Barriers Associated with the Implementation of Homework in Youth Mental Health Treatment and Potential Mobile Health Solutions

• Published in: Cognitive therapy and research Vol. 45; no. 2; pp. 272 - 286
• Main Authors: Bunnell, Brian E., Nemeth, Lynne S., Lenert, Leslie A., Kazantzis, Nikolaos, Deblinger, Esther, Higgins, Kristen A., Ruggiero, Kenneth J.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.04.2021; Springer Nature B.V
• Subjects: Caregivers; Clinical Psychology; Cognitive ability; Cognitive Psychology; Homework; Medicine; Medicine & Public Health; Memory; Mental health; Original Article; Quality of Life Research; Trauma; health; Technology; Barriers; Cognitive behavioral therapy; Homework; mHealth; Cognitive Behavioral Therapy
• ISSN: 0147-5916; 1573-2819
• DOI: 10.1007/s10608-020-10090-8

Background Homework, or between-session practice of skills learned during therapy, is integral to effective youth mental health TREATMENTS. However, homework is often under-utilized by providers and patients due to many barriers, which might be mitigated via m Health solutions. Methods Semi-structured qualitative interviews were conducted with nationally certified trainers in Trauma Focused Cognitive Behavioral Therapy (TF-CBT; n  = 21) and youth TF-CBT patients ages 8–17 ( n  = 15) and their caregivers ( n  = 12) to examine barriers to the successful implementation of homework in youth mental health treatment and potential m Health solutions to those barriers. Results The results indicated that many providers struggle to consistently develop, assign, and assess homework exercises with their patients. Patients are often difficult to engage and either avoid or have difficulty remembering to practice exercises, especially given their busy/chaotic home lives. Trainers and families had positive views and useful suggestions for m Health solutions to these barriers in terms of functionality (e.g., reminders, tracking, pre-made homework exercises, rewards) and user interface (e.g., easy navigation, clear instructions, engaging activities). Conclusions This study adds to the literature on homework barriers and potential m Health solutions to those barriers, which is largely based on recommendations from experts in the field. The results aligned well with this literature, providing additional support for existing recommendations, particularly as they relate to treatment with youth and caregivers.