Psychotherapy for posttraumatic stress disorder (PTSD) routinely ought to include homework. Many evidence-based treatments (EBTs) for other disorders also include homework, and the systematic nature of the homework and the goal of homework to directly improve function are common differences between EBTs and the less-structured types of psychotherapies.
The rationale for homework is quite simple. Homework provides opportunities for patients to take the skills they practised in offices and employ them in real-life situations. Real-life exposure is where the rubber hits the road. The triggers are more real. The anxiety is more intense. The associated memories, sensations, and images are richer. The automatic negative thoughts that arise may be deeper, different, or more salient than the automatic negative thoughts that arise in office-based exposures. All of these elements allow a deeper dive into symptoms in the context of everyday functioning.
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