Measuring homework compliance in cognitive-behavioral therapy for adolescent depression: review, preliminary findings, and implications for theory and practice.

Wetterneck et al. (2006) watched how often teens with depression did their CBT homework. They tracked each worksheet and exercise across every therapy session. The team wanted real-time numbers, not a guess at the end.

Homework was done only 56 % of the time. Some kids started strong then quit. The line sloped down as weeks passed. Session-by-session counts showed the slide better than a final look back.

Deshais et al. (2019) also counted compliance, but with first-graders and worksheets. Their line went up when they added group prizes. Same outcome label, opposite trend.

de Merlier et al. (2024) tried to lift homework in college kids by blocking social media. Scores rose a little, not much. Again, homework stayed stubborn.

Huntington et al. (2023) found only half of behavior studies even ask clients if the plan feels fair. T et al. did not ask teens either, so we still don’t know if low scores mean the work felt useless.

If you run CBT with teens, expect about half of the homework to disappear and the rate to shrink each week. Check every session, not just at discharge. A quick 0-10 rating at the start of each meeting gives you early warning and something to graph. Pair the check with a mini-plan — smaller tasks, tighter rewards, or shorter deadlines — to fight the slide before it wins.