Facilitating homework and generalization of skills to the real world

Homework is one of the fundamental components of cognitive behavioral therapy (CBT) for youth anxiety and depressive disorders. Practicing CBT therapists report widespread use of therapeutic homework (Kazantzis, Lampropoulos, and Deane 2005), but they also acknowledge variations in how it is used (Houlding, Schmidt, and Walker 2010). Theoretically, homework tasks are important because they (i) encourage opportunities to practice skills learned in session; (ii) give the therapist a chance to determine the youth?s understanding of skills; (iii) allow the youth to generalize therapeutic skills to real-life situations; and (iv), in anxiety, help the youth gradually face feared situations in his/her own environment (Hudson and Kendall 2002). CBT homework is typically discussed and assigned during each session and reviewed at the beginning of the next session. Therapy homework for anxiety initially includes skills practice and eventually out-of-session exposure tasks: in both, the youth practices skills learned in therapy by engaging in real-life situations (Kendall and Hedtke 2006a). Therapy homework for youth suffering from depression entails keeping a mood diary or log, skills practice (e.g., challenging depressogenic thinking), and pleasant activity scheduling through behavioral activation (Clarke, Lewinsohn, and Hops 1990; Curry et al. 2005; Stark et al. 1996)