What can you do when your clients don’t do their homework?
First thing is to understand why. A straight forward question is a good place to start but may not reveal the real reason. Remember there is a lot of desirability bias at work here – we all think of ourselves as good parents and would like our child’s therapist to think of us this way also…
So whether you were able to find the root cause, or not, here are a few useful techniques you can use to improve compliance:
- Education – make sure they understand what they need to do. You’d be surprised at how many times what you think they got from the coaching session and what they actually got is very different.
- Handout – make sure they have the means to remember when and what to do. It’s not enough they nod their heads during sessions, you need to give them some sort of handout. Visual aid with a clearly articulated program.
- Routine – tying the assignment to a daily routine of your client or their child is a lot more effective than trying to get them to add another chore to their busy schedule. Start by reviewing the routines and match the assignment to the routine that fits.
- Motivation – make sure they see the direct relationship between the assignments and their goals. The sooner they see the impact the carryover program has on what bothers them, the more likely they are to stick with it.
- Review – reviewing previously assigned homework in the following session has been demonstrated to most strongly predict compliance (Bryant, Simons & Thase, 1999). Careful review of homework demonstrates that homework is important.
- Gamification – make sure it looks fun. Some caregivers would have no problem gamifying every boring task you throw at them, but for many others a gamification envelop is a much needed (yet little admitted) support.
- Control – make sure to leave room for client control. Nobody likes following orders. Give them a choice. Keep it limited to the specific effect you want to achieve but try to come up with more than one alternative for every assignment.
- Gradual – most clients are overwhelmed to begin with. Adding another assignment is likely to raise objections. Start small and work your way up to the desired program. Make sure to assess not only the therapeutic condition but also the overwhelming factor. Keep control of the pace and don’t move up the intensity curve too fast so not to burnout the client/caregivers.
And if you think that your clients are harder cases to ‘crack’ and these tips won’t work for them, then stay tuned for troubleshooting compliance on our next blog…
Bryant, M. J., Simons, A. D., & Thase, M. E. (1999). Therapist Skill and Patient Variables in Homework Compliance: Controlling an Uncontrolled Variable in Cognitive Therapy Outcome Research. Cognitive Therapy and Research, 23, 381-399.
Oren Steinberg is co-founder of SensoryTreat, providing a carryover empowerment platform for pediatric therapists and caregivers of children with Autism and other developmental disabilities.