of Educational Research, “ Does Homework Improve Academic Achievement? A Synthesis of Researcher, 1987-2003 ,” 2006.

To help students find the right balance and succeed, teachers and educators must start the homework conversation, both internally at their school and with parents. But in order to successfully advocate on behalf of students, teachers must be well educated on the subject, fully understanding the research and the outcomes that can be achieved by eliminating or reducing the homework burden. There is a plethora of research and writing on the subject for those interested in self-study.

For teachers looking for a more in-depth approach or for educators with a keen interest in educational equity, formal education may be the best route. If this latter option sounds appealing, there are now many reputable schools offering online master of education degree programs to help educators balance the demands of work and family life while furthering their education in the quest to help others.

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THE ALGONQUIN HARBINGER

• Excessive homework negatively impacts mental health, causes unnecessary stress

Caroline Lou

Opinion Editor Jula Utzschneider writes on the overwhelming chip on every student’s shoulder: homework.

Jula Utzschneider , Opinion Editor November 10, 2021

When the bell rings to end last period every day, I feel a sense of relief. However, this feeling soon wears off as I realize just how much work I have to do after the already-stressful school day ends.

While homework can be beneficial, more often than not, it is assigned excessively and unnecessarily. Teachers give a significant amount of homework, often due the next day. This causes students to spend far too much time doing such assignments and can be detrimental.

A 2013 study conducted at Stanford University found that students in top-performing school districts who spend too much time on homework experience more stress, physical health problems, a lack of balance in their lives and alienation from society. That study, published in The Journal of Experimental Education , suggested that any more than two hours of homework per night is counterproductive. However, students who participated in the study reported doing slightly more than three hours of homework every night.

And, yes, the amount of homework given to students depends on the course level they take. But, with increasingly competitive college acceptance rates (demanding more extracurriculars and college-level classes), many students feel forced to take these more challenging courses. This is a huge problem, especially as teachers give homework only thinking about their own class, not the five or six others students have.

Additionally, when it came to stress, more than 70% of students in the Stanford study said they were “often or always stressed over schoolwork,” with 56% listing homework as a primary stressor. More than 80% of students reported having at least one stress-related symptom (such as headaches, exhaustion, sleep deprivation, weight loss, stomach problems and more) in the past month, and 44% said they had experienced three or more symptoms. 

Less than 1% of the students said homework was not a stressor, demonstrating that the vast majority feel overwhelmed and pressured by the amount of work they receive.

Not to mention, the time spent on these assignments could easily be spent doing something enjoyable. Many students feel forced or obligated to choose homework over practicing other talents or skills, which should never be the case. Teachers should be encouraging these extracurriculars, rather than making it impossible for students to partake in them.

In terms of what teachers can do, it’s quite simple, really. Homework is intended for students to either practice a subject further or to cover topics teachers couldn’t during the allotted class time. It should not be busywork that just wastes a student’s time. 

Teachers should be giving students work that is absolutely necessary (not busy work), and eliminate it altogether where they can. It is extremely important that students not only get through high school but thrive and enjoy it too.

How much time do you spend doing homework on an average school night?

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Jula began writing for The Harbinger her freshman year after taking Journalism. While at first hesitant, she grew to love reporting and specifically opinion...

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Does Homework Cause Stress? Exploring the Impact on Students’ Mental Health

How much homework is too much?

Jump to: The Link Between Homework and Stress | Homework’s Impact on Mental Health | Benefits of Homework | How Much Homework Should Teacher’s Assign? | Advice for Students | How Healium Helps

Homework has become a matter of concern for educators, parents, and researchers due to its potential effects on students’ stress levels. It’s no secret students often find themselves grappling with high levels of stress and anxiety throughout their academic careers, so understanding the extent to which homework affects those stress levels is important. 

By delving into the latest research and understanding the underlying factors at play, we hope to curate insights for educators, parents, and students who are wondering  is homework causing stress in their lives?

The Link Between Homework and Stress: What the Research Says

Over the years, numerous studies investigated the relationship between homework and stress levels in students. 

One study published in the Journal of Experimental Education found that students who reported spending more than two hours per night on homework experienced higher stress levels and physical health issues . Those same students reported over three hours of homework a night on average.

This study, conducted by Stanford lecturer Denise Pope, has been heavily cited throughout the years, with WebMD eproducing the below video on the topic– part of their special report series on teens and stress : 

Additional studies published by Sleep Health Journal found that long hours on homework on may be a risk factor for depression while also suggesting that reducing workload outside of class may benefit sleep and mental fitness .

Lastly, a study presented by Frontiers in Psychology highlighted significant health implications for high school students facing chronic stress, including emotional exhaustion and alcohol and drug use.

Homework’s Potential Impact on Mental Health and Well-being

Homework-induced stress on students can involve both psychological and physiological side effects. 

1. Potential Psychological Effects of Homework-Induced Stress:

• Anxiety: The pressure to perform academically and meet homework expectations can lead to heightened levels of anxiety in students. Constant worry about completing assignments on time and achieving high grades can be overwhelming.

• Sleep Disturbances : Homework-related stress can disrupt students’ sleep patterns, leading to sleep anxiety or sleep deprivation, both of which can negatively impact cognitive function and emotional regulation.

• Reduced Motivation: Excessive homework demands could drain students’ motivation, causing them to feel fatigued and disengaged from their studies. Reduced motivation may lead to a lack of interest in learning, hindering overall academic performance.

2. Potential Physical Effects of Homework-Induced Stress:

• Impaired Immune Function: Prolonged stress could weaken the immune system, making students more susceptible to illnesses and infections.

• Disrupted Hormonal Balance : The body’s stress response triggers the release of hormones like cortisol, which, when chronically elevated due to stress, can disrupt the delicate hormonal balance and lead to various health issues.

• Gastrointestinal Disturbances: Stress has been known to affect the gastrointestinal system, leading to symptoms such as stomachaches, nausea, and other digestive problems.

• Cardiovascular Impact: The increased heart rate and elevated blood pressure associated with stress can strain the cardiovascular system, potentially increasing the risk of heart-related issues in the long run.

• Brain impact: Prolonged exposure to stress hormones may impact the brain’s functioning , affecting memory, concentration, and cognitive abilities.

The Benefits of Homework

It’s important to note that homework also offers many benefits that contribute to students’ academic growth and development, such as: 

• Development of Time Management Skills: Completing homework within specified deadlines encourages students to manage their time efficiently. This valuable skill extends beyond academics and becomes essential in various aspects of life.

• Preparation for Future Challenges : Homework helps prepare students for future academic challenges and responsibilities. It fosters a sense of discipline and responsibility, qualities that are crucial for success in higher education and professional life.

• Enhanced Problem-Solving Abilities: Homework often presents students with challenging problems to solve. Tackling these problems independently nurtures critical thinking and problem-solving skills.

While homework can foster discipline, time management, and self-directed learning, the middle ground may be to  strike a balance that promotes both academic growth and mental well-being .

How Much Homework Should Teachers Assign?

As a general guideline, educators suggest assigning a workload that allows students to grasp concepts effectively without overwhelming them . Quality over quantity is key, ensuring that homework assignments are purposeful, relevant, and targeted towards specific objectives. 

Advice for Students: How to balance Homework and Well-being

Finding a balance between academic responsibilities and well-being is crucial for students. Here are some practical tips and techniques to help manage homework-related stress and foster a healthier approach to learning:

• Effective Time Management : Encourage students to create a structured study schedule that allocates sufficient time for homework, breaks, and other activities. Prioritizing tasks and setting realistic goals can prevent last-minute rushes and reduce the feeling of being overwhelmed.

• Break Tasks into Smaller Chunks : Large assignments can be daunting and may contribute to stress. Students should break such tasks into smaller, manageable parts. This approach not only makes the workload seem less intimidating but also provides a sense of accomplishment as each section is completed.

• Find a Distraction-Free Zone : Establish a designated study area that is free from distractions like smartphones, television, or social media. This setting will improve focus and productivity, reducing time needed to complete homework.

• Be Active : Regular exercise is known to reduce stress and enhance mood. Encourage students to incorporate physical activity into their daily routine, whether it’s going for a walk, playing a sport, or doing yoga.

• Practice Mindfulness and Relaxation Techniques : Encourage students to engage in mindfulness practices, such as deep breathing exercises or meditation, to alleviate stress and improve concentration. Taking short breaks to relax and clear the mind can enhance overall well-being and cognitive performance.

• Seek Support : Teachers, parents, and school counselors play an essential role in supporting students. Create an open and supportive environment where students feel comfortable expressing their concerns and seeking help when needed.

How Healium is Helping in Schools

Stress is caused by so many factors and not just the amount of work students are taking home.  Our company created a virtual reality stress management solution… a mental fitness tool called “Healium” that’s teaching students how to learn to self-regulate their stress and downshift in a drugless way. Schools implementing Healium have seen improvements from supporting dysregulated students and ADHD challenges to empowering students with body awareness and learning to self-regulate stress . Here’s one of their stories. 

By providing students with the tools they need to self-manage stress and anxiety, we represent a forward-looking approach to education that prioritizes the holistic development of every student. 

To learn more about how Healium works, watch the video below.

About the Author

Sarah Hill , a former interactive TV news journalist at NBC, ABC, and CBS affiliates in Missouri, gained recognition for pioneering interactive news broadcasting using Google Hangouts. She is now the CEO of Healium, the world’s first biometrically powered immersive media channel, helping those with stress, anxiety, insomnia, and other struggles through biofeedback storytelling. With patents, clinical validation, and over seven million views, she has reshaped the landscape of immersive media.

London Spring

Can Homework Cause Mental Health Issues?

Deborah c. escalante.

October 18, 2023

As students, we have all experienced the pressure and stress that comes along with homework. Whether we are in primary school, high school, or university, it seems like there is always an assignment due or an exam to study for. While homework is an essential part of the learning process, can it lead to mental health issues?

Research suggests that excessive homework can cause mental health problems in students. This is because too much homework can lead to feelings of anxiety, stress, and even depression. This is especially true for students who are already struggling with mental health issues.

Table of Contents

The Negative Effects of Homework on Mental Health

There are several negative effects of homework on mental health. For starters, too much homework can lead to sleep deprivation, which can cause many mental health problems. Lack of sleep can lead to mood swings, irritability, cognitive impairment, and even depression. This is because when we are sleep-deprived, our brains do not have enough time to rest and recharge.

Additionally, too much homework can lead to feelings of anxiety and stress. Students who are given too much homework often feel like they are drowning in assignments, which can lead to feelings of overwhelming stress. This stress can manifest itself in physical symptoms like headaches, stomach aches, and fatigue.

Finally, excessive homework can lead to a lack of social life and isolation. With all the time spent on homework, students do not have the time to participate in extracurricular activities or spend time with friends and family. This can lead to feelings of loneliness and isolation, which can be detrimental to mental health.

Solutions to Excessive Homework

So what can be done to alleviate the negative effects of excessive homework on mental health? The first step is for teachers and schools to recognize the negative effects of excessive homework and take steps to reduce the amount of homework that students are assigned.

Additionally, parents can play a role by monitoring their child’s homework load and communicating with teachers if they feel that their child is being assigned an excessive amount of homework. This can help to reduce stress and anxiety levels for students.

Finally, students should practice good time management skills and develop healthy study habits. This means setting aside time for homework each day, taking breaks when needed, and getting enough sleep. It’s also important for students to prioritize their mental health and take care of themselves physically, emotionally, and mentally.

In conclusion, excessive homework can cause mental health issues in students. Research shows that too much homework can lead to feelings of anxiety, stress, and even depression. It’s essential for teachers, parents, and students to work together to reduce the amount of homework that students are assigned and to prioritize the mental health of students. By doing so, we can ensure that our students are healthy, happy, and successful both in and outside of the classroom.

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