Expanding a health technology solution to address therapist challenges in implementing homework with adult therapy clients: A mixed methods study (Preprint)

Abstract

Homework is implemented with variable effectiveness in real-world therapy settings, indicating a need for innovative solutions to homework challenges. We developed Adhere.ly, a user-friendly, HIPAA compliant, web-based platform to help therapists implement homework with youth clients and their caregivers. The initial version had limited functionality and was designed for youth clients and their caregivers and required expanding available features and exercises to suit adult clients.

The purpose of this study was to better understand barriers and potential solutions to homework implementation experienced by therapists seeing adult clients and obtain their input on new features and exercises that would enable Adhere.ly to better meet their needs when working with this population.

This study used an exploratory, sequential, mixed methods design that included 13 semi-structured focus groups with mental health therapists and clinic leadership and a survey administered to 100 therapists. Analyses were performed using NVivo qualitative analysis software and SPSS.

Findings revealed common barriers such as clients and therapists being busy, forgetting to complete homework, managing multiple platforms/homework materials, and lack of client motivation. Adhere.ly was perceived as a potential solution, particularly its user-friendly interface and text-based reminders. Therapists suggested integrating Adhere.ly with telemedicine and electronic health record platforms, adding more exercises to support manualized therapy protocols, and therapy guides.

This study highlights the importance of technology-based solutions in addressing barriers to homework implementation in mental health treatment with adult clients. Adhere.ly shows promise in addressing these challenges and has the potential to improve therapy efficiency and homework completion rates. The input from therapists informed the development of Adhere.ly, guiding the expansion of features and exercises to better meet the needs of therapists working with adult clients.