Item Details

Homework setting in cognitive behavioral therapy: A study of discursive strategies

Issue: Vol 11 No. 2 (2014)

Journal: Communication & Medicine

Subject Areas: Healthcare Communication Linguistics

DOI: 10.1558/cam.v11i2.16169

Abstract:

In recent years cognitive behavioral therapy (CBT), a form of psychotherapy, has risen to prominence due to a large number of studies attesting to its efficacy. A crucial part of the model of CBT is the use of the therapeutic strategy, homework, in which the client undertakes therapeutic tasks between sessions. The focus of this study is on how homework is implemented in sessions of CBT. This is undertaken through an analysis utilizing theme-orientated discourse analysis of video recorded sessions of CBT of one therapist and a client. Through tracking the focal theme of homework, the analysis focuses on homework as a face-threatening act (Brown and Levinson 1987) and how discursive strategies are employed to manage this issue. Other analytic themes include the use of frames (Goffman 1974) and constructed dialogue (Tannen 2007). It is the expertise of the therapist in putting into practice the therapeutic task of homework that is the subject of this study.

Author: Andrew Beckwith, Jonathan Crichton

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References :

Addis, M. E. and Jacobson, N. S. (2000) A closer look at the treatment rationale and homework compliance in cognitive-behavioral therapy for depression. Cognitive Therapy and Research 24 (3): 313–326. http://dx.doi.org/10.1023/a:1005563304265


Andrews, G., Oakley-Browne, M., Castle, D., Judd, F. and Baillie, A. (2003) Summary of guideline for the treatment of panic disorder and agoraphobia. Australasian Psychiatry 11 (1): 29–33. http://dx.doi.org/10.1046/j.1440-1665.2003.00529.x


American Psychiatric Association (2006) American Psychiatric Association Practice Guidelines for the Treatment of Psychiatric Disorders: Compendium. Arlington, VA: American Psychiatric Publishing.


Beck, A. T., Rush, A. J., Shaw, B. F. and Emery, G. (1979) Cognitive Therapy of Depression. New York: Guilford Press.


Beckwith, A. and Crichton, J. (2010) The negotiation of the problem statement in cognitive behvioural therapy. Communication and Medicine 7 (1): 23–
32. http://dx.doi.org/10.1558/cam.v7il.23


Brown, P. and Levinson, S. C. (1987) Politeness: Some Universals in Language Usage. Cambridge: Cambridge University Press.


Buchbinder, M. H. (2008) ‘You're still sick!’ Framing, footing, and participation in children’s medical play. Discourse Studies 10 (2): 139–159. http://dx.doi.org/10.1177/1461445607087018


Burns, D. D. and Nolen-Hoeksema, S. (1991) Coping styles, homework compliance, and the effectiveness of cognitive behavioral therapy. Journal of Consulting and Clinical Psychology 59 (2): 305–311. http://dx.doi.org/10.1037/0022-006X.59.2.305


Burns, D. D. and Spangler, D. L. (2000) Does psychotherapy homework lead to improvements in depression in cognitive behavioral therapy or does improvement lead to increased homework compliance? Journal of Consulting and Clinical Psychology 68 (1): 46–56. http://dx.doi.org/10.1037/0022-006X.68.1.46


Candlin, C. (2000) Reinventing the patient/client: New challenges to healthcare communication. Paper presented at the Cardiff Lecture, Health Communication Research Centre, Cardiff University.


Crowe, M. and Luty, S. (2005) Recovery from depression: A discourse analysis of interpersonal psychotherapy. Nursing Inquiry 12 (1): 43–50. http://dx.doi.org/10.1111/j.1440-1800.2005.00250.x


Davis, K. (1986) The process of problem (re)formulation in psychotherapy. Sociology of Health and Illness 8 (1): 44–74. http://dx.doi.org/10.1111/1467-9566.ep11346469


Deane, F. P., Glaser, N. M., Oades, L. G. and Kazantzis, N. (2005) Psychologists’ use of homework assignments with clients who have schizophrenia. Clinical Psychologist 9 (1): 24–30. http://dx.doi.org/10.1080/13284200500048141


Dobson, K. S. (2010) Handbook of Cognitive Behavior Therapies. Third edition. New York: Guilford Press.


Ellis, P. M., Hickie, I. B. and Smith, D. A. R. (2003) Summary of guideline for the treatment of depression. Australasian Psychiatry 11 (1): 34–38. http://dx.doi.org/10.1046/j.1440-1665.2003.00530.x


Ferrara, K. W. (1994) Therapeutic Ways With Words. Oxford: Oxford University Press.


Goffman, E. (1974) Frame Analysis. Boston: University Press of New England.


Harmon, T. M., Nelson, R. O. and Hayes, S. C. (1980) Self-monitoring of mood versus activity by depressed clients. Journal of Consulting and Clinical Psychology 48 (1): 30–38. http://dx.doi.org/10.1037/0022–006x.48.1.30


Kazantzis, N., Deane, F. P. and Ronan, K. R. (2000) Homework assignments in cognitive and behavioral therapy: A meta-analysis. Clinical Psychology: Science and Practice 7 (2): 189–202. http://dx.doi.org/10.1093/clipsy.7.2.189


Kazantzis, N., Deane, F. P., Ronan, K. R. and L’Abate, L. (eds) (2004) Using Homework Assignments in Cognitive Behavior Therapy. London: Routledge.


Kornblith, S. J., Rehm, L. P., O’Hara, M. W. and Lamparski, D. M. (1983) The contribution of self-reinforcement training and behavioral assignments to the efficacy of self-control therapy for depression. Cognitive Therapy and Research 7 (6): 499–
527. http://dx.doi.org/10.1007/bf01172888


Kurri, K. and Wahlstrom, J. (2007) Reformulations of agentless talk in psychotherapy. Text and Talk 27 (3): 315–338. http://dx.doi.org/10.1515/TEXT.2007.013


Labov, W. and Fanshel, D. (1977) Therapeutic Discourse: Psychotherapy as Conversation. New York: Academic Press.


Leahy, R. and Holland, S. (2000) Treatment Plans and Interventions for Depression and Anxiety Disorders. New York: Guilford Press.


Ledley, D. R., Marx, B. P. and Heimberg, R. G. (2010) Making Cognitive Behavioral Therapy Work: Clinical Process for New Practitioners. Second edition. New York: Guilford Press.


Lepper, G. and Mergenthaler, E. (2008) Observing therapeutic interaction in the ‘Lisa’ case. Psychotherapy Research 18 (6): 634–644. http://dx.doi.org/10.1080/10503300701442001


Leung, A. W. and Heimberg, R. G. (1996) Homework compliance, perceptions of control, and outcome of cognitive-behavioral treatment of social phobia. Behaviour Research and Therapy 34 (5/6): 423–432. http://dx.doi.org/10.1016/0005-7967(96)00014-9


Lutz, W. and Hill, C. E. (2009) Quantitative and qualitative methods for psychotherapy research. Psychotherapy Research 19 (4–5): 369–373. http://dx.doi.org/10.1080/10503300902948053


Marks, I. (1986) Behavioural Psychotherapy: Maudsley Pocket Book of Clinical Management. Bristol, UK: IOP Publishing.


McLeod, J. (2001) Qualitative Research in Counselling and Psychotherapy. London: Sage.


Mishler, E. G. (1984) The Discourse of Medicine: Dialectics of Medical Interviews. Norwood, NJ: Ablex.


NVivo (2008) NVivo Version 8 [Qualitative data anaylsis software]. QSR International.


Papp, L. A. and Kleber, M. S. (2002) Phenomenology of generalized anxiety disorder. In D. J. Stein and E. Hollander (eds) The American Psychiatric Publishing Textbook of Anxiety Disorders, 109–118. Washington, DC: American Psychiatric Publishing.


Peräkylä, A., Antaki, C., Vehvilainen, S. and Leudar, I. (eds) (2008) Conversation Analysis and Psychotherapy. Cambridge: Cambridge University Press. http://dx.doi.org/10.1017/CBO9780511490002


Roberts, C. and Sarangi, S. (2005) Theme-orientated discourse analysis of medical encounters. Medical Education 39 (6): 632–640. http://dx.doi.org/10.1111/j.1365-2929.2005.02171.x


Roth, A. and Fonagy, P. (2005) What Works for Whom?: A Critical Review of Psychotherapy Research. Second edition. London: Guilford Press.


Sacks, H. (1995) Lectures on Conversation: Volumes One and Two. Oxford: Blackwell. http://dx.doi.org/10.1002/9781444328301


Sanchez-Meca, J., Rosa-Alcazar, A. I., Marin-Martinez, F. and Gomez-Conesa, A. (2010) Psychological treatment of panic disorder with or without agoraphobia: A meta-analysis. Clinical Psychology Review 30 (1): 37–50. http://dx.doi.org/10.1016/j.cpr.2009.08.011


Sarangi, S. and Roberts, C. (1999) The dynamics of interactional and institutional orders in work-related settings. In S. Sarangi and C. Roberts (eds) Talk, Work and Institutional Order: Discourse in Medical, Mediation and Management Settings, 1–57. Berlin: Mouton de Gruyter.


Schegloff, E. A. (1982) Discourse as an interactional achievement: Some uses of ‘uh huh’ and other things that come between sentences. In D. Tannen (ed.) Analyzing Discourse: Text and Talk. Georgetown University Round Table on Languages and Linguistics, 71–93. Washington, DC: Georgetown University press.


Stivers, T. (2006) Treatment decisions: Negotiations between doctors and parents in acute care encounters. In J. Heritage and D. Maynard (eds) Communication in Medical Care, 279–312. Cambridge: Cambridge University Press.


Swann, J., Deumert, A., Lillis, T. and Mesthrie, R. (2004) A Dictionary of Sociolinguistics. Edinburgh: Edinburgh University Press.


Tannen, D. (2007) Talking Voices. Repetition, Dialogue, and Imagery in Conversational Discourse. Second edition. Cambridge: Cambridge University Press. http://dx.doi.org/10.1017/CBO9780511618987


ten Have, P. (2007) Appendix A: Transcription conventions. In D. Silverman (ed.) Doing Conversation Analysis: A Practical Guide. Second edition, 215–
216. London: Sage.


Wright, J. H., Basco, M. R. and Thase, M. E. (2006) Learning Cognitive Behavior Therapy: An Illustrated Guide. Washington, DC: American Psychiatric Publishing.