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What Is Therapy Homework?

Sanjana is a health writer and editor. Her work spans various health-related topics, including mental health, fitness, nutrition, and wellness.

Dr. Sabrina Romanoff, PsyD, is a licensed clinical psychologist and a professor at Yeshiva University’s clinical psychology doctoral program.

Astrakan Images / Getty Images

Types of Therapy That Involve Homework

If you’ve recently started going to therapy , you may find yourself being assigned therapy homework. You may wonder what exactly it entails and what purpose it serves. Therapy homework comprises tasks or assignments that your therapist asks you to complete between sessions, says Nicole Erkfitz , DSW, LCSW, a licensed clinical social worker and executive director at AMFM Healthcare, Virginia.

Homework can be given in any form of therapy, and it may come as a worksheet, a task to complete, or a thought/piece of knowledge you are requested to keep with you throughout the week, Dr. Erkfitz explains.

This article explores the role of homework in certain forms of therapy, the benefits therapy homework can offer, and some tips to help you comply with your homework assignments.

Therapy homework can be assigned as part of any type of therapy. However, some therapists and forms of therapy may utilize it more than others.

For instance, a 2019-study notes that therapy homework is an integral part of cognitive-behavioral therapy (CBT) . According to Dr. Erkfitz, therapy homework is built into the protocol and framework of CBT, as well as dialectical behavior therapy (DBT) , which is a sub-type of CBT.

Therefore, if you’re seeing a therapist who practices CBT or DBT, chances are you’ll regularly have homework to do.

On the other hand, an example of a type of therapy that doesn’t generally involve homework is eye movement desensitization and reprocessing (EMDR) therapy. EMDR is a type of therapy that generally relies on the relationship between the therapist and client during sessions and is a modality that specifically doesn’t rely on homework, says Dr. Erkfitz.

However, she explains that if the client is feeling rejuvenated and well after their processing session, for instance, their therapist may ask them to write down a list of times that their positive cognition came up for them over the next week.

"Regardless of the type of therapy, the best kind of homework is when you don’t even realize you were assigned homework," says Erkfitz.

Benefits of Therapy Homework

Below, Dr. Erkfitz explains the benefits of therapy homework.

It Helps Your Therapist Review Your Progress

The most important part of therapy homework is the follow-up discussion at the next session. The time you spend reviewing with your therapist how the past week went, if you completed your homework, or if you didn’t and why, gives your therapist valuable feedback on your progress and insight on how they can better support you.

It Gives Your Therapist More Insight

Therapy can be tricky because by the time you are committed to showing up and putting in the work, you are already bringing a better and stronger version of yourself than what you have been experiencing in your day-to-day life that led you to seek therapy.

Homework gives your therapist an inside look into your day-to-day life, which can sometimes be hard to recap in a session. Certain homework assignments keep you thinking throughout the week about what you want to share during your sessions, giving your therapist historical data to review and address.

It Helps Empower You

The sense of empowerment you can gain from utilizing your new skills, setting new boundaries , and redirecting your own cognitive distortions is something a therapist can’t give you in the therapy session. This is something you give yourself. Therapy homework is how you come to the realization that you got this and that you can do it.

"The main benefit of therapy homework is that it builds your skills as well as the understanding that you can do this on your own," says Erkfitz.

Tips for Your Therapy Homework

Below, Dr. Erkfitz shares some tips that can help with therapy homework:

• Set aside time for your homework: Create a designated time to complete your therapy homework. The aim of therapy homework is to keep you thinking and working on your goals between sessions. Use your designated time as a sacred space to invest in yourself and pour your thoughts and emotions into your homework, just as you would in a therapy session .
• Be honest: As therapists, we are not looking for you to write down what you think we want to read or what you think you should write down. It’s important to be honest with us, and yourself, about what you are truly feeling and thinking.
• Practice your skills: Completing the worksheet or log are important, but you also have to be willing to put your skills and learnings into practice. Allow yourself to be vulnerable and open to trying new things so that you can report back to your therapist about whether what you’re trying is working for you or not.
• Remember that it’s intended to help you: Therapy homework helps you maximize the benefits of therapy and get the most value out of the process. A 2013-study notes that better homework compliance is linked to better treatment outcomes.
• Talk to your therapist if you’re struggling: Therapy homework shouldn’t feel like work. If you find that you’re doing homework as a monotonous task, talk to your therapist and let them know that your heart isn’t in it and that you’re not finding it beneficial. They can explain the importance of the tasks to you, tailor your assignments to your preferences, or change their course of treatment if need be.

"When the therapy homework starts 'hitting home' for you, that’s when you know you’re on the right track and doing the work you need to be doing," says Erkfitz.

A Word From Verywell

Similar to how school involves classwork and homework, therapy can also involve in-person sessions and homework assignments.

If your therapist has assigned you homework, try to make time to do it. Completing it honestly can help you and your therapist gain insights into your emotional processes and overall progress. Most importantly, it can help you develop coping skills and practice them, which can boost your confidence, empower you, and make your therapeutic process more effective.

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Conklin LR, Strunk DR, Cooper AA. Therapist behaviors as predictors of immediate homework engagement in cognitive therapy for depression . Cognit Ther Res . 2018;42(1):16-23. doi:10.1007/s10608-017-9873-6

Lebeau RT, Davies CD, Culver NC, Craske MG. Homework compliance counts in cognitive-behavioral therapy . Cogn Behav Ther . 2013;42(3):171-179. doi:10.1080/16506073.2013.763286

By Sanjana Gupta Sanjana is a health writer and editor. Her work spans various health-related topics, including mental health, fitness, nutrition, and wellness.

• Last edited on September 9, 2020

Homework in CBT

Table of contents, why do homework in cbt, how to deliver homework, strategies to increase confidence.

Homework assignments in Cognitive Behavioural Therapy (CBT) can help your patients educate themselves further, collect thoughts, and modify their thinking.

Homework is not something that you just assign randomly. You should make sure you:

• tailor the homework to the patient
• provide a rationale for why the patient needs to do the homework
• uncover any obstacles that might prevent homework from being done (i.e. - busy work schedule, significant neurovegetative symptoms)

Types of homework

Types of homework assignments.

You should also decide the frequency of the homework should be assigned: should it be daily, weekly?

If your patient does not do homework, that’s OK! Explore as a team, in a non-judgmental way, to explore why the homework was not done. Here are some ways to increase adherence to homework:

• Tailor the assignments to the individual
• Provide a rationale for how and why the assignment might help
• Determine the homework collaboratively
• Try to start the homework during the session. This creates some momentum to continue doing the homework
• Set up systems to remember to do the assignments (phone reminders, sticky notes
• It is better to start with easier homework assignments and err on the side of caution
• They should be 90-100% confident they will be able to do this assignment
• Covert rehearsal - running through a thought experiment on a situation
• Change the assignment - It is far better to substitute an easier homework assignment that patients are likely to do than to have them establish a habit of not doing what they had agreed to in session
• Intellectual/emotional role play - “I’ll be the intellectual part of you; you be the emotional part. You argue as hard as you can against me so I can see all the arguments you’re using not to read your coping cards and start studying. You start.”

• Jan 30, 2023
• 26 min read

19 Tips to Motivate Clients With Therapy Homework- (Infographic)

Updated: Sep 14, 2023

Our team reached out to a group of therapists to find out what tips they had to offer on how to get clients to do their therapy homework. The infographic below is a collection summary of the quotes we received from 19 therapists.

While many of the interventions are known among professionals, each participant offers unique insight while answering the same question. The sessions that each therapist has with their clients are fantastic opportunities for discovery and figuring things out. The truth is that much of the learning and growth often come from the application of what has been discovered and figured out. In other words, you never get the full value of your in-person sessions without doing the homework!

Here are what our contributors recommended (you can find the full transcript and a link to the official article down below).

19 Therapists Weigh in On How to Motivate Clients Who Don’t Do Their Therapy Homework

Therapy sessions bring people to many new realizations. However, real learning takes place when a client attempts to apply these new ways of thinking and acting to their everyday life and to the goals they wish to accomplish. A big part of the process is the homework or exercises a therapist assigns to a client. If a client doesn’t do their homework, does this make the therapist's job much harder?

Below you will find the testimony of 19 different therapists that are weighing in on this very real and common occurrence. Each therapist gives their two cents on whether this issue is counter-productive, ways to get around, and more importantly ways to motivate their clients!

Tina Marie Del Rosario, LCSW, MSW, Adjunct Professor @ Pepperdine University

Owner of Healing Collective Therapy Group

https://healingcollectivetherapy.com

A common theme I see in people who lack motivation is the absence of self-compassion. Clients who show up faithfully are clearly displaying a form of motivation. But when it comes to doing the work, there are clients who meet resistance and acts of avoidance. .

What interventions have you found to be helpful in motivating clients?

I find that starting with a psychodynamic approach is necessary. Exploring what is coming up for the client when resistance and avoidance are present is often helpful. The thoughts, attitudes and emotions attached to these feelings have come from some past experience.

Identifying where it is coming from can help the client process said past experience(s) and recognize the lack of relevance it has to present day. More often than not, self-critical narratives are attached to the feelings of resistance.

These criticisms evoke both somatic symptoms and self-protection motivations that lead to avoidance. Becoming aware of what is coming up and how it is showing up is necessary to combat lack of motivation. Once identified, we can then work together to process it all and begin to change the narrative.

When clients realize their lack of motivation is not coming from “laziness” or “a character flaw,” they then can begin to remove the self-critical narratives and replace them with self-compassion.

With this new internal dynamic and the absence of self-criticism, clients find it easier to begin to motivate themselves to do the work.

Ellie Borden, BA, RP, PCC

Registered Psychotherapist, Clinical Director and Clinical Supervisor.

https://www.mindbydesign.ca

Resistance can be a common part of any change process. Some people struggling with different challenges may appear not to want to change. Even those clients who attend therapy loyally and recognize the need for change in their lives may fail to complete their homework or take the necessary steps outside therapy to modify their behavior.

This is a powerful moment in therapy and can give a therapist the insight necessary to recognize the deeper issues affecting someone's motivation to take the necessary steps toward the change they seek. Often, recognizing avoidant patterns or behavior is an opportunity to identify unresolved matters and the core elements that require healing.

Moreover, a therapist can help an individual reformat their why for change. It is important that someone's why is emotionally driven and leads to effortless motivation. The responsibility for change is the client's alone. However, a trained professional can give someone the objective perspective needed to get them moving in the right direction.

While a therapist can help a client become more motivated to change, ultimately, the onus is on the client to change. With that in mind, there are specific methods that therapists can use with clients to properly motivate them to make the needed changes in their lives.

One of the most widely used interventions for motivating clients is motivational interviewing. The goal of motivational interviewing is to help clients increase their intrinsic desire to change and achieve their goals in therapy. One of the techniques in motivational interviewing is bolstering the client's sense of self-efficacy by helping them recall examples of overcoming challenges in the past. This can allow the client to see that change is achievable and that the situation may not be as hopeless as they think. Developing discrepancies is another technique in motivational interviewing.

This involves a therapist helping the client voice their thoughts, feelings, and conflicts to call attention to the discrepancy between how the client is behaving and how they would like to behave. Motivational interviewing is a great way to help clients recognize their inner strengths and develop the desire to change.

There are many reasons why a client may resist taking the proper action discussed in therapy. One is fear of failure. Some clients, particularly those who are clinically depressed, do not have much faith in themselves or their ability to succeed. Even the slightest real or perceived setback can cause them to catastrophize or engage in negative self-talk such as I am so stupid or I am a failure who can never do anything right. With such a mindset, it is no wonder many clients are unwilling to attempt the steps required for positive change, even if they may truly desire to change. This is one reason why strengthening a client's self-efficacy is crucial.

Another cause of a client's resistance to change is a lack of clear goals. Some clients may struggle to articulate a vision of what desired change looks like, even if they sense that something has gone wrong. Helping the client develop a clear and realistic plan for change can give them additional motivation for following through with the often difficult and confusing work of pursuing meaningful changes in their lives.

Sarah F. O'Brien, LCSW, LLC

Thrive & Shine Counseling

https://www.sarahobrienlcsw.com

Without fail, as a therapist I will point out the discrepancy-mentioning to them how consistent they are with attending sessions, yet how inconsistent they are with completing homework. This usually sparks conversation and processing about why this may be happening for the client.

As a Clinical Social Worker, we are trained to assess a person fully within the context of their life circumstances, something we call BioPsychoSocialSpiritual assessment. With this, I may ask and find extenuating at-home circumstances that prevent clients from being able to complete homework i.e. too busy, not setting enough boundaries at work, ignoring self-care, over-committing to things that aren't beneficial to client's mental health.

What interventions have you found to be *helpful with motivating clients?

To increase client commitment to the change process, I use interventions such as:

*Psychoeducation* (explaining to them, with psychotherapy, most of 'the work' occurs outside of session to achieve desired change).

*Motivational Interviewing techniques* (to prompt and explore client reasons for lack of homework follow through and their awareness, if any, about this).

*Creative homework assignments* based on client's interests or talents (outside the box stuff that doesn't include worksheets or even writing anything down i.e. going for a walk and looking for different types of flowers or trees--this is a mindfulness practice. Or art/expressive assignments i.e. creating a playlist, making a collage or vision board, designing a room or space in their mind-- this is emotional processing, gaining new perspective, finding a safe 'place' to decompress).

*Encourage and suggest clients develop a reward system* for themselves for completing homework assignments (small gifts or tokens for completing that week's assignment, i.e. getting special coffee, taking an hour off work early, favorite dessert they rarely have etc. And larger tokens for consistent completion--every week for a month, for example, or tracking progress or having a breakthrough from the homework-- i.e. taking a weekend trip, taking a whole day off for self, purchasing non-practical or coveted item for self).

Although people willingly engage in therapy, the change process is often arduous and longer than we anticipate (or desire!). People lose motivation, it happens. Enjoyable assignments and rewards for completion are the external factors that motivate us until some positive change starts to occur. When noticeable, positive differences emerge from 'doing the work' outside of sessions, internal motivation often kicks in for clients and they WANT to keep doing homework BECAUSE it's producing the change they want to see in themselves.

Candace Kotkin-De Carvalho, LSW, LCADC, CCS, CCTP

Absolute Awakenings | Morris Plains, New Jersey

https://absoluteawakenings.com/

Therapy isn't a magic pill; clients need to work on their issues as part of the process. One strategy that may help is setting up firm boundaries. This can include scheduling regular appointments and requiring homework assignments between sessions. If a client repeatedly misses appointments or doesn't complete required tasks, it is helpful to schedule a check-in session to discuss this issue and help the client stay on track.

There may also be times when it's necessary to end therapy with a client who refuses to work on their issues. It can be challenging to make this decision, but it is important to do what's best for both the client and therapist to maintain a healthy professional relationship. If you are struggling with these issues, it may be helpful to seek out support from other mental health professionals or find a trusted mentor who can provide guidance.

Reflective listening and active listening can help clients feel heard and understood, which can ultimately motivate them to do the work. Reflective listening involves paraphrasing back to the client what you have heard them say. This way, empathy, and understanding are communicated, and the client feels more motivated to continue working on their issues. Active listening involves listening through nonverbal cues, such as eye contact, nodding, and facial expressions. This approach also encourages a client to articulate their own thoughts and feelings.

When it comes to doing their part in therapy, some clients may need additional support and guidance. This can include breaking down tasks into smaller parts, setting up time-bound goals, or providing positive reinforcement for progress made. If you give them homework assignments, check in with them at their next appointment to see how they are progressing and provide feedback or encouragement as needed.

For example, it may be overwhelming for some clients to make a major life change in one sitting, so you can help them develop a gradual plan to work toward their goals. Meanwhile, other clients may feel frustrated and unmotivated if they aren't making enough progress or meeting their goals quickly enough. In these cases, it can be helpful to provide positive reinforcement when they

make progress, such as offering verbal praise or tangible rewards.

Our behaviors are heavily affected by our thoughts, emotions, and environment. For clients who have been struggling with mental health issues for a long time, their thought patterns and coping mechanisms may be ingrained in their psyche. As a therapist, it is important to acknowledge that these behaviors may take time to change.

Often, this involves helping the client identify and understand unhealthy thought patterns and behaviors. This may involve identifying negative self-talk, challenging unhelpful beliefs, or learning coping strategies to better manage stress and anxiety. Accordingly, help the client focus on their strengths and build positive relationships with others. Acknowledging that they are working through a difficult time can provide support and motivation for them to keep going.

In addition, be mindful of your own thoughts and emotions as a therapist. For example, it is helpful to have regular supervision or check-ins with other mental health professionals so you can discuss any challenging client interactions. This will help ensure that your professional boundaries are maintained and that you provide the best support for your client.

Lauren Cook-McKay

Licensed Marriage, and Family Therapist and VP of Marketing at Divorce Answers

https://divorceanswers.com/

Although therapy is a two-way street in order to be successful, it's also a safe space for clients to be a mess. Dealing with incomplete homework usually involved capitalizing the inaction as a window to the realization of the issues they're dealing with in their lives.

Paradigm shifts were emphasized as a necessity, but the inaction itself is conceptualized as evidence of a barrier to wellness so it's leveraged for strategizing on better methods for management that are more suited to the client's capacities. We also make sure to leave room for these strategies to be adjusted until clients are ready to fully overcome their hindrances.

The most effective intervention that improves clients' motivations is the involvement of their support systems. Typically, the barriers they're facing and the reasons behind them being unpacked during the session bring forth the need to have sit-down talks with their loved ones. *Practicing that suggestion, they're able to verbally communicate the impact of the reactions and behaviors of the people around them which they've been repressing. *This frees them from their old self-concept and ultimately minimizes their hindrances.

After defining the specifics around the sequence of events that lead to the inaction of an assignment, analyses generally reveal that *clients feel unable due to complete them mostly due to the overwhelming pressure from expectations of accomplishing the assignment and/or apprehension of the mental labor being demanded by the task, as well as the potential impacts of the self-reflections that the task aims to bring to light. These reasons stop them from their tracks and/or deplete their mental energy to commit to the whole treatment.

Lawrence Barnier

Mental Health Officer

Women's Resources e-Information

https://www.wrei.org/

There are a few different ways to approach this situation. One way is to try to understand why the client is not doing the work. It could be that they do not understand what is expected of them, or they may feel overwhelmed and unsure of how to get started.

In these cases, it may be helpful to provide some guidance and support to help the client get started.

Another reason why a client may not be doing the work could be that they are not interested in changing their behavior. In these cases, the therapist may need to reassess the goals of therapy and decide if it is still appropriate to continue working with that client.

There are a number of interventions that can be helpful in motivating clients. One strategy is to set goals with the client and track their progress. This can help to provide feedback and encouragement and can help to show the client that they are making progress.

Another strategy is to provide positive reinforcement when the client demonstrates good behavior. This can help to encourage the client and can help to build a positive relationship with the therapist.

Finally, it is important to be understanding and supportive when the client does not meet their goals. This can help to provide motivation and can show the client that the therapist is there to help them.

Claudia Luiz

Psychoanalyst

http://www.claudialuiz.com

When clients “resist” in therapy, that resistance can yield more information than what the client can tell you consciously. If you focus on the resistances - why the homework isn’t getting done, why the client is stuck, why they can’t break negative patterns and integrate what they are learning - you are really getting into the zones that the client hasn’t been invited yet to explore.

We now know from neuroscience, the three areas of the brain that can hijack conscious effort. Fear, rage, and grief. When people are afraid of feeling things, they get stuck.

Neuroscience gives us a model for what the patient may be resisting. The other emotional zones, seeking, play, and love can be engaged in this exploration. The framework gives us a way of thinking of the clients' “stuckness” in a productive and creative way.

Joining the client in their “stuckness” with compassion and curiosity, while shifting the framework of what you are ultimately working on, avoids power struggles, or potentially shaming the client. It lets them know compassionately that we understand about resistances, and that talking more about feelings can hold the key to unlocking the mystery of what is standing in the way of progress.

Elisa Tidswell

Certified Coach and Therapist, Committed to Empowering Women, Breaking

Negative Generational Cycles, and Creating Economic Justice

https://elisatidswell.com

It's vital that therapists understand how to keep their clients accountable to their growth. Accountability is where therapists help their clients take action that will help them grow - and action is the only place where transformation takes place. Transformation is what clients pay their therapists for.

It's also really important that therapists get really good at accountability, otherwise, they can actually wind up demoralizing their clients. After all, if clients don't do their homework consistently they are likely to internalize it, believing that there is something wrong with them or that they are failing. This is the polar opposite of what therapists want for their clients.

So how can therapists help their clients do their homework? By cultivating an environment of curiosity and learning. Accountability is not about judgment or being 'told off', however, sadly this is exactly what many people believe it to be: they learned about accountability from their parents and school environments where not doing homework or handing in sub-par homework was met with shame. It's really important for therapists to dispel this mindset and ensure their clients know that accountability is about learning.

The best approach I have found after coaching hundreds of clients to stay accountable is to include three main parts to the accountability conversation. The first is for the client to share a win: something positive that's happened since they last met with their therapist. This could be an insight, a decision, a process (such as 'I felt my feelings!'), or something extrinsic, such as a pay rise. Sharing a win is important to put the client in a state of abundance and is commonly used by positive psychologists in their practice.

The second part is to consider a goal or homework that the client did do, and break it down to see why they did it. For example, what were they thinking, how were they feeling about it, how did the goal tie in with their values, what was their motivation to get it done, did they tell others about it, had they put it in their diary, and so on. The therapist and the client want to learn about what works for them so that they can double down on it.

The third part is to consider a goal or homework that the client didn't do and then see what they can learn from why they didn't do it. Was the goal too big and overwhelming, and actually needed to be broken down into smaller steps? Were they clear on how to get started with the homework or was their understanding fuzzy? Was the homework tied in with their vision or values? Had they put it in their diary? Did they have support from others? Was a limiting belief getting in the way? Once the therapist and client have learned more about why they didn't do it, they can create a new goal to support them in achieving the original one.

The best action a therapist can take in supporting their clients with their homework is to let go of judgement and to a growth mindset. They have to see accountability itself as a learning exercise where they can explore

what's going on for the client, and understand what works for them.

Trish Glynn, LMHC, CRC

Licensed mental health counselor

Owner and therapist at The Carey Center

https://careycenter.squarespace.com/

Therapy is all about meeting the client where they’re at. Of

course, therapy will work best when the client is actively engaged both in and outside the therapy room. Results tend to be better and come faster. But not everyone is doing the work when they leave the appointment. There can be many reasons as well as many ways to address this. As a therapist, you want to try to figure out the “why” as that will help you determine next best steps.

For example, maybe you’re assigning work that is “too much” or isn’t a good fit for them. Are you asking a client to journal every week when sitting down to write is a mismatch for them?

Part of therapy is figuring out why the client is stuck. That takes time and talking about it in order to understand what the individual reason and best response may be.

In some cases, we just need more details, and so we keep talking and exploring to figure it out.

The client has a reason for what they do or don’t do – and therapy is about finding that out. Progress can come from discussing things the client has maybe never talked about with anyone before.

Also, it can be helpful to seek out some emotionally compelling reasons for change. If you can come up with some really meaningful “why” that speaks to the client, that can create a shift. Logic is often useless. We often know why we should do things. Yet, we don’t. But emotion can get us moving. What interventions have you found to be helpful in motivating clients?

A lot depends on client preference. As a therapist, it’s important to build rapport and get to know who is in front of you. That’s the ideal way to figure out what will work best for them. Because something can be incredibly effective, but if it’s not a good fit for a particular person, it won’t matter. Often, an eclectic approach is best. We are all so very different. One of the most important elements in therapy is the relationship. That matters more than any particular intervention. That’s why people go to therapy to talk to someone – a self-help book, for example, can list out some

interventions, but nothing compares to the human relationship, the rapport, the empathy, and the positive regard, which occurs in the therapy room. You can’t buy that off a shelf. Elaborate on any details you find helpful for explaining the mindset of the client and how it changes.

Therapy involves understanding the current mindset of the client. We want to understand if it’s fixed, or more growth-oriented, for example. We want to consider how their mindset both helps and hinders them. It’s usually a fixed mindset that gets us into trouble. We think we can’t change and our circumstances, too, can’t change. We will give up more easily and ignore helpful feedback. With a growth mindset, we know we are a work in progress. We are more open to accepting challenges. We are more able to seek them out.

Changing from fixed to growth involves challenging current thoughts. For instance, you can get stuck making a lot of false assumptions. You can begin to question your thoughts. Is that true? How do I know? What else might be happening here? Am I being too black and white, and missing the grey areas?

We have to notice where our mindset is now. Then we begin questioning it. We begin really getting deliberate about looking at our thoughts. For most of us, we don’t really spend much time if any thinking about our thoughts. It can help to start pausing to consider what thoughts are in your mind. And then we can start examining them and challenging them. And that’s when we can begin to create a shift. We can’t change what we don’t look at and understand.

Janelle Marshall, LPC

Marshall Gray Counseling Services

https://www.marshallgraycounselling.com

How do you navigate clients who faithfully come to therapy, but don't do the work?

I check in with the client and help process any challenges that are interfering with their ability to do the work. Sometimes the perception of the client not “doing the work” is an indicator of emotional trauma or blockage that needs to be processed.

Journaling is one of my favorite interventions to share with clients. I find it helpful for clients to visualize their therapeutic goals and their thoughts behind how their lives will reflect the efforts attempted. Habit tracking is a tool that helps take motivation a step further with clients that are committed to the therapeutic process. I have a collection of reflective habit tracker journals that serve as a guide to help the user align their actions with their desired goals.

As a solution-focused therapist, I help prepare my clients to embrace the evolution of their mindset throughout our journey together. It’s also understood that the client’s anticipated mindset change is contingent upon their willingness to commit to the work assigned in and out of the session.

Miriam Manela

The Thrive Group

https://childrenbloom.com/

The best motivation for clients is first and foremost for the therapist to let go of having a NEED to change their client, to let go of convincing their client to change and to simply allow the client to do what they have been doing and nothing different.

I usually tell clients, without any judgment, but just to give them an awareness that typically when the follow-up program is kept then results are significantly faster. If there is no follow-up done, that is okay, I just like them to be aware that therapy can take quite a bit longer then.

The third technique I use in therapy to motivate clients to change from within themselves is to create intentions. Rather than giving the client something they need to do, I would make an intention with them, which they could say once a day to give themselves the awareness of their challenge. Or if not, they may only use their intention once a week when they come to me for a session.

An intention would sound something like, I noticed that when someone questions my authority, I get very agitated. or I noticed that when my child comes home from school, or my boss walks into my office I feel flustered, overwhelmed, frustrated or anxious, etc. So without needing to tell the client to do any specific exercise at home, we've instead created together an intention to repeat every day to give themselves awareness. I may have them create a reminder on their phone with it or post a sticky note in their bedroom or bathroom.

Just remembering their awareness helps them remember what to do to calm down, on their own.

Danielle Bagus, MSW, LSW

Relief Mental Health

https://www.reliefmh.com

When a client seeks out therapy, faithfully attends without fail but once in session we are going over the same issues over and over again and I have found they are not doing the work on themselves outside of the therapy sessions, I attempt to look for a support system that may help them.

This might be a significant other, a parent, sibling, friend, etc. I ask who is in their close circle who they trust to help hold them accountable. I will also hold them accountable but sometimes encouragement coming from a loved one or someone they don't want to let down will mean more.

I also have found that the homework might not necessarily match up with their skill set or what they are willing to put in at that time. Therefore, as their therapist, it's my responsibility to find a new method or way to connect with the client and help them be successful.

One size does not fit all when it comes to therapy. Therapists need to have lots of tools in their toolkit to meet the needs of the client and ultimately to meet the client where they are in the process of therapy.

I think this can really depend on the client and what they need out of therapy. I find that Cognitive Behavioral Therapy (CBT) works the best to motivate my clients to continue to do the work outside of therapy. CBT helps people with such a wide range of mental health issues and ultimately helps with really digging deep to find new ways of thinking, coping and behaving in certain situations.

Clients seek therapy for many different reasons. Some want to change their mindset, some wish to seek outside advice or help on a specific situation or topic (divorce, relationship, school based issues, family issues, etc.), some come because they have been diagnosed with a mental illness (bipolar, depression, schizophrenia, eating disorder, OCD) and need help maintaining a healthy mindset, some clients want an outside person to just listen, the list goes on. As a therapist, you are there to be an impartial, nonjudgmental resource for the client. You are there to help them realize different ways of doing things and different ways of thinking.

The client takes the first step in seeking out therapy but also needs to be the one doing the work and willing to change what they have always done with the guidance of their therapist. It's important for the therapist to always ask what the client wants out of therapy or a specific session. Sometimes the client doesn't know but I think our clients are more self-aware than they realize. If you can ask the right questions, they ultimately will tell you what they need, want or expect to get out of therapy in general or even a specific session.

Kellie Brown, LMHC, NCC, MCAP, (she, her)

Licensed Mental Health Counselor (LMHC)

Owner of Quiet Water Counseling in Florida

https://www.QuietWaterCounseling.com

Oftentimes when a client comes regularly to therapy but does not want to do work outside of sessions it comes down to the client being afraid of making changes in their lives. People get so use to doing things one way it is very hard to change directions and try something new.

So instead of setting clients up for failure by giving them a huge homework assignment that is very likely overwhelming and they probably won't do, I give them very small tasks to accomplish.

So instead of giving a client the homework assignment of going to an Alcoholics Anonymous meeting or joining a gym, I ask clients to research AA meetings, or research local gyms. The next week I might ask them to just drive to the location of the meeting, or drive to the gym location, but tell them they don't have to go in, I just want them to physically see where it is located.

Giving smaller homework assignments tends to help break down a huge change into something more manageable.

Elizabeth Mateer, MS, MA, LMHCA *(she/her/they)

Director, Divergent Wellbeing https://www.divergentwellbeing.com

Lead with curiosity. Asking why didn't you do X this week like we talked about automatically leads to defensiveness and shuts down motivation to discuss what happened. Something like After our conversation last week, you seemed excited to work on using that coping skill. I'm curious about what the barrier was when you thought about applying it this week. This framing allows the client to explore the *process* of doing the work, rather than the content of I didn't do it.

Don't let it go. As therapists, we tend to feel compassion and understanding toward our client's challenges. While this is an important skill in many aspects of therapy, it can sometimes be tempting to let it go when our clients are consistently not doing the work outside of therapy. This is not only avoidant ourselves, but it doesn't serve our clients by teaching them to take accountability for their well-being. We can still be compassionate while being direct.

Meet them where they are at. Clients know when they aren't doing what they said they would, and yet, they are still showing up. That says a lot about the relationship and trust you've already built with them. Highlighting any progress you see, regardless of how small, is an effective way to motivate clients to continue moving forward. Sometimes these clients just move at a slower pace than others we see coming into therapy ready to take action, and that's OK.

Self-reflect on what we are asking from them and if it is too much. Sometimes as therapists we see the potential a client has and give homework assignments that are beyond what is realistic in the present moment, especially if we have seen our clients for a long time and have an idea of what they are capable of. Is there a way to break down the work into smaller, more achievable pieces? For some clients, if a task seems too aspirational or unrealistic, they won't attempt it at all. Smaller steps towards progress are better than no progress at all.

Steve Carleton, LCSW, CACIII

Gallus Detox

https://www.gallusdetox.com/

Navigating clients who come to therapy but don't complete their homework can be difficult and often requires a tailored approach.

The first step is to create an honest dialogue with the client about why they are not completing the assigned tasks.It could be that the tasks are too challenging or time-consuming, or that they don't understand what is expected of them. It is important to understand the underlying reasons behind the lack of motivation, and build a plan together that works for both parties.

The next step is to offer alternative homework assignments that are tailored to each individual client's needs. This could include reading an article or book related to the problem being discussed in therapy, journaling about their thoughts and feelings, writing a letter to their future self, or attending a workshop or class related to the topic. It might even be more helpful to ask your client what they would like to work on or what they would find most helpful. This will help to make the homework assignments more meaningful and will give them a sense of ownership over their progress.

The last step is for the therapist to provide ongoing support and accountability for their client's progress. Check-ins at the end of each session are a great way to ensure that homework is being completed, and providing regular feedback can help the client stay motivated. Above all else, try to create an environment of understanding and acceptance that encourages your client to be open and honest about their progress. With patience and dedication, you can help your clients reach their goals.

Nirmala Bijraj, LMHC, NCC, She/Her/Hers*

Aligned Self, LLC

https://alignedself.co

I explore with them why they don't do the homework, what about getting it done, and doing it, makes it difficult.

I usually start with the least possibly intrusive change. We explore the change they want to make, identify the first step and then explore how to incorporate that change with the least amount of barriers and effort possible to start to build a new habit.

I've found if we start with something that feels like the least amount of effort, takes the least amount of time, and is the least intrusive on their life and schedule, then the client is most likely to do it.

For example: A client wants to work out in the mornings: *(this is a real scenario that I've worked with clients on with these steps). We start with building the habit of getting into gym clothes first thing in the morning when they wake up, the goal is to start the habit, we don't focus on how many times they work out or if they work out at all, just starting the first part of the process.

Then a week or two later or more depending on the client, we would add a 10-20 minute workout, something that they can actually make the time to do, 5 minutes if that's all the time they have to start with, again the least amount of effort that will help them start building the habit. And then continue to build on that habit until they're where they want to be with that goal.

Lindsey Ferris, MS, LMFTA

Individual & Couples Psychotherapist

https://www.talkhealthrive.com

If I notice that clients are coming regularly and sticking with therapy, but I'm not seeing progress or an effort to do out-of-session homework. I will bring this up directly to the client to ask them what they are seeing and how they are experiencing therapy. If they are seeing the changes and growth, they want to see, then I'll have them elaborate on this so I can understand from their perspective what growth and change looks like.

Oftentimes it takes checking in with my client to learn that they in fact are feeling the benefits and see growth in themselves in different ways than what I may be looking for, and it is a good idea to level set vs. assume that 'work' isn't being done or growth isn't happening.

If I find that clients are resistant to homework, or not making progress towards their therapeutic goals, I will address this directly and ask them what is getting in the way of doing homework and impacting their ability to engage fully in their therapy process. This can often lead to areas that need to be addressed first, before other priorities, so that any

therapy-interfering behavior can be resolved and progress can continue.

I find that oftentimes addressing directly with clients what I am observing in therapy interfering behavior or lack of compliance to homework can lead to thought-provoking insight and dialogue and instigate a change in how the client sees the way they show up for therapy. Once it is out on the table as a barrier to therapy compliance, the client and I can have an open dialogue about when either of us see it coming up in the room to work towards behaviors and changes that they want to see. When a client has insight into patterns that may be blocking them from growth, it can be a true aha moment that changes the engagement and adherence to therapeutic homework and growth.

William Schroeder

Licensed Counselor and Owner of Just Mind LLC

https://justmind.org/

Every therapist has clients like this and it's a helpful thing to not beat around the bush about. If you notice someone is saying they are motivated and then not doing the work, the meat of the therapy is digging into what's getting in the way.

Motivational interviewing could be one way to approach this. On a scale of 1-10, how motivated are you to see X change. If it's low, then that's helpful to know and you might need a new target. If it's high and there isn't follow through, then you need to see what ideas they have that might help them have success and assess their perception of those as well.

Sometimes trauma can get in the way and it can help to make sure this is properly assessed. There are a number of trauma screens but trauma can be a big barrier to change if it's not dealt with. Things like EMDR can be helpful in treating PTSD, for instance. 100% of single-trauma incidents and 77% of multiple-trauma survivors no longer met the diagnostic criteria for PTSD after 6 fifty-minute EMDR sessions.

It also can be helpful to assess ADHD to see if that's possibly a complicating factor. The World Health Organization has a simple test clinicians or clients can use to see if they might meet criteria.”

Alexandra Alex Cromer, LPC

Thrive Works

https://thriveworks.com/richmond-therapy/

A great tactic to navigate this is to have an honest conversation on their progress and introduce them to your theoretical framework/how you judge and measure client success.

The Transtheoretical Model of Change is my personal favorite, and it takes into account client motivation and any barriers that might be keeping them from making continued progress.

Another tactic is to discuss one of the main goals of therapy with a client; making the client more effective in their daily lives. Through this lens, we can invite the client into a bidirectional conversation in which we discuss progress and change as well as ways in which they believe your time together in therapy is effective.

I tend to favor a lot of motivational interviewing techniques as well as cognitive challenging skills to help motivate clients. If a client is faithfully attending session but is not doing the work, we could ask them a cognitive challenging question to get them to explore and identify their current patterns and routines and the efficacy of these.

Motivational interviewing techniques are similar in this way, in that they require work and active reflection on the part of the client in order to answer the questions. The most effective techniques to motivate clients are the ones which require the clients to do active work and are not closed-ended questions. The more you can allow a client to engage in self-reflection, research shows client motivation and propensity to change increases.

One of the biggest frustrations that therapists experience is a client who is seemingly not putting in the work or reportedly making progress and change. It's very common for a therapist to assume that a client is unwilling to change and is purposefully resistant to the process. Often, this is not the case and the client's stagnation can be better explained through a theoretical lens. For example, using the Transtheoretical Model of Change, we can identify that client barriers to progress come in the form of fear of failure, anxiety, and perceived low self-esteem, rather than willful ignorance.

Honest, direct conversations with clients allow them to see themselves through your perspective, and vice versa. Typically, research shows that clients who have a high sense of self-efficacy have a higher propensity to engage in change making behaviors. Therapists can increase client self-efficacy by continuing to engage clients in

Self-reflection.

Wrapping up…

The bottom line is that when clients do their homework things progress quicker, but when clients DON’T do their homework, we get new insights to resistances and what is actually going on inside. Thank you to all the fantastic therapists that contributed to this article! With great insight comes improved well-being.

You can find the original article published here: https://www.psychreg.org/therapists-weigh-how-motivate-clients-who-dont-do-their-therapy-homework/

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Homework in Psychotherapy: Its Purpose and Benefits

• © 2007

Handbook of Homework Assignments in Psychotherapy

Research, Practice, and Prevention

• Nikolaos Kazantzis 0 ,
• Luciano LĽAbate (Professor Emeritus of Psychology) 1

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Georgia State University, Atlanta, USA

Shows clearly that between-session activities are a core component of psychotherapy practice

Covers a wide range of psychotherapy approaches, illustrating each with clinical examples

Includes valuable coverage of complex and chronic disorders

Synthesizes recommendations for future conceptual empirical work

Includes supplementary material: sn.pub/extras

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Table of contents (26 chapters)

Front matter, brief behavioral marital therapy, introduction and historical overview.

• Nikolaos Kazantzis, Luciano LĽAbate

Psychotherapy Approaches

Behavior therapy.

• Deborah Roth Ledley, Jonathan D. Huppert

Client-Centered Therapy

• Marjorie C. Witty

Cognitive Therapy

• Judith S. Beck, Michael A. Tompkins

Emotion-Focused Experiential Therapy

• Jennifer A. Ellison, Leslie S. Greenberg

Interpersonal Psychotherapy

• Jami F. Young, Laura Mufson

Psychodynamic Therapy

• George Stricker

Acceptance and Commitment Therapy

• Michael P. Twohig, Heather M. Pierson, Steven C. Hayes

Brief Strategic Family Therapy

• Michael S. Robbins, Jose’ Szapocznik, Gonzalo A. Pe’rez

Personal Construct Therapy

• Robert A. Neimeyer, David A. Winter

Client Populations

Older adults.

• Helen M. De Vries
• Norman B. Epstein, Donald H. Baucom
• Kathleen Newcomb Rekart, Jay Lebow

Specific Problems

Borderline personality disorder.

• Noam Lindenboim, Alex L. Chapman, Marsha M. Linehan

Chronic Depression

• Lawrence P. Riso, Michael E. Thase

Chronic Pain

• Malcolm H. Johnson
• Psychotherapie
• personality
• rehabilitation

Nikolaos Kazantzis

Luciano LĽAbate

Book Title : Handbook of Homework Assignments in Psychotherapy

Book Subtitle : Research, Practice, and Prevention

Editors : Nikolaos Kazantzis, Luciano LĽAbate

DOI : https://doi.org/10.1007/978-0-387-29681-4

Publisher : Springer New York, NY

eBook Packages : Behavioral Science , Behavioral Science and Psychology (R0)

Copyright Information : Springer-Verlag US 2007

Hardcover ISBN : 978-0-387-29680-7 Published: 16 August 2006

Softcover ISBN : 978-1-4419-3995-1 Published: 29 October 2010

eBook ISBN : 978-0-387-29681-4 Published: 11 December 2006

Edition Number : 1

Number of Pages : XVIII, 464

Topics : Clinical Psychology , Personality and Social Psychology

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10 Solution-Focused Brief Therapy (SFBT) Exercises & Activities to do with your Clients

Solution-focused brief therapy was developed by Milton Erickson, Insoo Kim Berg, Steve de Shazer, and others, as an empowering treatment modality (Seligman, Reichenberg, 2010). Counselors work in collaboration with their clients to explore and identify skills, knowledge, and resources that the clients currently have to work through their problems and challenges (Seligman, Reichenberg, 2010). Keep reading to learn 10 solution-focused brief therapy exercises and activities you can do with your clients.

View all of our Solution-Focused Brief Therapy Worksheets

During SFBT sessions, Counselors work to help the client find times when the problem or challenge was absent, and times when it was less severe (Seligman, Reichenberg, 2010). These moments are then explored to see what was different about them, and how the clients faced the challenge.

Skills commonly used during solution-focused brief therapy include active listening, empathy, open-ended questions, explanations, reassurance, and suggestions (Seligman, Reichenberg, 2010). SFBT Counselors and Therapists rarely use confrontation and interpretation in their work (Seligman, Reichenberg, 2010).

Counselors who use solution-focused behavioral therapy should be actively engaged during sessions, communicate acceptance, suggest actions that encourage change, and use solution talk to create an environment that can effectively utilize solution-focused brief therapy. 

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Mental health concerns that can benefit from solution-focused brief therapy.

Solution-focused brief therapy can be applied effectively to a range of mental health concerns (Seligman, Reichenberg, 2010). With an encouraging and empowering nature, most clients respond well to SFBT and solution-focused behavioral therapy exercises.

Solution-focused behavioral therapy can be an effective treatment approach for clients who are experiencing communication challenges, anxiety , substance misuse and abuse, behavioral problems, and other relationship challenges. Additionally, it can be helpful for individuals who are struggling with their self-esteem .

Similar to other treatment modalities, solution-focused behavioral therapy is not appropriate for every client. Clients who experience severe mental health concerns including active mania, schizophrenia, and major depressive disorders would likely not benefit from solution-focused behavior therapy.

Additionally, solution-focused behavioral therapy focuses on the present and future moments. It does not incorporate a person’s past, which some clients benefit from exploring and processing. This can include individuals who are carrying shame and guilt and some trauma -related mental health concerns. 

Solution-Focused Brief Therapy Activities

If you have decided to use solution-focused brief therapy exercises in your sessions, you have a variety of options to choose from. Solution-focused behavioral activities provide clients with an opportunity to explore their own resources and strengths, as well as identify changes that they would like to work towards in their life. SFBT activities can also provide Clinicians and Therapists with an opportunity to introduce new skills and perspectives that can support clients and their goals.

Examples of solution-focused behavioral therapy treatment activities include:

• Clients who feel overwhelmed when exploring various problems or challenges they have can often benefit from breaking the problem down into smaller pieces. This can include identifying what the challenge is, what has contributed to it, what helps the concern, and what compounds the distress the individual experiences. TherapyByPro offers a Problem and Solution Worksheet that can act as a guide for this in therapy sessions. Allow for time in future sessions to follow up about the client’s ability to engage in behaviors that would help them move past their identified problem. 
• The Miracle Question is a popular and simple Solution Focused Behavioral Therapy exercise that you can incorporate into your session. With this, you can ask your client to imagine that while they are sleeping tonight, a miracle occurs that has their problem or challenge resolved. What would their life be like tomorrow? There are many ways that the miracle question can be worded, so find the way that feels natural and authentic for you and your counseling style. The miracle question can help clients explore the benefits of changing their behaviors, and barriers that may be preventing them from making progress toward their goals.
• Identifying and working towards goals can often feel overwhelming for our clients. As Counselors, we can help our clients break down goals that feel like a lot into smaller, more digestible, pieces. This can include exploring different behaviors that the client can incorporate into their day that work towards accomplishing their goals. Providing clients with a worksheet, similar to the Goal Setting Action Plan Worksheet offered by TherapyByPro, can act as a reminder outside of sessions regarding what they can do to make forward progress. Allow for time in future sessions to assess any progress made toward the client’s discussed goal.
• The use of scaling questions is another SFBT technique that can be used in sessions. Scaling questions can be used to gauge their current experiences as they relate to goals. As an example, you may ask your client on a scale of 1-10, how prepared do they feel to make a change in their behavior today? Scaling questions can be used to explore the progress they have made, the intensity of their distress, and the level of impairment they are experiencing.  Using the same scaling question in later sessions can help both parties develop an understanding of progress that is, or isn’t, being made.
• Identifying strengths, skills, and attributes can help clients recognize their ability to accomplish challenging tasks. The Overcoming Difficulties with Strengths worksheet at TherapyByPro begins by asking your client to take a different perspective and explore what others may say are their strengths and skills. With this shift in viewpoint, clients may experience a change in their ability to recognize how the strengths that they may have overlooked can support them as they work towards their goals. 
• Looking for exceptions can help clients gain a new perspective on their thoughts and concerns. As an example, if a client is struggling with their ability to exercise each day, ask them to describe a day when they were able to exercise. What was different that day compared to the others? And how did it make them feel that they were able to exercise that day? Exception questions can be helpful in breaking black-and-white thinking patterns that act as barriers for our clients.
• A Negative Habits Worksheet can be helpful for clients who are struggling with unhealthy behaviors (ie. biting nails), and those who would like to add new behaviors to their routine (ie. exercising). You can explore how their life would look if they were to change their behavior and the benefits that they would gain from doing so. Follow up in later sessions regarding changes that your client was able to engage in.
• To focus on making progress, ask your client to identify 3 goals for the next month. Work with them to specifically identify the steps needed to achieve their goal and ensure that their expectations are realistic for them. An example of an unrealistic goal would be to lose a significant amount of weight in 4 weeks. Explore how the client’s strengths and skills can support them while they work to achieve this goal, and how this goal would impact their overall well-being. Allow for time to check in on their progress over the next month.
• A simple Solution Focused Behavioral Therapy exercise would simply look at the advantages and disadvantages associated with a change in the client’s behavior. Exploring the pros and cons of a change can lead to further discussion about barriers they are experiencing, and how they can work to overcome them. If you use worksheets in your therapy sessions, TherapyByPro offers a Motivation and Ambivalence Worksheet that you can use during therapy sessions.  
• A SFBT exercise that can be used for a variety of concerns and topics would be the use of homework exercises. Homework exercises ask your client to continue working on something discussed during the session, outside of their therapy sessions. Examples of homework would include keeping a journal of their distress while raising it on a 1-10 scale, using new coping skills 3 times before their next session, or completing a specific worksheet provided in the session. Time should be spent in their next session following up on their ability to complete their homework assignment, and processing their experience with it. 

Final Thoughts On Choosing Activities for SFBT

Solution-focused brief therapy can be an effective strategy when working with clients who present with an array of concerns. This form of treatment is intended to yield results in fewer sessions than other treatment modalities. This makes it an effective option for clients who are looking to make a behavioral change within their daily routine.

Some SFBT exercises, such as homework assignments, can be used in conjunction with other treatment modalities. As an example, a clinician who is providing psychoeducation about mindfulness skills for a form of behavioral therapy may ask their client to practice using a set number of skills before their next session.

If you feel that solution-focused behavioral therapy activities would be effective for the population that you work with, you can seek out continued education credits and other training that focuses on this treatment modality. Supervision can be a great resource when determining your readiness to utilize new treatment skills and modalities in your clinical work.

TherapyByPro is an online mental health directory that connects mental health pros with clients in need. If you’re a mental health professional, you can Join our community and add your practice listing here . We have assessments, practice forms, and worksheet templates mental health professionals can use to streamline their practice. View all of our mental health worksheets here .

Seligman, L., & Reichenberg, L.W. (2010). Theories of Counseling and Psychotherapy:

Systems, Strategies, and Skills (3rd ed., pp. 220–225).  Pearson Education, Inc.

Author: Kayla Loibl, MA, LMHC

Kayla is a Mental Health Counselor who earned her degree from Niagara University in Lewiston, New York. She has provided psychotherapy in a residential treatment program and an outpatient addiction treatment facility in New York as well as an inpatient addiction rehab in Ontario, Canada. She has experience working with individuals living with a variety of mental health concerns including depression , anxiety, bipolar disorder, borderline personality disorder , and trauma.

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Unlocking Emotional Growth: Effective Therapy Activities for Homework

The power of therapy homework.

Engaging in therapy activities for homework can greatly enhance the effectiveness of therapeutic interventions. By extending therapy beyond the confines of the therapy room, individuals have the opportunity to reinforce what they have learned, practice new skills, and promote  emotional growth  in a more comprehensive way.

Understanding the Benefits of Therapy Activities for Homework

Homework assignments in therapy serve multiple purposes and offer a range of benefits. Firstly, they provide individuals with the opportunity to  actively participate  in their own healing process. By taking an active role in their therapy, individuals can develop a sense of ownership and empowerment, leading to increased motivation and engagement.

Homework assignments also provide a bridge between therapy sessions, allowing individuals to  maintain continuity  and reinforce the concepts and strategies discussed during therapy. Regular practice outside the therapy room helps to solidify new skills and behaviors, making them more likely to become integrated into daily life.

Moreover, therapy homework assignments encourage  self-reflection  and help individuals gain a deeper understanding of their thoughts, emotions, and behaviors. By engaging in activities such as journaling and reflection, individuals can explore their experiences on a deeper level and gain insights that may not arise during therapy sessions alone.

How Homework Assignments Support Emotional Growth

Therapy homework assignments support  emotional growth  by providing individuals with opportunities to practice and apply therapeutic techniques in real-life situations. Through repeated practice and application, individuals can develop new coping skills, challenge negative thought patterns, and modify maladaptive behaviors.

Homework activities that focus on cognitive-behavioral techniques, such as  identifying and challenging negative thought patterns ,  behavior tracking and goal setting , and  problem-solving and decision-making exercises , can help individuals develop healthier cognitive patterns and improve their emotional well-being.

Role-playing and social skills practice assignments allow individuals to practice skills such as  assertiveness and boundary setting ,  building empathy and perspective-taking , and  enhancing communication and conflict resolution skills . These activities create opportunities for individuals to improve their interpersonal relationships and build stronger connections with others.

Finally, self-care and relaxation strategies incorporated into homework assignments, such as  developing a self-care routine ,  stress reduction techniques , and  incorporating relaxation exercises into daily life , can help individuals manage stress, enhance self-care practices, and promote overall emotional well-being.

By actively engaging in therapy activities for homework, individuals can maximize the benefits of therapy and accelerate their emotional growth. These assignments serve as a vital component of the therapeutic process, allowing individuals to practice skills, deepen self-awareness, and enact positive change in their lives.

Effective Therapy Activities for Homework

To enhance the effectiveness of therapy and promote emotional growth, engaging in  therapy activities for homework  is an invaluable practice. These activities provide individuals with an opportunity to reflect, practice new skills, and reinforce what they have learned during therapy sessions. In this section, we will explore three effective therapy activities for homework:  journaling and reflection ,  mindfulness and meditation exercises , and  creative expression through art or writing .

Journaling and Reflection

Journaling and reflection are powerful techniques that encourage individuals to explore their thoughts, emotions, and experiences in a structured manner. By writing down their thoughts and feelings, individuals can gain clarity, process challenging situations, and track their progress over time.

Therapy homework assignments  involving journaling and reflection can include prompts such as:

• Write about a recent experience that triggered strong emotions. Reflect on how you responded and what you learned from the situation.
• Describe a situation where you felt proud of yourself. Explore the qualities and strengths that allowed you to overcome challenges.
• Identify a recurring negative thought pattern. Challenge and reframe this thought with a more positive and realistic perspective.

By incorporating regular journaling and reflection into their routine, individuals can gain deeper insights into their emotions, patterns of thinking, and areas for personal growth. It can also serve as a valuable tool for communication with their therapist. For more therapeutic activities and downloadable worksheets, you may visit our article on  therapeutic homework activities .

Mindfulness and Meditation Exercises

Mindfulness and meditation exercises are effective homework activities that promote self-awareness, stress reduction, and emotional well-being. These practices involve focusing one’s attention on the present moment, cultivating a non-judgmental attitude, and nurturing a sense of calm.

Therapy homework assignments related to mindfulness and meditation can include:

• Practice a guided mindfulness meditation for 10 minutes each day. Pay attention to your breath, sensations in your body, and any thoughts or emotions that arise.
• Engage in a mindful eating exercise. Slow down and savor each bite, paying attention to the taste, texture, and sensations in your body.
• Take a mindful walk in nature. Notice the sights, sounds, and smells around you, allowing yourself to fully immerse in the present moment.

Regular practice of mindfulness and meditation exercises can help individuals develop a greater sense of self-awareness, manage stress and anxiety, and cultivate a more positive outlook on life. To explore additional therapeutic activities and resources, you can refer to our article on  online therapy homework resources .

Creative Expression through Art or Writing

Engaging in creative expression through art or writing can be an effective way to explore emotions, foster self-discovery, and promote healing. These therapy activities encourage individuals to express themselves creatively, tapping into their unique perspectives and experiences.

Therapy homework assignments involving creative expression can include:

• Create an art piece that represents your emotions or a specific life event. Reflect on the colors, shapes, and symbols used and discuss their significance with your therapist.
• Write a letter to your past self, offering words of encouragement, forgiveness, or advice. Reflect on how your perspective has evolved and what lessons you have learned.
• Develop a vision board that visually represents your goals, aspirations, and values. Display it in a prominent place as a reminder of what you are working towards.

Through creative expression, individuals can tap into their inner wisdom, explore their emotions, and gain a deeper understanding of themselves. It provides a safe and non-judgmental space for self-expression and self-discovery. For more therapeutic activities and tools, you can explore our article on  digital therapy homework resources .

By actively engaging in these therapy activities for homework, individuals can enhance their therapy journey, promote emotional growth, and apply the lessons learned in therapy to their everyday lives. It is important to approach these activities with an open mindset, allowing oneself to fully immerse in the process of self-exploration and personal development.

Cognitive-Behavioral Techniques

Cognitive-behavioral techniques are widely used in therapy to help individuals identify and modify negative thought patterns, develop problem-solving skills, and set goals for personal growth. When incorporated into therapy homework, these techniques can be highly effective in promoting emotional well-being and facilitating positive change. Let’s explore three key cognitive-behavioral techniques commonly used in therapy homework assignments:  identifying and challenging negative thought patterns ,  behavior tracking and goal setting , and  problem-solving and decision-making exercises .

Identifying and Challenging Negative Thought Patterns

Negative thought patterns can significantly impact our emotions and behaviors. In therapy homework, clients are often encouraged to identify and challenge these negative thoughts to promote more positive thinking. This technique involves recognizing and examining automatic negative thoughts (ANTs) – those quick, automatic, and unhelpful thoughts that arise in response to certain situations. By bringing awareness to these thoughts, individuals can begin to challenge their validity and replace them with more realistic, balanced, and positive alternatives.

A common method used in therapy homework to identify and challenge negative thought patterns is the ABC model. This model involves breaking down a situation into three components:  Activating event ,  Beliefs , and  Consequences . By analyzing these components, individuals can gain insight into the thoughts and beliefs that contribute to their emotional and behavioral reactions. They can then work on replacing negative beliefs with more adaptive and constructive ones.

Behavior Tracking and Goal Setting

Behavior tracking and goal setting are essential cognitive-behavioral techniques used in therapy homework to promote self-awareness, monitor progress, and facilitate behavioral change . By tracking their behaviors and emotions, individuals can identify patterns, triggers, and areas for improvement.

In therapy homework assignments, clients may be asked to keep a behavior or mood diary, noting their daily activities, thoughts, emotions, and any associated behaviors. This helps individuals gain a better understanding of how their thoughts and actions impact their well-being. Based on this information, specific goals can be set to target problematic behaviors or promote positive changes.

Setting achievable and measurable goals is crucial for effective therapy homework. By breaking down larger goals into smaller, attainable steps, individuals can experience a sense of accomplishment and stay motivated throughout the process. Regularly reviewing and adjusting these goals, with the guidance of a therapist, helps to ensure progress and maintain focus.

Problem-Solving and Decision-Making Exercises

Therapy homework often includes problem-solving and decision-making exercises to enhance individuals’ ability to cope with challenges, make effective choices, and take control of their lives. These exercises involve identifying problems, generating potential solutions, evaluating their pros and cons, and implementing the most appropriate course of action.

In therapy homework assignments, individuals may be asked to practice problem-solving techniques, such as brainstorming, considering alternative perspectives, and weighing the advantages and disadvantages of different options. By engaging in these exercises, individuals develop valuable skills that can be applied to various aspects of their lives, leading to increased confidence and a greater sense of control.

By incorporating cognitive-behavioral techniques into therapy homework, individuals can actively participate in their own emotional growth and development. These techniques provide practical tools and strategies to challenge negative thinking, track progress, set goals, solve problems, and make informed decisions. With consistent practice and support from a therapist, individuals can make significant strides in their personal growth journey.

Remember to consult with your therapist or practitioner for personalized guidance on incorporating these techniques into your therapy homework.

Role-Playing and Social Skills Practice

In therapy,  role-playing  and  social skills practice  activities can be highly effective tools for individuals seeking to improve their interpersonal interactions and enhance their communication abilities. These activities provide a safe environment for individuals to practice and refine their social skills, allowing them to build confidence and develop healthier relationships. Let’s explore three key aspects of role-playing and social skills practice:  practicing assertiveness and boundary setting ,  building empathy and perspective-taking , and  enhancing communication and conflict resolution skills .

Practicing Assertiveness and Boundary Setting

Role-playing exercises can be used to practice assertiveness and boundary setting. Through these activities, individuals can learn how to express their needs, opinions, and boundaries in a clear and respectful manner. By simulating various scenarios, individuals can develop effective communication strategies and gain confidence in expressing themselves assertively.

During these exercises, the therapist or a trusted partner can act as the other person in the role-play, allowing the individual to practice setting boundaries and asserting themselves. This can be particularly helpful for individuals who struggle with saying no, expressing their needs, or maintaining personal boundaries.

Building Empathy and Perspective-Taking

Role-playing activities can also help individuals build empathy and develop their perspective-taking skills. By assuming the role of another person in a simulated scenario, individuals can gain a deeper understanding of different perspectives and experiences. This can enhance their ability to empathize with others and foster more meaningful and compassionate connections.

For example, the therapist may assign roles where individuals must step into the shoes of someone they have conflicts with or have difficulty understanding. This exercise allows individuals to practice viewing situations from another person’s point of view, promoting empathy and enhancing their interpersonal skills.

Enhancing Communication and Conflict Resolution Skills

Role-playing can be a valuable tool for individuals looking to enhance their communication and conflict resolution skills. By engaging in simulated scenarios, individuals can practice active listening, effective communication, and collaborative problem-solving. These activities provide an opportunity to learn and refine techniques for managing conflicts constructively.

In role-playing exercises, individuals can explore different communication styles and practice using assertive and respectful language to express their thoughts and feelings. They can also work on active listening skills, allowing them to truly understand others’ perspectives and respond empathetically.

Through repeated practice and guidance from the therapist, individuals can develop and refine their communication and conflict resolution skills, which can be applied in real-life situations.

By incorporating role-playing and social skills practice into therapeutic homework assignments, individuals can actively engage in the learning process and accelerate their emotional growth. These activities provide a safe space to practice and refine interpersonal skills, empowering individuals to navigate relationships with confidence and efficacy.

Self-Care and Relaxation Strategies

When it comes to therapy homework, incorporating self-care and relaxation strategies can be highly beneficial for promoting emotional growth and enhancing overall well-being. Taking time for self-care activities can help individuals manage stress, reduce anxiety, and improve their mental health. In this section, we will explore three effective self-care and relaxation strategies:  developing a self-care routine ,  stress reduction techniques , and  incorporating relaxation exercises into daily life .

Developing a Self-Care Routine

A self-care routine involves intentionally setting aside time for activities that nurture and replenish your mind, body, and soul. It is a personalized practice that can include a variety of activities such as practicing mindfulness, engaging in hobbies, exercising, or simply taking a break to relax.

To develop a self-care routine, start by identifying activities that bring you joy, reduce stress, and promote relaxation. It can be helpful to create a schedule or set specific times during the day for self-care. This ensures that you prioritize self-care and make it a regular part of your routine.

Here are some examples of self-care activities that you can consider incorporating into your routine:

• Mindfulness or meditation exercises : Engage in mindfulness or meditation practices to bring a sense of calm and presence to your day. You can find guided meditations or mindfulness apps to assist you in your practice.
• Physical exercise : Engaging in physical activity not only benefits your physical health but also contributes to your mental well-being. Whether it’s going for a walk, practicing yoga, or participating in a sport, find an activity that you enjoy and can incorporate into your routine.
• Engaging in hobbies : Dedicate time to activities that bring you joy and help you relax. It could be reading, painting, playing a musical instrument, or any other hobby that allows you to express yourself and unwind.

By developing a self-care routine and incorporating these activities into your daily life, you can create a space for relaxation, rejuvenation, and emotional growth.

Stress Reduction Techniques

Stress can have a significant impact on emotional well-being. Incorporating stress reduction techniques into your therapy homework can help you manage stress more effectively and improve your overall mental health. Here are some stress reduction techniques that you can explore:

• Deep breathing exercises : Deep breathing exercises can help activate the body’s relaxation response and reduce stress. Take slow, deep breaths in through your nose, hold for a few seconds, and exhale slowly through your mouth.
• Progressive muscle relaxation : This technique involves systematically tensing and relaxing different muscle groups in your body to promote relaxation and reduce muscle tension.
• Guided imagery : Guided imagery is a relaxation technique that involves visualizing calming and peaceful scenes to reduce stress and promote a sense of relaxation.
• Time management : Effective time management can help reduce stress by allowing you to prioritize tasks, set realistic goals, and create a sense of control over your schedule.

Incorporating Relaxation Exercises into Daily Life

In addition to developing a self-care routine and practicing stress reduction techniques, incorporating relaxation exercises into your daily life can further support emotional growth. These exercises can be easily integrated into your routine and can help you unwind, reduce anxiety, and promote a sense of calm.

Here are some relaxation exercises that you can try:

• Progressive muscle relaxation : As mentioned earlier, progressive muscle relaxation involves systematically tensing and relaxing different muscle groups in your body. This exercise can be done anytime and anywhere to release tension and promote relaxation.
• Guided meditation : Guided meditation involves listening to a recorded meditation that guides you through a calming and focused state of mind. You can find guided meditation resources online or use meditation apps .
• Journaling : Writing in a journal can be a therapeutic way to express your thoughts, emotions, and concerns. It can help you gain clarity, process emotions, and promote relaxation.
• Nature walks : Spending time in nature has been shown to reduce stress and improve overall well-being. Take regular walks in natural surroundings, focusing on the sights, sounds, and smells of the environment.

Incorporating these self-care and relaxation strategies into your therapy homework can provide you with valuable tools for managing stress, enhancing emotional growth, and improving your overall well-being. Remember, self-care is a personal journey, and it’s important to find what works best for you.

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21 Best Interpersonal Therapy Techniques & Worksheets [PDF]

The authors of the study, Gerald Klerman and Myrna Weissman, found that major depression was a diagnosable and treatable psychiatric illness greatly influenced by a focus on interpersonal factors (Dietz, Weinberg, & Mufson, 2018).

Subsequent research confirmed that targeting a client’s interpersonal context yielded positive results and led to what became IPT (Markowitz & Weissman, 2012).

This article introduces IPT and examines interventions and techniques that support the treatment of mental disorders through the link between the quality of interpersonal relationships and mental health.

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This Article Contains:

What is interpersonal therapy, relationship to emotional intelligence, 5 ipt techniques, useful worksheets for your sessions, a list of ipt interventions, interpersonal group therapy: 5 activities, 2 valuable manuals and workbooks, 3 books on the topic, a look at the emotional intelligence masterclass, a take-home message.

Interpersonal psychotherapy (IPT) was initially developed as a time-limited treatment for depression. It has since been extended to treat several other mood and non-mood disorders and validated in multiple clinical research studies (Weissman, Markowitz, & Klerman, 2000).

The underlying principle of IPT is that while the problem presented by a client may have many factors and causes, it typically occurs within a social and interpersonal context. Losing a job, divorce, death of a loved one, relocation, and retirement impact our environment and relationships.

In IPT, the client focuses on “the relationship between the onset and fluctuation in their symptoms and what is currently going on in their life” (Weissman et al., 2000). They learn to understand interpersonal problems and how to deal with them.

Weissman et al. (2000) offer the example of a woman experiencing major depression, describing its onset over several months and the multiple factors involved, including that the woman’s children recently left home.

They point out the different approaches that several therapeutic models might use in treatment. The biological psychiatrist may suggest antidepressants, while the psychoanalyst will most likely propose talking therapy to deal with unresolved childhood difficulties.

The Cognitive-Behavioral Therapist may observe that the “depression is producing distorted thoughts and perceptions of the patient’s current situation,” and the client can learn to challenge these irrational thoughts (Weissman et al., 2000).

The authors conclude that there is no single, dominant approach (we have only listed a selection; there are others) to the treatment of mental illness, but that crucially it occurs within the environment of interpersonal relationships (Weissman et al., 2000; Dietz et al., 2018).

IPT suggests that clinical depression and other mood disorders occur within an interpersonal context. When directed at such relationships, appropriate psychotherapeutic interventions can facilitate recovery (Weissman et al., 2000).

IPT focuses “on reducing the depressive symptoms and improving the state of the client’s significant relationships that appear linked to their mood symptoms” (Dietz et al., 2018).

In the case of the depressed woman, “the onset or recurrence of a depressive episode was related to the patient’s social and interpersonal relationships at the time” (Markowitz & Weissman, 2012).

Indeed, based on strong empirical evidence, several psychosocial aspects typically underpin depression (Markowitz & Weissman, 2012):

• Social support offers protection for mental health.
• Depression has an interpersonal context and is often linked to disruption to social relationships and roles.
• Vulnerable individuals are at greater risk of depressive episodes during challenging interpersonal episodes such as grief, relationship disputes, and lack of social support.

Clinical studies have backed up IPT’s efficacy. “[L]ife events can provide a plausible focus for depressed and otherwise dysphoric patients” (Markowitz & Weissman, 2012). We can also combine the approach with other treatments, including pharmacotherapy and CBT.

Research and clinical experience find that clients can be helped and symptoms improved through working on changes in social functioning in the present (Markowitz & Weissman, 2012).

Appropriate techniques encourage interpersonal relationships and reduce interpersonal difficulties, facilitating improvements to emotional processing and enhancing empathy (Newman, Jacobson, & Castonguay, 2014; Lipsitz & Markowitz, 2013).

While limited research exists regarding the direct relationship between IPT and emotional intelligence, studies confirm the link between improvements in empathy and emotional processing and enhanced emotional intelligence (Nelis, Quoidbach, Mikolajczak, & Hansenne, 2009).

Therefore, it seems highly likely that IPT can improve interpersonal relationships and generate personal insights that promote emotional intelligence.

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Dimaggio, Ottavi, Popolo, and Salvatore (2020) highlight the importance of metacognition in understanding interpersonal relationships and treating personality disorders.

Recognizing the emotions we experience and “the thoughts that pass through our minds at particular moments” helps us navigate relationship difficulties and misunderstandings (Dimaggio et al., 2020).

Such metacognitive functioning varies greatly depending on the relational context in which a client finds themselves, but it can be improved (Dimaggio et al., 2020).

Several IPT techniques can help interpersonal understanding, including (Dimaggio et al., 2020):

• Guided imagery and re-scripting The client relives an upsetting or traumatic episode, imagining how they could conduct themselves in a similar, future situation.

With guided imagery therapy , such imagery exposure can desensitize and take the fear out of what is ahead.

• Drama techniques Role-playing a problematic scene can improve self-reflectivity and help clients understand others’ minds, leading to deeper insights.

Such techniques used in drama therapy offer the client a safe environment to test innovative behavior before using it in real life.

• Bodily work Exercises involving grounding, breath regulation, and physical training can increase physical and mental wellbeing and “improve emotional and behavioral regulation and access positive self-images” (Dimaggio et al., 2020). Understanding and experiencing strong, energizing physical states can help break damaging interpersonal patterns.
• Mindfulness and attention regulation Mindfulness is a well-researched tool for increasing self-awareness and self-knowledge, and recognizing that ideas are not facts.

Crucially, mindfulness can help develop a sense of agency, where the client learns they are “not the victim” of their own thoughts and that they can influence how they experience their flow of consciousness (Dimaggio et al., 2020).

• Restructuring attention Paying attention to the body’s internal signals, position in a room, and sounds can help reduce stress and improve awareness and emotional regulation (Dimaggio et al., 2020).

A suitably trained therapist can improve such relationships and subsequently reduce related mental health issues, such as depression, through appropriate techniques and interventions , including:

Mood Thermometer

The mood thermometer provides a highly effective way to track a client’s mood and identify associated interpersonal interactions.

This visual guide identifies mood changes and how they link to different interpersonal events (for example, in class or at home). It is especially effective for children who are less practiced at spotting moods and potentially related events (Dietz et al., 2018).

Ask the client to complete the Mood Thermometer worksheet to capture times in their life when they felt the mood described at each point along the continuum. The information and awareness gained can be helpful for discussion and insights.

Closeness Circle

The closeness circle is a valuable way to identify patterns of difficulty in maintaining strong interpersonal relationships. The diagram focuses attention on and encourages the development of interpersonal skills (Dietz et al., 2018).

Completing the Closeness Circle worksheet helps the therapist and client form a better understanding of the meaningful relationships in the client’s lives.

Interpersonal Relationships worksheet

Within IPT, the client needs to be aware of their relationships with others and understand their consequences on their lives.

The Interpersonal Relationships worksheet provides helpful prompts to explore each relationship, uncover what makes them special, and determine their impact on the client (modified from Dietz et al., 2018), such as:

Tell me about [person]. What are they like? What don’t you like about them? What do you like about them?

Interpersonal Parenting Tips worksheet

For most parents, relationships with their children (especially in their teenage years) can, at times, become strained.

The Interpersonal Parenting Tips worksheet contains a list of practical tips for parents to strengthen the relationship with their children and reduce conflict through a focus on:

• Finding the right time to talk
• Considering the intention, not the outcome
• Finding the right balance in how you talk and respond
• Practicing self-care

Wanting to Be Heard in an interpersonal relationship worksheet

Clients often don’t feel heard in their relationships.

With a few simple techniques and tips, it is possible to significantly improve our ability to process experiences, communicate our needs more effectively, and handle interpersonal conflict.

The Wanting to Be Heard worksheet contains a list of practical tips for clients to communicate effectively:

• Using good timing
• Making time for the other person
• Using I feel statements
• Doing your homework (prepare)
• Not giving up

Emotional Repetition and Attention Remodeling

Therapists often pick up on phrases or sentences that the client repeatedly uses to describe themselves in negative and unhelpful ways (Dimaggio et al., 2020).

Techniques that use such phrases can reduce the emotional intensity of frequently encountered situations and prevent the client from feeling overwhelmed (Dimaggio et al., 2020).

Use the Emotional Repetition and Attention Remodeling worksheet to capture common phrases and learn how to desensitize negative feelings encountered under challenging situations.

Typically, after repeating the phrases and then practicing attention remodeling, the client reports a decrease or disappearance in the negative feelings (Dimaggio et al., 2020).

Interpersonal psychotherapy for depression video

IPT helps the client revisit and improve interpersonal relationships through a variety of interventions, including:

Mindfulness

Mindfulness can be highly valuable in individual IPT sessions (and beyond) when implementing changes in client’s lives (Dimaggio et al., 2020).

Mindful meditations help the client pay more attention to their environment, the present moment, and their senses.

• The Five Senses Worksheet brings awareness to each part of the body, grounds the client in the present, and encourages them to pay more attention to physical sensations, reducing stress and anger in difficult situations.
• The Breath Awareness Meditation is a mindful breathing technique that can help calm the mind and promote awareness of movements and sensations in the body.

Visualization

Imagery is a valuable therapy technique, with clients either visualizing and living future scenarios or returning to traumatic memories (Dimaggio et al., 2020).

Imagery re-scripting has proven successful in the treatment of many disorders, including social anxiety, post-traumatic stress disorder, eating disorders, and depression.

• The Event Visualization Worksheet helps clients reduce concern and anxiety surrounding an event they are worrying about as a means to reduce catastrophizing and increase self-confidence.
• The Visualization for Kids Handout is a useful aid for introducing children to the benefits of visualization for calming themselves during stress.

Body interventions can “stimulate awareness of psychological functioning and enrich the mental landscape” (Dimaggio et al., 2020).

Interpersonal schemas become rooted in the body based on repetitive intersubjective experiences becoming part of someone’s identity. They ultimately impact posture, behavior, and interaction with the environment (Dimaggio et al., 2020).

• Techniques include grounding of the body. The therapist works with the client to encourage a sense of balance and an improved awareness of their body in space.
• Body exercises including yoga and martial arts can help posture, improve breathing habits, and encourage feelings of energy, effectiveness, and powerfulness.

Group therapy offers a safe place to notice such schemas, learn from the group, and find new ways of behaving.

Group activities include (Dimaggio et al., 2020):

• Sessions begin with a warm-up , where participants are encouraged to talk openly with one another and learn to overcome fears of being judged.
• The therapist typically describes motivations in general before exploring each one more deeply. The group discusses the elements that activate it; for example, what drives them to compete or seek attention?
• Visual tools such as photographs, videos, and cartoons can help illustrate concepts and successfully imprint them in memory.
• The group can then discuss personal experiences associated with each motivation and other psychoeducational information.
• Role-play can be highly effective in a group setting. The clients begin by writing down an autobiographical episode that becomes a script for staging in the next role-play. It is played out to explore the situation and the interactions between different people and roles. The role-play provides a safe environment to try out new forms of behavior and identify the reactions it provokes.

Two invaluable and inspiring IPT workbooks for those requiring help include:

1. Mastering Depression Through Interpersonal Psychotherapy: Patient Workbook – Myrna Weissman

This book offers a user-friendly guide to IPT for people affected by depression.

It takes the reader through the theory and, at each stage, provides worksheets they can complete, helping them think about their problems and depression in a more constructive way.

Find the book on Amazon .

2. A Cognitive-Interpersonal Therapy Workbook for Treating Anorexia Nervosa: The Maudsley Model – Ulrike Schmidt, Helen Startup, and Janet Treasure

This valuable book is a practical resource aimed at adults with anorexia nervosa, their families, and the professionals working with them.

It provides the reader with a step-by-step guide to recovery, covering nutrition, developing treatment goals, thinking styles, and creating an identity beyond the condition.

While there are several therapy books on IPT, we have chosen three of our favorites below.

1. The Guide to Interpersonal Psychotherapy – Myrna Weissman, John Markowitz, and Gerald Klerman

The originators of the treatment have written this book, and it remains a definitive guide to IPT.

It covers the value of IPT in treating depression and its adaptation for other diagnoses and patient populations.

While covering the evidence-led background of IPT, it also teaches the reader how to deliver the treatment.

2. Metacognitive Interpersonal Therapy – Giancarlo Dimaggio, Paolo Ottavi, Raffaele Popolo, and Giampaolo Salvatore

While exploring the concepts behind IPT, this valuable book introduces essential treatments and techniques, including guided imagery, re-scripting, mindfulness, and more.

The book guides the client toward change, prioritizing their goals and needs to overcome pain and act creatively in their everyday lives.

3. Family-based Interpersonal Psychotherapy for Depressed Preadolescents: Clinician Guide – Laura Dietz, Rebecca Weinberg, and Laura Mufson

This family-based book contains IPT guidance and interventions for depressed preadolescents. It helps reduce symptoms by teaching readers the skills to improve interpersonal relationships.

The text includes psychoeducation in relation to preadolescent depression, parenting challenges, behavioral expectations, and prevention strategies.

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While IPT arose from an investigation into treatments for depression, it has since been extended, its tools and techniques proving highly successful in treating other mental health issues (Weissman et al., 2000).

Indeed, research studies have shown IPT to be highly effective in treating mood and other disorders. Not only does it offer a valuable tool for the therapist in its own right, but it can also be used in conjunction with other treatments (Lipsitz & Markowitz, 2013).

The therapy focuses on interpersonal problems in the client’s life that precipitate and maintain mental health problems and increase interpersonal stress. Through IPT, the therapist works collaboratively with the client to enhance emotional support, decrease interpersonal stress, facilitate emotional processing, and improve interpersonal skills (Lipsitz & Markowitz, 2013).

With a solid foundation in research and the number of practitioners continuing to grow, IPT offers a proven technique to improve interpersonal relationships and mental healthcare .

Try out the techniques with new and existing clients to recognize essential relationships and focus attention on those that have broken down.

We hope you enjoyed reading this article. For more information, don’t forget to download our three Positive CBT Exercises for free .

• Dietz, L. J., Weinberg, R., & Mufson, L. (2018). Family-based interpersonal psychotherapy for depressed preadolescents: Clinician guide . Oxford University Press.
• Dimaggio, G., Ottavi, P., Popolo, R., & Salvatore, G. (2020). Metacognitive interpersonal therapy: Body, imagery and change . Routledge.
• Lipsitz, J. D., & Markowitz, J. C. (2013). Mechanisms of change in interpersonal therapy (IPT). Clinical Psychology Review , 33 (8), 1134–1147.
• Markowitz, J. C., & Weissman, M. M. (2012). Interpersonal psychotherapy: Past, present and future. Clinical Psychology & Psychotherapy , 19 (2), 99–105.
• Nelis, D., Quoidbach, J., Mikolajczak, M., & Hansenne, M. (2009). Increasing emotional intelligence: (How) is it possible? Personality and Individual Differences , 47 (1), 36–41.
• Newman, M. G., Jacobson, N. C., & Castonguay, L. (2014). Interpersonal and emotion-focused processing psychotherapy for generalized anxiety disorder. In P. M. Emmelkamp & T. Ehring (Eds.), The Wiley handbook of anxiety disorders (pp. 840–851). Wiley.
• Schmidt, U., Startup, H., & Treasure, J. (2018).  Cognitive-interpersonal therapy workbook for treating anorexia nervosa: The Maudsley model. Routledge.
• Weissman, M. M. (2005).  Mastering depression through interpersonal therapy: Patient workbook.  Graywind.
• Weissman, M. M., Markowitz, J. C., & Klerman, G. L. (2000). Comprehensive guide to interpersonal psychotherapy . Basic Books.
• Weissman, M. M., Markowitz, J. C., & Klerman, G. L. (2017).  The guide to interpersonal psychotherapy: Updated and expanded edition. Oxford University Press.

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