Examining the Role of Homework Compliance in Acceptance-Enhanced Behavior Therapy for Trichotillomania

IF 3.4 2区心理学 Q2 PSYCHIATRY

Behavior Therapy Pub Date : 2025-01-16 DOI:10.1016/j.beth.2025.01.003

Kathryn E. Barber, Douglas W. Woods, Michael P. Twohig, Stephen M. Saunders, Scott N. Compton, Martin E. Franklin

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Abstract

Between-session therapy homework is a key component of cognitive-behavioral therapies, yet its role in trichotillomania treatment remains understudied. The present study examined the associations between homework compliance and treatment outcomes in acceptance and commitment therapy (ACT) enhanced behavior therapy (AEBT) for trichotillomania. Participants included 35 adults with trichotillomania who participated in a 12-week randomized controlled trial of AEBT. Therapists documented patient homework assignment completion and rated homework adherence after each session. Trichotillomania symptom severity was assessed posttreatment and at 6-month follow-up. Higher overall homework completion rate and therapist-rated homework adherence predicted lower trichotillomania symptom severity at posttreatment and follow-up. These findings were consistent for homework compliance during early and late treatment phases and for both ACT and behavior therapy–based homework assignments. A stronger therapeutic relationship strengthened the positive effects of homework compliance on symptom reduction. Higher automatic pulling moderated the association between overall homework completion and better outcomes. Predictors of higher homework compliance included higher therapeutic relationship quality, younger age, and lower anxiety. These findings underscore the importance of between-session homework in trichotillomania treatment and support the inclusion of both ACT and behavior therapy assignments. Interventions to promote homework compliance could enhance the efficacy of AEBT and lead to greater symptom improvements.

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家庭作业依从性在拔毛癖接受强化行为治疗中的作用

治疗间隙作业是认知行为疗法的关键组成部分，但其在拔毛癖治疗中的作用仍未得到充分研究。本研究探讨了接受与承诺疗法（ACT）强化行为疗法（AEBT）治疗拔毛癖患者家庭作业依从性与治疗结果的关系。参与者包括35名患有拔毛癖的成年人，他们参加了为期12周的AEBT随机对照试验。治疗师记录了患者的家庭作业完成情况，并在每次治疗后对家庭作业依从性进行评分。治疗后和6个月随访时评估拔毛症症状严重程度。较高的家庭作业完成率和治疗师评定的家庭作业依从性预示着治疗后和随访中较低的拔毛症症状严重程度。这些发现在治疗早期和晚期的家庭作业依从性以及ACT和基于行为治疗的家庭作业中都是一致的。治疗关系越强，作业依从性对症状减轻的正向作用越强。更高的自动拉动调节了整体作业完成与更好的结果之间的关联。较高的家庭作业依从性的预测因子包括较高的治疗关系质量、较年轻的年龄和较低的焦虑。这些发现强调了在拔毛癖治疗中课间作业的重要性，并支持ACT和行为治疗作业的纳入。促进家庭作业依从性的干预措施可以提高AEBT的疗效，并导致更大的症状改善。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Behavior Therapy Multiple-

CiteScore

7.40

自引率

2.70%

发文量

113

审稿时长

121 days

期刊介绍： Behavior Therapy is a quarterly international journal devoted to the application of the behavioral and cognitive sciences to the conceptualization, assessment, and treatment of psychopathology and related clinical problems. It is intended for mental health professionals and students from all related disciplines who wish to remain current in these areas and provides a vehicle for scientist-practitioners and clinical scientists to report the results of their original empirical research. Although the major emphasis is placed upon empirical research, methodological and theoretical papers as well as evaluative reviews of the literature will also be published. Controlled single-case designs and clinical replication series are welcome.