ABSTRACT
Homework assignments carried out between sessions are an essential part of cognitive therapy and, in theory, are thought to be central to determining outcome. Beck et al. (1979) described homework as “an integral, vital component of treatment” (p. 272) and recommended that homework assignments should be utilised throughout therapy but, especially in the earlier phases with depressed patients, to “improve level of functioning, counteract obsessive thinking, change attitudes, and give a feeling of gratification” (p. 141). This can be achieved by providing the person with opportunities to collect information, test dysfunctional beliefs and practise new skills. Delusional beliefs will rarely change following intellectual challenging alone (Chadwick et al., 1996), and are more likely to be strengthened rather than weakened if the patient perceives the therapist’s stance as confrontational. It is only by experiencing emotions and behaving in different ways that patients can collect new evidence to use in the reappraisal of delusional beliefs (Morrison, 1998b). Glaser et al. (2000) reviewed the available empirical evidence and concluded that patients with schizophrenia who receive CBT that includes homework assignments, improve at least 60 per cent more than those who receive treatment without homework tasks.
