Patients' experiences of homework tasks in cognitive behavioural therapy for psychosis: a qualitative analysis

This paper examines the experiences of individuals who agreed to undertake homework as part of cognitive behavioural therapy for psychosis. It attempts to identify factors that individuals believe influence homework compliance and thereby alert therapists to their possible impact, and, using grounded theory, dispel the myth that individuals with psychosis cannot meaningfully express their experiences and views. Ten participants, who either did (six) or did not (four) comply with homework were interviewed and a grounded theory approach was used to understand and generate theories relating to their completion of homework assignments. The factors cited as affecting homework compliance were motivation, recall of the assignment, difficulty, putting off, understanding of the rationale, perceived benefits, insight, effort and relevance. The most cited theme was insight, with four of the high compliance group accounting for 21 references and three of the low compliance group accounting for nine references. However, the high compliance group gained insight into problem development, maintenance and the use of effective strategies to realize goals whereas the low compliance group gained only an identification of their problems and an understanding of their development. Three participants in the low compliance group believed that their assignments were sometimes irrelevant to their needs but this was true of only one out of the six in the high compliance group. Further research into assessing and addressing non‐acceptance of treatment rationale may be indicated.