Evaluating The Relationship Between Collaborative Therapist Behaviors, Homework Adherence, And Treatment Outcome In Cognitive Behavioral Therapy

The use of homework assignments is considered an integral part of cognitive behavioral therapy (CBT). Although homework adherence has been shown to contribute to treatment outcome for depression, little research has been conducted which successfully identifies therapist characteristics which may facilitate homework adherence. Although therapeutic collaboration is referenced in clinical literature as a method of facilitating homework, no empirical investigation documents the extent to which therapeutic collaboration facilitates homework adherence. The following study proposes to test the extent to which therapeutic collaboration facilitates homework adherence and treatment outcome, and to further validate the positive relationship between homework adherence and treatment outcome. Data collected for this study consists of audiotaped therapy sessions of social workers and licensed professional counselors delivering a manualized CBT protocol for depression. The protocol included twenty, 60 minute CBT sessions delivered to patients diagnosed with Major Depressive Disorder (MDD). The hypotheses for the proposed study are: 1) Adequate therapist directiveness will have a positive relationship with treatment outcome and homework adherence 2) Inadequate therapist direction will have a negative relationship with treatment outcome and homework adherence 3) Excessive therapist direction will have a negative relationship with treatment outcome and homework adherence; 4) Homework adherence will mediate the relationship between therapist directiveness and treatment outcome.