Improving Between-Session Carryover

Improving Between-Session Carryover

“So how did your homework assignment this week go?”

“Uh, what was I supposed to do again?”

This exchange between a CBT therapist and a client is common. Often even when clients are on board and excited about working on their cognitive distortions or tackling their exposure hierarchy, they may forget or avoid actually completing the tasks during the week. One of the challenges of psychotherapy is getting the client to generalize the learning and gains they make in the treatment room to their “real life”, especially since for most outpatient treatment, therapy is only one hour (out of 168 per week). Tools or treatments which integrate into the context of a person’s life, outside of the therapy hour, can help. Increasing daily awareness of one’s mental health by mood tracking, scheduling times to accomplish specific therapy-related activities (e.g. meditation or exposure exercises), or reminders to complete thought records can all help move therapeutic work out of the treatment room and into clients’ daily lives.

Using blended (digital and in-person) treatment approaches can be used to make therapy more efficient. Digital tools can reinforce and expand upon education provided in-session. Additionally, having on-demand access to content allows clients to refer back to key topics when they want, rather than having to try to remember those points from their weekly session. Furthermore, some clients may not be as able to absorb key points in session, due to underlying psychopathology, distraction, or differences in learning style. Increased engagement with educational material can help clients see the value of the assignment and increase motivation to complete tasks or homework.

Clients in therapy do best when given goals which are SMART (Specific, Measurable, Attainable, Realistic and Time-limited), but sometimes therapists may not have enough time in session to highlight the rationale of these assignments. Augmenting therapy with digital tools can allow clinicians to more easily provide valuable information about the purpose of homework, and by scheduling reminders for a specific time or date, therapists and clients can discuss any potential roadblocks ahead of time to increase the likelihood of completion. The completion of between-session homework assignments or meditation exercises improves the efficacy of therapy, and the ability to easily remind clients of their assignments between sessions can only help in this process.

Breaking down barriers between the therapy session and real life, through tools which integrate into day-to-day activities can increase individuals’ awareness of their mental health and make them more willing and able to implement the changes they learn about in session. This can be accomplished by making therapeutic tasks such as thought records, goal setting, or mood tracking more “bite-sized”, enjoyable, and doable. Many individuals balk at the idea of completing paper-based thought records, or simply lose them, but are willing to engage with an appealing and easy-to-use digital app. This shift can really help clients feel like the clinician is meeting them where they are, and help them be more engaged in and committed to their treatment plan.

Pacifica for Clinicians provider-facing dashboard tool that allows clinicians to administer and score clinical assessments, conduct teletherapy, assign between-session homework, and manage schedules. By integrating seamlessly with the consumer mobile app, Pacifica for Clinicians can enhance client engagement, improve between-session carryover, and treatment adherence.