An exploration of homework completion in cognitive behavioral treatments for bulimia-spectrum eating disorders

The impact of homework completion on outcome from cognitive behavioral therapies (CBTs) for eating disorders (EDs) is unknown. We examined homework completion during two CBTs for bulimia-spectrum EDs and tested the associations among homework and treatment outcomes. After each session, therapists rated the quantity of self-monitoring completed (e.g. tracking food intake and ED symptoms), and degree of completion of the previous week's written (e.g. completing a worksheet) and behavioral (e.g. completing an at-home food exposure, regularly eating) homework on a Likert scale. On average, patients (N = 42) completed 50-100% of self-monitoring homework, moderate completion of written homework, and below-moderate completion of behavioral homework. Average behavioral homework completion, but not self- monitoring or written homework, was related to end-of-treatment symptom cessation. Improving homework completion might enhance the efficacy of CBTs for EDs.