Homework (mutually agreed tasks for the patient to complete outside the therapy session) is animportant component of Cognitive Behavioral Therapy (CBT). CBT homework disconfirmsnegative thoughts and beliefs; focuses subjective accounts to more objective detailed accounts;allows therapist and patient to review the past week's activities; and helps the therapist to relatethe session to specific tasks (Beck et al., 1979). Compliance with homework has been shown toimprove the clinical results of CBT (Persons et al., 1988). At the present time there is noconsensus as to the average rate of adherence in completing homework assignments (Detweiler& Whisman, 1999).The identification and reliable measurement of barriers affecting completion ofhomework assignments may improve the potency of CBT, thereby producing further reductionsin depressive symptoms and improvement in ultimate clinical outcome. It may also assistresearchers to identify factors related to variance in treatment outcome, thereby strengthening thegeneralizability of investigational findings for the clinical community.A two-phase study was conducted to develop an instrument that may assist CBT patients,therapists, and researchers to ascertain the barriers that may be preventing completion ofhomework assignments. Phase I involved the interview of 20 depressed patients and 20therapists to elicit perceived barriers to homework completion in order to develop an item poolfor the draft instrument. In Phase II, the draft instrument was administered to 56 subjects on 2separate occasions.Factor Analysis revealed a 2-factor solution of "Patient Factors" and "Therapist/TaskFactors." Internal Consistency demonstrated Alpha Coefficients of the Subscale and Entirescales that ranged from .80 to .95. Test-Re-Test correlations demonstrated Pearson correlationsof .72 to .95. The only consistent demographic predictors of levels of Barriers to CBTHomework Completion Scale scores were race and marital status. The Patient subscale was ableto satisfactorily classify patients (75 to 79 %) with low and high adherence to homeworkassignments. There were no consistent predictors of assignment compliance. The Barriers toCBT Homework Completion Scale scores did correlate significantly with AssignmentCompliance (.32 to .46). Sample size most likely limited the ability to fully evaluate thepsychometric properties of this draft instrument. Future studies will expand upon this pilot studyof the Barriers to CBT Homework Completion Scale
