September 27th, 2020

Homework: The crucial, underrepresented part of therapy

By Dan Whale

  • Anxiety
  • Confidence
  • Depression
  • Social Anxiety
  • Therapy

For many of us, our first impression of what therapy is comes from TV or film. Often we’ll see the protagonist lying down on a couch, talking through their past and experiencing some sort of ‘eureka moment’ with their therapist.

Another common depiction will be a character reeling off all that is going wrong in their life to a passive looking therapist. They then usually carry on with the rest of their life and therapy, as well as their mental health in general, is never mentioned again.

In Psychoanalytic Therapy, this isn’t a million miles off, and more common approaches such as CBT do also involve looking into your past and experiencing eureka moments. However, on the whole this is not a great representation of what therapy is like. Why? Because therapy involves much more hard work than this.

If you ask therapists for the most common misconceptions around therapy (which we did by the way, you can watch the video here) one of the first things they’ll tell you is that it’s not just talking. Changing how we think, feel and behave is no small feat - it takes dedication and practice. You need to be thinking about what you have learnt in sessions and applying it to daily life. Talking through what you’re experiencing is important, but it can only take you so far.

Luckily, you’re not left on your own. Your therapist will do all they can to support you throughout your therapy, celebrating your successes and helping to steer you back on track when you need it. One of the best ways they can help you to progress is by giving you homework.

Homework is a key part of the most commonly offered therapeutic approach - CBT. What the homework looks like will vary massively depending on your individual experiences, personal preferences, what you have tried before and more.

Unlike traditional homework, therapy homework is created collaboratively. It will always aim to involve meaningful, enjoyable activities which give a true sense of achievement.

We couldn’t possibly outline every piece of homework you might receive in therapy, but the examples below will help you get a general idea.

Examples of homework

Worry diary

If you are experiencing anxiety, a therapist may ask you to fill out a ‘worry diary’. Every time you feel anxious, you will write down the physical details of the worry (who, what, where, when), its intensity on a scale of 1-10, what the worry entails and what it is predicting will happen.

You will also write down what you’re thinking about and how you’re feeling in the time you have allocated to worry, in what’s known as a ‘worry period’. This makes it far easier for you to discuss exactly where your anxiety is coming from in the next session, as opposed to thinking back over the past week and feeling like there was a lot of anxiety, but not really knowing why.

Writing each episode of anxiety down also enables you to process it as it happens, using skills and techniques learnt in sessions to reduce the impact it has on your day.

Behaviour activation

When experiencing depression, it can be very difficult to break certain cycles. We know that exercise, socialising with others and challenging ourselves mentally can all give our mood a boost. However, how do you get started when you’re feeling depressed? We will often tell ourselves that we’ll start exercising when it gets a bit warmer, or that we’ll cancel plans this time as we’re not feeling up to it, but will go to the next event.

By not making changes, we don’t feel any happier, and therefore don’t feel any more motivated to do the things that can make us happy. This vicious cycle is what behaviour activation attempts to break.

With behaviour activation, you and your therapist might create a plan in which you can set yourself weekly behavioural goals and record whether or not you do them. The meaningful, pleasurable activities you agree upon provide much more encouragement to do things that you don’t naturally want to do. This is one of the best ways of ending depressive patterns.

Behavioural experiments

Behavioural experiments are often suggested for treating a variety of mental health conditions, including social anxiety. An example of social anxiety could be that you are always very cautious over what you say, out of fear of saying something ‘stupid’ and being mocked.

In this instance a therapist may well say to you ‘well, let’s test that a) you would say something stupid if you were speaking spontaneously, b) people will mock you if you do and c) that it will really matter anyway.

By encouraging you to have 5 conversations that week, each lasting at least 5 minutes, where you speak completely spontaneously, you and your therapist can build an evidence base to challenge the beliefs you had.

It is almost certain that in cases such as this, you perform far better in conversation than you thought you would and any communicative ‘errors’ go unaddressed by others.

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These are just a small selection of tasks your therapist may ask you to complete between your sessions, but it will all depend on the condition you’re experiencing, your therapist and what’s appropriate for you.

The key thing to remember is that if you want to get the most out of therapy, you have to put the work in. Therapists don’t set homework for fun - working on your mental health between sessions has been shown time and time again to have a huge impact on your progress.

If you find yourself struggling, your therapist will be there to help. Homework can always be adapted and changed and it’s important to find what works for you.

If you’re interested in how therapy can bring positive change to your life, contact us today at hello@helloself.com.

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