Evaluating Homework Adherence in Studies of Mindfulness Based Cognitive Therapy for Female Sexual Dysfunction

Homework is a key factor in the effectiveness of mindfulness-based interventions, yet there is no standardized method for measuring homework adherence, particularly in interventions targeting female sexual dysfunction (FSD). This study aimed to describe current methods used to assess homework adherence in research on mindfulness-based interventions for FSD. A descriptive secondary analysis was conducted using data from three randomized clinical trials, totaling 197 women. The analysis focused on the frequency and duration of formal and informal mindfulness practices, assessed immediately post-treatment and at follow-up (6-12 months). Results indicated diverse and inconsistent methods to evaluate homework completion, with a general decline in adherence over time. Participants showed moderate engagement, with formal practices declining more sharply than informal ones and brief exercises showing marked reductions in frequency. These findings highlight the need for consistent monitoring of homework adherence to ensure treatment fidelity and to optimize outcomes. Strengths include the longitudinal approach and methodological recommendations. Limitations involve the use of unvalidated and variable measurement tools. In conclusion, this research underscores the urgent need for psychometrically validated instruments to assess homework adherence in mindfulness-based interventions for FSD and provides practical guidance for researchers and clinicians.