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Related Experiment Video

Updated: May 14, 2026

Exploring the Neural Correlates of Cognitive Reappraisal in Obsessive-Compulsive Disorder Using Task-based Functional Magnetic Resonance Imaging

Exploring the Neural Correlates of Cognitive Reappraisal in Obsessive-Compulsive Disorder Using Task-based Functional Magnetic Resonance Imaging

Published on: March 14, 2025

Homework compliance counts in cognitive-behavioral therapy.

Richard T Lebeau¹, Carolyn D Davies, Najwa C Culver

¹Department of Psychology, University of California, Los Angeles, CA 90095-1563, USA. rlebeau@ucla.edu

Cognitive Behaviour Therapy

|February 20, 2013

Summary

Homework compliance, not treatment expectancy, significantly predicts better outcomes in cognitive-behavioral therapy (CBT) for anxiety disorders. Improving homework completion is a practical strategy for enhancing treatment effectiveness.

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Area of Science:

Psychology
Clinical Psychology
Behavioral Therapy

Background:

Prior research indicates an association between treatment engagement and outcomes in behavioral therapy for anxiety.
Previous studies often suffered from weak measurement of engagement, unaddressed baseline variables, and limited simultaneous analysis of engagement factors.

Purpose of the Study:

To investigate the relationship between treatment expectancy and homework compliance.
To determine the predictive power of these two engagement variables on treatment improvement in cognitive-behavioral therapy (CBT) for anxiety disorders.

Main Methods:

84 adults with principal anxiety disorders received up to 12 sessions of CBT or Acceptance and Commitment Therapy.
Treatment outcomes were assessed via pre- and post-treatment clinical severity ratings.
Treatment expectancy was rated after session one; homework compliance was assessed by clinicians each session.

Main Results:

Treatment expectancy and homework compliance showed a weak correlation, contrary to hypotheses.
Homework compliance significantly predicted 10% of the variance in treatment outcome.
Treatment expectancy did not significantly predict treatment outcome.

Conclusions:

Homework compliance appears to be a more critical engagement variable than treatment expectancy for treatment outcomes in anxiety disorders.
Enhancing homework compliance offers a practical and effective method to improve clinical results in CBT for anxiety.