Homework compliance: An uncontrolled variable in cognitive therapy outcome research

Laura Primakoff, Norman Epstein, Lino Covi

Research output: Contribution to journalArticlepeer-review

89 Scopus citations


Although patient compliance with homework assignments is considered a major component of cognitive therapy for depression, research studies have rarely investigated homework compliance as a variable potentially influencing treatment outcome. This paper reviews the literature on outcome studies of cognitive therapy for depression and describes research design problems that result from the failure to assess and control for differential homework compliance. These design problems limit the internal validity of outcome studies and make it difficult to compare studies that included allegedly similar treatments but produced different results. Recommendations for evaluating the role of homework compliance in outcome research on cognitive therapy and other treatment approaches are described. The need for adequate measures of homework compliance and quality is stressed, and potential criteria for use in cognitive therapy homework rating scales are proposed.

Original languageEnglish (US)
Pages (from-to)433-446
Number of pages14
JournalBehavior Therapy
Issue number4
StatePublished - Sep 1986
Externally publishedYes

ASJC Scopus subject areas

  • Clinical Psychology


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