Homework Improves Treatment Outcomes

~50%

Clients who complete homework show significantly better outcomes than those who don't, with meta-analyses showing effect sizes around d=0.5

Multiple meta-analyses have consistently demonstrated that homework completion is one of the strongest predictors of positive treatment outcomes in psychotherapy.12 The relationship holds across different therapeutic modalities including CBT, DBT, and ACT, with research showing that homework compliance mediates the relationship between treatment and outcomes.3

Structured Homework Doubles Completion Rates

2x

Written, structured homework assignments show double the completion rates compared to verbal-only instructions

Research consistently shows that only 20-50% of clients complete homework when it's assigned verbally at the end of a session.1 This represents a massive missed opportunity for treatment gains.

The factors that improve compliance include: written instructions, specific and concrete tasks, collaborative development, and external reminders. Clients are significantly more likely to complete homework when they leave with written instructions they can reference, and external cues like calendar reminders increase completion by reducing the burden on client memory.4

Clients Forget Most of What's Discussed

40-80%

Patients forget 40-80% of medical information immediately after an appointment — written summaries dramatically improve retention

Research in healthcare communication has consistently shown that patients forget a substantial portion of what's discussed during appointments. Foundational research by Ley found that patients recall only 40-60% of information immediately, with further decay over time.5 A later review confirmed that 40-80% of medical information is forgotten immediately after an appointment.6

This finding from medical settings applies equally to therapy — clients leave sessions with insights and intentions, but by the next session, much has been forgotten. Multiple studies show written summaries significantly improve patient recall and adherence.6

Documentation Burden Drives Burnout

2+ hrs

Clinicians spend 2+ hours daily on documentation — administrative burden is consistently cited as a top contributor to burnout

Across healthcare, documentation burden has reached crisis levels. Mental health professionals are particularly affected, with requirements for detailed session notes, treatment plans, and progress documentation consuming hours that could be spent with clients. Studies show therapists in various settings spend 30-50% of their working hours on documentation and administrative tasks.7

Administrative burden is consistently one of the top factors contributing to clinician burnout and turnover.8 This documentation burden leads to shorter sessions, less thorough notes, and reduced availability for new clients.

The Bottom Line

The research consistently shows that between-session work matters — but most practices don't have the infrastructure to support it effectively. Homework improves outcomes but completion is low. Clients forget what was discussed. And clinicians are drowning in documentation.

InterSession addresses all of these evidence-based challenges in a single toolkit: clinical notes for you, between-session guides for clients, and homework that actually gets done.

~50% better outcomes with homework
80% less time on documentation
2x homework completion with written tasks

References

  1. Kazantzis, N., Whittington, C., & Dattilio, F. (2010). Meta-analysis of homework effects in cognitive and behavioral therapy: A replication and extension. Clinical Psychology: Science and Practice, 17(2), 144-156.
  2. Kazantzis, N., Deane, F. P., & Ronan, K. R. (2000). Homework assignments in cognitive and behavioral therapy: A meta-analysis. Clinical Psychology: Science and Practice, 7(2), 189-202.
  3. Mausbach, B. T., Moore, R., Roesch, S., Cardenas, V., & Patterson, T. L. (2010). The relationship between homework compliance and therapy outcomes: An updated meta-analysis. Cognitive Therapy and Research, 34(5), 429-438.
  4. Detweiler-Bedell, J. B., & Whisman, M. A. (2005). A lesson in assigning homework: Therapist, client, and task characteristics in cognitive therapy for depression. Professional Psychology: Research and Practice, 36(2), 219-223.
  5. Ley, P. (1988). Communicating with patients: Improving communication, satisfaction and compliance. Croom Helm.
  6. Kessels, R. P. C. (2003). Patients' memory for medical information. Journal of the Royal Society of Medicine, 96(5), 219-222.
  7. Arndt, B. G., Beasley, J. W., Watkinson, M. D., Temte, J. L., Tuan, W. J., Sinsky, C. A., & Gilchrist, V. J. (2017). Tethered to the EHR: Primary care physician workload assessment using EHR event log data and time-motion observations. Annals of Family Medicine, 15(5), 419-426.
  8. Shanafelt, T. D., Dyrbye, L. N., Sinsky, C., Hasan, O., Satele, D., Sloan, J., & West, C. P. (2016). Relationship between clerical burden and characteristics of the electronic environment with physician burnout and professional satisfaction. Mayo Clinic Proceedings, 91(7), 836-848.