Encouraging patients to complete therapeutic work outside of treatment sessions, sometimes known as “between-session work” (BSW), is a key part of Cognitive Behavioural Therapies (CBT). These activities help patients apply skills learned in therapy to their everyday lives, where problems naturally occur.
Previous research shows that when patients actively engage in BSW, they experience better treatment outcomes and greater symptom reduction. However, engagement with BSW can vary, and difficulties completing tasks are commonly reported.
This review analysed 59 studies to understand what influences engagement with BSW in CBT-based interventions, identifying ten key themes. Positive patient beliefs about BSW such as perceived helpfulness, and effective practitioner planning and review of tasks, including providing a rationale and addressing difficulties, were associated with greater between-session engagement. In contrast, patient resistance during sessions often indicated disengagement between sessions. The impact of other factors like patient symptoms, cultural environment, and the therapeutic relationship were less clear.
The review highlights that while completing BSW may be challenging, the strongest predictors of engagement are changeable, suggesting important ways to improve practice and support for patients, helping them get the most out of their therapy.
Read the full paper here: Bennion, M., Lovell, K., Blakemore, A., Vicary, E., & Bee, P. (2024). Predictors of engagement with between-session work in Cognitive Behavioural Therapy (CBT)-based interventions: A mixed-methods systematic review and “best fit” framework synthesis. Cognitive Behaviour Therapy, 1–37. https://doi.org/10.1080/16506073.2024.2369939
Cognitive Behaviour Therapy A peer reviewed, multidisciplinary journal devoted to the application of behavioural and cognitive sciences to clinical psychology and psychotherapy.
