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

What the research shows

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

Key studies

  • Kazantzis, Whittington & Dattilio (2010) — Meta-analysis in Journal of Consulting and Clinical Psychology finding homework significantly associated with treatment outcomes across 46 studies
  • Mausbach, Moore, Roesch et al. (2010) — Research showing homework compliance mediates the relationship between treatment and outcomes in CBT
  • Kazantzis, Deane & Ronan (2000) — Earlier meta-analysis establishing the homework-outcome relationship

Structured Homework Doubles Completion Rates

2x

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

The compliance problem

Research consistently shows that only 20-50% of clients complete homework when it's assigned verbally at the end of a session. 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.

Key findings

  • Written vs verbal — Clients are significantly more likely to complete homework when they leave with written instructions they can reference
  • Calendar integration — External cues and reminders increase completion by reducing the burden on client memory
  • Specificity matters — Vague assignments ("practice mindfulness") show lower completion than specific ones ("10-minute body scan Monday and Wednesday morning")

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

The recall problem

Research in healthcare communication has consistently shown that patients forget a substantial portion of what's discussed during appointments. 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.

Key findings

  • Ley (1979, 1988) — Foundational research showing patients recall only 40-60% of information immediately, with further decay over time
  • Kessels (2003) — Review in Journal of the Royal Society of Medicine confirming 40-80% of medical information is forgotten immediately
  • Written information improves recall — Multiple studies show written summaries significantly improve patient recall and adherence

Documentation Burden Drives Burnout

2+ hrs

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

The admin problem

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.

Key findings

  • Time allocation — Studies show therapists in various settings spend 30-50% of their working hours on documentation and administrative tasks
  • Burnout correlation — Administrative burden is consistently one of the top factors contributing to clinician burnout and turnover
  • Impact on care — 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