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Homework Makes a Good Counseling Session Even Bet

Columns - Professional Development

Wednesday, 31 July 2002

What's the simplest way to make a good counseling session even better? Give the client a homework assignment. In this brief article I'm going to provide you with a homework assignment that has unusual merit for helping clients with addictions. I'll also share 15 hints to help you create your own innovative assignments.

Just how powerful are homework assignments? One homework assignment literally altered the face of treatment. Not long ago I interviewed Albert Ellis, the father of rational emotive behavior therapy (REBT). He told me a fascinating story about a landmark psychotherapeutic homework assignment he gave himself that literally spawned the REBT movement and changed the course of counseling and therapy for at least the next 50 years.

At age 19, Ellis was petrified at the thought of approaching women. Two hundred days a year he would go to the Bronx Botanical Garden in New York. He wanted to meet women but didn't have the courage to initiate conversation. Ellis began reading the work of the early behaviorists suggesting that if you confronted your fears they would often disappear. So, in the words of Albert Ellis, "I gave myself a famous homework assignment in August."

Each day he challenged himself to approach every single woman who was alone on a park bench and talk to her. "I'll give myself one minute, one lousy minute," he told himself, "and if I die ... well ... I die." He approached a total of 130 women. Thirty immediately got up and walked away. Out of all the women only one made a date with him and she subsequently didn't show up. The good news was that Ellis overcame his fear of approaching women. From that point on homework became one of the bedrocks of his theory.

William Glasser, the father of reality therapy agrees. In a letter I received he wrote, "Psychotherapy can begin in the office, but it must be lived outside of the office. Homework with therapy is a good way to get this process started." What type of therapist uses homework assignments? A better question might be: What type of therapist doesn't? Last year I completed a book related to this subject. I discovered that psychotherapeutic homework is used by individual therapists, group therapists, and even marriage and family counselors. In addition to rational emotive therapy and reality therapy mentioned above, counselors practicing assertiveness training, behavior therapy, cognitive behavior therapy, Salter's conditioned reflex therapy, gestalt therapy, career counseling, neuro-linguistic programming, transactional analysis, person-centered therapy, brief-strategic or solution oriented therapy, and logotherapy, to name a few, depend on this procedure. In a nutshell, outstanding therapists from virtually every persuasion rely on homework. When working with the addictive personality I keep coming back to a highly efficacious strategy I created that I have dubbed "the after hours-therapist."

This strategy takes advantage of the fact that most people are actually very adept at modeling the behavior of others, as well as anticipating what others will say or do. The intervention allows clients to progress at a faster rate and flourish as if they were receiving additional sessions (something we can all use in the golden age of managed care). Another plus is that this paradigm can zero in on one of a substance abuser's worst hurdles: What to do when an uncontrollable urge to engage in an addictive behavior occurs outside the treatment setting.

This paradigm is not appropriate for the first session or two. You should always meet with the client a minimum of three or four sessions before you prescribe this activity. Also, always tailor the assignment to your client's specific problem (e.g., drinking, drugs, love addiction, etc.). Here is how I introduce the exercise: "I have noticed that you are an extremely perceptive person. For instance, you seem to know exactly what your boss is going to say. In the last session you suggested that your brother would call you and ask you to go drinking on Monday night and he did. I have seen you for nine sessions now and you probably have an excellent idea of what I'm going to say and how I'm going to say it. So here's what I want you to do. Whenever you get the uncontrollable urge to drink (gamble, etc.) I want you to begin a dialogue as if you were right here in my office. In other words, based on what you have learned in our sessions, I want you to tell me about your urges and then play the part of me and respond to yourself. If you are not sure what I would say, just take an educated guess. You can write it in a journal or record the imaginary session into a tape recorder. Bring your journal or your tape to the next session so we can examine it."

In many cases the mere act of creating the make-believe session curbs the client's urge to engage in the addictive behavior. The beauty of this simple exercise is that it teaches the client to think like a counselor, which is one of the most important goals of treatment or rehab.

Finally, challenge yourself to create your own innovative homework assignments. I have 15 recommendations to help you implement your strategies.

Only use assignments with which you feel comfortable.

Carry out the strategy with a spirit of empathy and optimism.

Always check ethical guidelines prior to implementing any technique.

Use caution to ensure that clients are not embarrassed or physically harmed by the assignment.

If you are a student or are undergoing supervision for licensure or certification, check with your supervisor before you actually prescribe the technique.

Role-play the homework assignment with a trained colleague or supervisor before you actually attempt it for the first time with a client.

Never attempt a technique for which you have no training.

Do not assume that even an effective homework assignment will work in every case.

Do not assume that a homework assignment that worked well with a client will work effectively with the same client at a later date.

Always take multicultural and diversity considerations into account.

Only use language the client can understand and be as specific as possible.

Bend, fold, and mutilate existing strategies to increase your comfort level and to meet the needs of your client.

Realize that some homework assignments need to be used repeatedly to be effective.

Realize that therapeutic timing can make or break a technique.

Process the impact of the technique with the client whenever possible.

Howard G. Rosenthal, EdD, CCMHC, is the program coordinator of Human Services, St. Louis Community College at Florissant Valley, and the author of the academic bestseller the Encyclopedia of Counseling, Master Review and Tutorial for the National Counselor Examination. His web site is www.a-zuc.com/counseling.