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Health Hazards of Homework

March 18, 2014 | Julie Greicius Pediatrics .

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A new study by the Stanford Graduate School of Education and colleagues found that students in high-performing schools who did excessive hours of homework “experienced greater behavioral engagement in school but also more academic stress, physical health problems, and lack of balance in their lives.”

Those health problems ranged from stress, headaches, exhaustion, sleep deprivation, weight loss and stomach problems, to psycho-social effects like dropping activities, not seeing friends or family, and not pursuing hobbies they enjoy.

In the Stanford Report story about the research, Denise Pope , a senior lecturer at the Stanford Graduate School of Education and a co-author of the  study published in the  Journal of Experimental Education , says, “Our findings on the effects of homework challenge the traditional assumption that homework is inherently good.”

The study was based on survey data from a sample of 4,317 students from 10 high-performing high schools in California communities in which median household income exceeded $90,000. Of the students surveyed, homework volume averaged about 3.1 hours each night.

“It is time to re-evaluate how the school environment is preparing our high school student for today’s workplace,” says Neville Golden, MD , chief of adolescent medicine at Stanford Medicine Children’s Health and a professor at the School of Medicine. “This landmark study shows that excessive homework is counterproductive, leading to sleep deprivation, school stress and other health problems. Parents can best support their children in these demanding academic environments by advocating for them through direct communication with teachers and school administrators about homework load.”

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Denise Pope

Education scholar Denise Pope has found that too much homework has negative effects on student well-being and behavioral engagement. (Image credit: L.A. Cicero)

A Stanford researcher found that too much homework can negatively affect kids, especially their lives away from school, where family, friends and activities matter.

“Our findings on the effects of homework challenge the traditional assumption that homework is inherently good,” wrote Denise Pope , a senior lecturer at the Stanford Graduate School of Education and a co-author of a study published in the Journal of Experimental Education .

The researchers used survey data to examine perceptions about homework, student well-being and behavioral engagement in a sample of 4,317 students from 10 high-performing high schools in upper-middle-class California communities. Along with the survey data, Pope and her colleagues used open-ended answers to explore the students’ views on homework.

Median household income exceeded $90,000 in these communities, and 93 percent of the students went on to college, either two-year or four-year.

Students in these schools average about 3.1 hours of homework each night.

“The findings address how current homework practices in privileged, high-performing schools sustain students’ advantage in competitive climates yet hinder learning, full engagement and well-being,” Pope wrote.

Pope and her colleagues found that too much homework can diminish its effectiveness and even be counterproductive. They cite prior research indicating that homework benefits plateau at about two hours per night, and that 90 minutes to two and a half hours is optimal for high school.

Their study found that too much homework is associated with:

* Greater stress: 56 percent of the students considered homework a primary source of stress, according to the survey data. Forty-three percent viewed tests as a primary stressor, while 33 percent put the pressure to get good grades in that category. Less than 1 percent of the students said homework was not a stressor.

* Reductions in health: In their open-ended answers, many students said their homework load led to sleep deprivation and other health problems. The researchers asked students whether they experienced health issues such as headaches, exhaustion, sleep deprivation, weight loss and stomach problems.

* Less time for friends, family and extracurricular pursuits: Both the survey data and student responses indicate that spending too much time on homework meant that students were “not meeting their developmental needs or cultivating other critical life skills,” according to the researchers. Students were more likely to drop activities, not see friends or family, and not pursue hobbies they enjoy.

A balancing act

The results offer empirical evidence that many students struggle to find balance between homework, extracurricular activities and social time, the researchers said. Many students felt forced or obligated to choose homework over developing other talents or skills.

Also, there was no relationship between the time spent on homework and how much the student enjoyed it. The research quoted students as saying they often do homework they see as “pointless” or “mindless” in order to keep their grades up.

“This kind of busy work, by its very nature, discourages learning and instead promotes doing homework simply to get points,” Pope said.

She said the research calls into question the value of assigning large amounts of homework in high-performing schools. Homework should not be simply assigned as a routine practice, she said.

“Rather, any homework assigned should have a purpose and benefit, and it should be designed to cultivate learning and development,” wrote Pope.

High-performing paradox

In places where students attend high-performing schools, too much homework can reduce their time to foster skills in the area of personal responsibility, the researchers concluded. “Young people are spending more time alone,” they wrote, “which means less time for family and fewer opportunities to engage in their communities.”

Student perspectives

The researchers say that while their open-ended or “self-reporting” methodology to gauge student concerns about homework may have limitations – some might regard it as an opportunity for “typical adolescent complaining” – it was important to learn firsthand what the students believe.

The paper was co-authored by Mollie Galloway from Lewis and Clark College and Jerusha Conner from Villanova University.

Media Contacts

Denise Pope, Stanford Graduate School of Education: (650) 725-7412, [email protected] Clifton B. Parker, Stanford News Service: (650) 725-0224, [email protected]

Candida Fink M.D.

Homework Struggles May Not Be a Behavior Problem

Exploring some options to understand and help..

Posted August 2, 2022 | Reviewed by Abigail Fagan

  • What Is Anxiety?
  • Take our Generalized Anxiety Disorder Test
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  • Mental health challenges and neurodevelopmental differences directly affect children's ability to do homework.
  • Understanding what difficulties are getting in the way—beyond the usual explanation of a behavior problem—is key.
  • Sleep and mental health needs can take priority over homework completion.

Chelsea was in 10th grade the first time I told her directly to stop doing her homework and get some sleep. I had been working with her since she was in middle school, treating her anxiety disorder. She deeply feared disappointing anyone—especially her teachers—and spent hours trying to finish homework perfectly. The more tired and anxious she got, the harder it got for her to finish the assignments.

Antonio Guillem/Shutterstock

One night Chelsea called me in despair, feeling hopeless. She was exhausted and couldn’t think straight. She felt like a failure and that she was a burden to everyone because she couldn’t finish her homework.

She was shocked when I told her that my prescription for her was to go to sleep now—not to figure out how to finish her work. I told her to leave her homework incomplete and go to sleep. We briefly discussed how we would figure it out the next day, with her mom and her teachers. At that moment, it clicked for her that it was futile to keep working—because nothing was getting done.

This was an inflection point for her awareness of when she was emotionally over-cooked and when she needed to stop and take a break or get some sleep. We repeated versions of this phone call several times over the course of her high school and college years, but she got much better at being able to do this for herself most of the time.

When Mental Health Symptoms Interfere with Homework

Kids with mental health or neurodevelopmental challenges often struggle mightily with homework. Challenges can come up in every step of the homework process, including, but not limited to:

  • Remembering and tracking assignments and materials
  • Getting the mental energy/organization to start homework
  • Filtering distractions enough to persist with assignments
  • Understanding unspoken or implied parts of the homework
  • Remembering to bring finished homework to class
  • Being in class long enough to know the material
  • Tolerating the fear of not knowing or failing
  • Not giving up the assignment because of a panic attack
  • Tolerating frustration—such as not understanding—without emotional dysregulation
  • Being able to ask for help—from a peer or a teacher and not being afraid to reach out

This list is hardly comprehensive. ADHD , autism spectrum disorder, social anxiety , generalized anxiety, panic disorder, depression , dysregulation, and a range of other neurodevelopmental and mental health challenges cause numerous learning differences and symptoms that can specifically and frequently interfere with getting homework done.

Saharak Wuttitham/Shutterstock

The Usual Diagnosis for Homework Problems is "Not Trying Hard Enough"

Unfortunately, when kids frequently struggle to meet homework demands, teachers and parents typically default to one explanation of the problem: The child is making a choice not to do their homework. That is the default “diagnosis” in classrooms and living rooms. And once this framework is drawn, the student is often seen as not trying hard enough, disrespectful, manipulative, or just plain lazy.

The fundamental disconnect here is that the diagnosis of homework struggles as a behavioral choice is, in fact, only one explanation, while there are so many other diagnoses and differences that impair children's ability to consistently do their homework. If we are trying to create solutions based on only one understanding of the problem, the solutions will not work. More devastatingly, the wrong solutions can worsen the child’s mental health and their long-term engagement with school and learning.

To be clear, we aren’t talking about children who sometimes struggle with or skip homework—kids who can change and adapt their behaviors and patterns in response to the outcomes of that struggle. For this discussion, we are talking about children with mental health and/or neurodevelopmental symptoms and challenges that create chronic difficulties with meeting homework demands.

How Can You Help a Child Who Struggles with Homework?

How can you help your child who is struggling to meet homework demands because of their ADHD, depression, anxiety, OCD , school avoidance, or any other neurodevelopmental or mental health differences? Let’s break this down into two broad areas—things you can do at home, and things you can do in communication with the school.

mental health problems with homework

Helping at Home

The following suggestions for managing school demands at home can feel counterintuitive to parents—because we usually focus on helping our kids to complete their tasks. But mental health needs jump the line ahead of task completion. And starting at home will be key to developing an idea of what needs to change at school.

  • Set an end time in the evening after which no more homework will be attempted. Kids need time to decompress and they need sleep—and pushing homework too close to or past bedtime doesn’t serve their educational needs. Even if your child hasn’t been able to approach the homework at all, even if they have avoided and argued the whole evening, it is still important for everyone to have a predictable time to shut down the whole process.
  • If there are arguments almost every night about homework, if your child isn’t starting homework or finishing it, reframe it from failure into information. It’s data to put into problem-solving. We need to consider other possible explanations besides “behavioral choice” when trying to understand the problem and create effective solutions. What problems are getting in the way of our child’s meeting homework demands that their peers are meeting most of the time?
  • Try not to argue about homework. If you can check your own anxiety and frustration, it can be more productive to ally with your child and be curious with them. Kids usually can’t tell you a clear “why” but maybe they can tell you how they are feeling and what they are thinking. And if your child can’t talk about it or just keeps saying “I don't know,” try not to push. Come back another time. Rushing, forcing, yelling, and threatening will predictably not help kids do homework.

Lapina/Shutterstock

Helping at School

The second area to explore when your neurodiverse child struggles frequently with homework is building communication and connections with school and teachers. Some places to focus on include the following.

  • Label your child’s diagnoses and break down specific symptoms for the teachers and school team. Nonjudgmental, but specific language is essential for teachers to understand your child’s struggles. Breaking their challenges down into the problems specific to homework can help with building solutions. As your child gets older, help them identify their difficulties and communicate them to teachers.
  • Let teachers and the school team know that your child’s mental health needs—including sleep—take priority over finishing homework. If your child is always struggling to complete homework and get enough sleep, or if completing homework is leading to emotional meltdowns every night, adjusting their homework demands will be more successful than continuing to push them into sleep deprivation or meltdowns.
  • Request a child study team evaluation to determine if your child qualifies for services under special education law such as an IEP, or accommodations through section 504—and be sure that homework adjustments are included in any plan. Or if such a plan is already in place, be clear that modification of homework expectations needs to be part of it.

The Long-Term Story

I still work with Chelsea and she recently mentioned how those conversations so many years ago are still part of how she approaches work tasks or other demands that are spiking her anxiety when she finds herself in a vortex of distress. She stops what she is doing and prioritizes reducing her anxiety—whether it’s a break during her day or an ending to the task for the evening. She sees that this is crucial to managing her anxiety in her life and still succeeding at what she is doing.

Task completion at all costs is not a solution for kids with emotional needs. Her story (and the story of many of my patients) make this crystal clear.

Candida Fink M.D.

Candida Fink, M.D. , is board certified in child/adolescent and general psychiatry. She practices in New York and has co-authored two books— The Ups and Downs of Raising a Bipolar Child and Bipolar Disorder for Dummies.

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Is homework a necessary evil?

After decades of debate, researchers are still sorting out the truth about homework’s pros and cons. One point they can agree on: Quality assignments matter.

By Kirsten Weir

March 2016, Vol 47, No. 3

Print version: page 36

After decades of debate, researchers are still sorting out the truth about homework’s pros and cons. One point they can agree on: Quality assignments matter.

  • Schools and Classrooms

Homework battles have raged for decades. For as long as kids have been whining about doing their homework, parents and education reformers have complained that homework's benefits are dubious. Meanwhile many teachers argue that take-home lessons are key to helping students learn. Now, as schools are shifting to the new (and hotly debated) Common Core curriculum standards, educators, administrators and researchers are turning a fresh eye toward the question of homework's value.

But when it comes to deciphering the research literature on the subject, homework is anything but an open book.

The 10-minute rule

In many ways, homework seems like common sense. Spend more time practicing multiplication or studying Spanish vocabulary and you should get better at math or Spanish. But it may not be that simple.

Homework can indeed produce academic benefits, such as increased understanding and retention of the material, says Duke University social psychologist Harris Cooper, PhD, one of the nation's leading homework researchers. But not all students benefit. In a review of studies published from 1987 to 2003, Cooper and his colleagues found that homework was linked to better test scores in high school and, to a lesser degree, in middle school. Yet they found only faint evidence that homework provided academic benefit in elementary school ( Review of Educational Research , 2006).

Then again, test scores aren't everything. Homework proponents also cite the nonacademic advantages it might confer, such as the development of personal responsibility, good study habits and time-management skills. But as to hard evidence of those benefits, "the jury is still out," says Mollie Galloway, PhD, associate professor of educational leadership at Lewis & Clark College in Portland, Oregon. "I think there's a focus on assigning homework because [teachers] think it has these positive outcomes for study skills and habits. But we don't know for sure that's the case."

Even when homework is helpful, there can be too much of a good thing. "There is a limit to how much kids can benefit from home study," Cooper says. He agrees with an oft-cited rule of thumb that students should do no more than 10 minutes a night per grade level — from about 10 minutes in first grade up to a maximum of about two hours in high school. Both the National Education Association and National Parent Teacher Association support that limit.

Beyond that point, kids don't absorb much useful information, Cooper says. In fact, too much homework can do more harm than good. Researchers have cited drawbacks, including boredom and burnout toward academic material, less time for family and extracurricular activities, lack of sleep and increased stress.

In a recent study of Spanish students, Rubén Fernández-Alonso, PhD, and colleagues found that students who were regularly assigned math and science homework scored higher on standardized tests. But when kids reported having more than 90 to 100 minutes of homework per day, scores declined ( Journal of Educational Psychology , 2015).

"At all grade levels, doing other things after school can have positive effects," Cooper says. "To the extent that homework denies access to other leisure and community activities, it's not serving the child's best interest."

Children of all ages need down time in order to thrive, says Denise Pope, PhD, a professor of education at Stanford University and a co-founder of Challenge Success, a program that partners with secondary schools to implement policies that improve students' academic engagement and well-being.

"Little kids and big kids need unstructured time for play each day," she says. Certainly, time for physical activity is important for kids' health and well-being. But even time spent on social media can help give busy kids' brains a break, she says.

All over the map

But are teachers sticking to the 10-minute rule? Studies attempting to quantify time spent on homework are all over the map, in part because of wide variations in methodology, Pope says.

A 2014 report by the Brookings Institution examined the question of homework, comparing data from a variety of sources. That report cited findings from a 2012 survey of first-year college students in which 38.4 percent reported spending six hours or more per week on homework during their last year of high school. That was down from 49.5 percent in 1986 ( The Brown Center Report on American Education , 2014).

The Brookings report also explored survey data from the National Assessment of Educational Progress, which asked 9-, 13- and 17-year-old students how much homework they'd done the previous night. They found that between 1984 and 2012, there was a slight increase in homework for 9-year-olds, but homework amounts for 13- and 17-year-olds stayed roughly the same, or even decreased slightly.

Yet other evidence suggests that some kids might be taking home much more work than they can handle. Robert Pressman, PhD, and colleagues recently investigated the 10-minute rule among more than 1,100 students, and found that elementary-school kids were receiving up to three times as much homework as recommended. As homework load increased, so did family stress, the researchers found ( American Journal of Family Therapy , 2015).

Many high school students also seem to be exceeding the recommended amounts of homework. Pope and Galloway recently surveyed more than 4,300 students from 10 high-achieving high schools. Students reported bringing home an average of just over three hours of homework nightly ( Journal of Experiential Education , 2013).

On the positive side, students who spent more time on homework in that study did report being more behaviorally engaged in school — for instance, giving more effort and paying more attention in class, Galloway says. But they were not more invested in the homework itself. They also reported greater academic stress and less time to balance family, friends and extracurricular activities. They experienced more physical health problems as well, such as headaches, stomach troubles and sleep deprivation. "Three hours per night is too much," Galloway says.

In the high-achieving schools Pope and Galloway studied, more than 90 percent of the students go on to college. There's often intense pressure to succeed academically, from both parents and peers. On top of that, kids in these communities are often overloaded with extracurricular activities, including sports and clubs. "They're very busy," Pope says. "Some kids have up to 40 hours a week — a full-time job's worth — of extracurricular activities." And homework is yet one more commitment on top of all the others.

"Homework has perennially acted as a source of stress for students, so that piece of it is not new," Galloway says. "But especially in upper-middle-class communities, where the focus is on getting ahead, I think the pressure on students has been ratcheted up."

Yet homework can be a problem at the other end of the socioeconomic spectrum as well. Kids from wealthier homes are more likely to have resources such as computers, Internet connections, dedicated areas to do schoolwork and parents who tend to be more educated and more available to help them with tricky assignments. Kids from disadvantaged homes are more likely to work at afterschool jobs, or to be home without supervision in the evenings while their parents work multiple jobs, says Lea Theodore, PhD, a professor of school psychology at the College of William and Mary in Williamsburg, Virginia. They are less likely to have computers or a quiet place to do homework in peace.

"Homework can highlight those inequities," she says.

Quantity vs. quality

One point researchers agree on is that for all students, homework quality matters. But too many kids are feeling a lack of engagement with their take-home assignments, many experts say. In Pope and Galloway's research, only 20 percent to 30 percent of students said they felt their homework was useful or meaningful.

"Students are assigned a lot of busywork. They're naming it as a primary stressor, but they don't feel it's supporting their learning," Galloway says.

"Homework that's busywork is not good for anyone," Cooper agrees. Still, he says, different subjects call for different kinds of assignments. "Things like vocabulary and spelling are learned through practice. Other kinds of courses require more integration of material and drawing on different skills."

But critics say those skills can be developed with many fewer hours of homework each week. Why assign 50 math problems, Pope asks, when 10 would be just as constructive? One Advanced Placement biology teacher she worked with through Challenge Success experimented with cutting his homework assignments by a third, and then by half. "Test scores didn't go down," she says. "You can have a rigorous course and not have a crazy homework load."

Still, changing the culture of homework won't be easy. Teachers-to-be get little instruction in homework during their training, Pope says. And despite some vocal parents arguing that kids bring home too much homework, many others get nervous if they think their child doesn't have enough. "Teachers feel pressured to give homework because parents expect it to come home," says Galloway. "When it doesn't, there's this idea that the school might not be doing its job."

Galloway argues teachers and school administrators need to set clear goals when it comes to homework — and parents and students should be in on the discussion, too. "It should be a broader conversation within the community, asking what's the purpose of homework? Why are we giving it? Who is it serving? Who is it not serving?"

Until schools and communities agree to take a hard look at those questions, those backpacks full of take-home assignments will probably keep stirring up more feelings than facts.

Further reading

  • Cooper, H., Robinson, J. C., & Patall, E. A. (2006). Does homework improve academic achievement? A synthesis of research, 1987-2003. Review of Educational Research, 76 (1), 1–62. doi: 10.3102/00346543076001001
  • Galloway, M., Connor, J., & Pope, D. (2013). Nonacademic effects of homework in privileged, high-performing high schools. The Journal of Experimental Education, 81 (4), 490–510. doi: 10.1080/00220973.2012.745469
  • Pope, D., Brown, M., & Miles, S. (2015). Overloaded and underprepared: Strategies for stronger schools and healthy, successful kids . San Francisco, CA: Jossey-Bass.

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Homework as a Mental Health Concern It's time for an in depth discussion about homework as a major concern for those pursuing mental health in schools. So many problems between kids and their families, the home and school, and students and teachers arise from conflicts over homework. The topic is a long standing concern for mental health practitioners, especially those who work in schools. Over the years, we have tried to emphasize the idea that schools need to ensure that homework is designed as "motivated practice," and parents need to avoid turning homework into a battleground. These views are embedded in many of the Center documents. At this time, we hope you will join in a discussion of what problems you see arising related to homework and what you recommend as ways to deal with such problems, what positive homework practices you know about, and so forth. Read the material that follows, and then, let us hear from you on this topic. Contact: [email protected] ######################### As one stimulus, here's a piece by Sharon Cromwell from Education World prepared for teachers " The Homework Dilemma: How Much Should Parents Get Involved? " http://www.education-world.com/a_curr/curr053.shtml . What can teachers do to help parents help their children with homework? Just what kind of parental involvement -- and how much involvement -- truly helps children with their homework? The most useful stance parents can take, many experts agree, is to be somewhat but not overly involved in homework. The emphasis needs to be on parents' helping children do their homework themselves -- not on doing it for them. In an Instructor magazine article, How to Make Parents Your Homework Partner s, study-skills consultant Judy Dodge maintains that involving students in homework is largely the teacher's job, yet parents can help by "creating a home environment that's conducive to kids getting their homework done." Children who spend more time on homework, on average, do better academically than children who don't, and the academic benefits of homework increase in the upper grades, according to Helping Your Child With Homework , a handbook by the Office of Education Research and Improvement in the U.S. Department of Education. The handbook offers ideas for helping children finish homework assignments successfully and answers questions that parents and people who care for elementary and junior high school students often ask about homework. One of the Goals 2000 goals involves the parent/school relationship. The goal reads, "Every school will promote partnerships that will increase parental involvement and participation in promoting the social, emotional, and academic growth of children." Teachers can pursue the goal, in part, by communicating to parents their reasons for assigning homework. For example, the handbook states, homework can help children to review and practice what they have learned; prepare for the next day's class; use resources, such as libraries and reference materials; investigate topics more fully than time allows in the classroom. Parents can help children excel at homework by setting a regular time; choosing a place; removing distractions; having supplies and resources on hand; monitoring assignments; and providing guidance. The handbook cautions against actually doing the homework for a child, but talking about the assignment so the child can figure out what needs to be done is OK. And reviewing a completed assignment with a child can also be helpful. The kind of help that works best depends, of course, partly on the child's age. Elementary school students who are doing homework for the first time may need more direct involvement than older students. HOMEWORK "TIPS" Specific methods have been developed for encouraging the optimal parental involvement in homework. TIPS (Teachers Involve Parents in Schoolwork) Interactive Homework process was designed by researchers at Johns Hopkins University and teachers in Maryland, Virginia, and the District of Columbia to meet parents' and teachers' needs, says the Phi Delta Kappa Research Bulletin . The September 1997 bulletin reported the effects of TIPS-Language Arts on middle-grade students' writing skills, language arts report card grades, and attitudes toward TIPS as well as parents' reactions to interactive homework. TIPS interactive homework assignments involve students in demonstrating or discussing homework with a family member. Parents are asked to monitor, interact, and support their children. They are not required to read or direct the students' assignments because that is the students' responsibility. All TIPS homework has a section for home-to-school communication where parents indicate their interaction with the student about the homework. The goals of the TIPS process are for parents to gain knowledge about their children's school work, students to gain mastery in academic subjects by enhancing school lessons at home, and teachers to have an understanding of the parental contribution to student learning. "TIPS" RESULTS Nearly all parents involved in the TIPS program said TIPS provided them with information about what their children were studying in school. About 90 percent of the parents wanted the school to continue TIPS the following year. More than 80 percent of the families liked the TIPS process (44 percent a lot; 36% a little). TIPS activities were better than regular homework, according to 60 percent of the students who participated. About 70 percent wanted the school to use TIPS the next year. According to Phi Delta Kappa Research Bulletin , more family involvement helped students' writing skills increase, even when prior writing skills were taken into account. And completing more TIPS assignments improved students' language arts grades on report cards, even after prior report card grades and attendance were taken into account. Of the eight teachers involved, six liked the TIPS process and intended to go on using it without help or supplies from the researchers. Furthermore, seven of the eight teachers said TIPS "helps families see what their children are learning in class." OTHER TIPS In "How to Make Parents Your Homework Partners," Judy Dodge suggests that teachers begin giving parent workshops to provide practical tips for "winning the homework battle." At the workshop, teachers should focus on three key study skills: Organizational skills -- Help put students in control of work and to feel sure that they can master what they need to learn and do. Parents can, for example, help students find a "steady study spot" with the materials they need at hand. Time-management skills -- Enable students to complete work without feeling too much pressure and to have free time. By working with students to set a definite study time, for example, parents can help with time management. Active study strategies -- Help students to achieve better outcomes from studying. Parents suggest, for instance, that students write questions they think will be on a test and then recite their answers out loud. Related Resources Homework Without Tears by Lee Canter and Lee Hauser (Perennial Library, 1987). A down-to-earth book by well-known experts suggests how to deal with specific homework problems. Megaskills: How Families Can Help Children Succeed in School and Beyond by Dorothy Rich (Houghton Mifflin Company, 1992). Families can help children develop skills that nurture success in and out of school. "Helping Your Student Get the Most Out of Homework" by the National PTA and the National Education Association (1995). This booklet for teachers to use with students is sold in packages of 25 through the National PTA. The Catalog item is #B307. Call 312-549-3253 or write National PTA Orders, 135 South LaSalle Street, Dept. 1860, Chicago, IL 60674-1860. Related Sites A cornucopia of homework help is available for children who use a computer or whose parents are willing to help them get started online. The following LINKS include Internet sites that can be used for reference, research, and overall resources for both homework and schoolwork. Dr. Internet. The Dr. Internet Web site, part of the Internet Public Library, helps students with science and math homework or projects. It includes a science project resource guide Help With Homework. His extensive listing of Internet links is divided into Language Art Links, Science Links, Social Studies Links, Homework Help, Kids Education, and Universities. If students know what they are looking for, the site could be invaluable. Kidz-Net... Links to places where you can get help with homework. An array of homework help links is offered here, from Ask Dr. Math (which provides answers to math questions) to Roget's Thesaurus and the White House. Surfing the Net With Kids: Got Questions? Links to people -- such as teachers, librarians, experts, authors, and other students -- who will help students with questions about homework. Barbara J. Feldman put together the links. Kidsurfer: For Kids and Teens The site, from the National Children's Coalition, includes a Homework/Reference section for many subjects, including science, geography, music, history, and language arts. Homework: Parents' Work, Kid's Work, or School Work? A quick search of this title in the Education Week Archives and you'll find an article presenting a parent's viewpoint on helping children with homework. @#@#@#@@# As another stimulus for the discussion, here is an excerpt from our online continuing education module Enhancing Classroom Approaches for Addressing Barriers to Learning ( https://smhp.psych.ucla.edu ) Turning Homework into Motivated Practice Most of us have had the experience of wanting to be good at something such as playing a musical instrument or participating in a sport. What we found out was that becoming good at it meant a great deal of practice, and the practicing often was not very much fun. In the face of this fact, many of us turned to other pursuits. In some cases, individuals were compelled by their parents to labor on, and many of these sufferers grew to dislike the activity. (A few, of course, commend their parents for pushing them, but be assured these are a small minority. Ask your friends who were compelled to practice the piano.) Becoming good at reading, mathematics, writing, and other academic pursuits requires practice outside the classroom. This, of course, is called homework. Properly designed, homework can benefit students. Inappropriately designed homework, however, can lead to avoidance, parent-child conflicts, teacher reproval, and student dislike of various arenas of learning. Well-designed homework involves assignments that emphasize motivated practice. As with all learning processes that engage students, motivated practice requires designing activities that the student perceives as worthwhile and doable with an appropriate amount of effort. In effect, the intent is to personalize in-class practice and homework. This does not mean every student has a different practice activity. Teachers quickly learn what their students find engaging and can provide three or four practice options that will be effective for most students in a class. The idea of motivated practice is not without its critics. I don't doubt that students would prefer an approach to homework that emphasized motivated practice. But �� that's not preparing them properly for the real world. People need to work even when it isn't fun, and most of the time work isn't fun. Also, if a person wants to be good at something, they need to practice it day in and day out, and that's not fun! In the end, won't all this emphasis on motivation spoil people so that they won't want to work unless it's personally relevant and interesting? We believe that a great deal of learning and practice activities can be enjoyable. But even if they are not, they can be motivating if they are viewed as worthwhile and experienced as satisfying. At the same time, we do recognize that there are many things people have to do in their lives that will not be viewed and experienced in a positive way. How we all learn to put up with such circumstances is an interesting question, but one for which psychologists have yet to find a satisfactory answer. It is doubtful, however, that people have to experience the learning and practice of basic knowledge and skills as drudgery in order to learn to tolerate boring situations. Also in response to critics of motivated practice, there is the reality that many students do not master what they have been learning because they do not pursue the necessary practice activities. Thus, at least for such individuals, it seems essential to facilitate motivated practice. Minimally, facilitating motivated practice requires establishing a variety of task options that are potentially challenging -- neither too easy nor too hard. However, as we have stressed, the processes by which tasks are chosen must lead to perceptions on the part of the learner that practice activities, task outcomes, or both are worthwhile -- especially as potential sources of personal satisfaction. The examples in the following exhibit illustrate ways in which activities can be varied to provide for motivated learning and practice. Because most people have experienced a variety of reading and writing activities, the focus here is on other types of activity. Students can be encouraged to pursue such activity with classsmates and/or family members. Friends with common interests can provide positive models and support that can enhance productivity and even creativity. Research on motivation indicates that one of the most powerful factors keeping a person on a task is the expectation of feeling some sense of satisfaction when the task is completed. For example, task persistence results from the expectation that one will feel smart or competent while performing the task or at least will feel that way after the skill is mastered. Within some limits, the stronger the sense of potential outcome satisfaction, the more likely practice will be pursued even when the practice activities are rather dull. The weaker the sense of potential outcome satisfaction, the more the practice activities themselves need to be positively motivating. Exhibit � Homework and Motivated Practice Learning and practicing by (1) doing using movement and manipulation of objects to explore a topic (e.g., using coins to learn to add and subtract) dramatization of events (e.g., historical, current) role playing and simulations (e.g., learning about democratic vs. autocratic government by trying different models in class; learning about contemporary life and finances by living on a budget) actual interactions (e.g., learning about human psychology through analysis of daily behavior) applied activities (e.g., school newspapers, film and video productions, band, sports) actual work experience (e.g., on-the-job learning) (2) listening reading to students (e.g., to enhance their valuing of literature) audio media (e.g., tapes, records, and radio presentations of music, stories, events) listening games and activities (e.g., Simon Says; imitating rhymes, rhythms, and animal sounds) analyzing actual oral material (e.g., learning to detect details and ideas in advertisements or propaganda presented on radio or television, learning to identify feelings and motives underlying statements of others) (3) looking directly observing experts, role models, and demonstrations visual media visual games and activities (e.g., puzzles, reproducing designs, map activities) analyzing actual visual material (e.g., learning to find and identify ideas observed in daily events) (4) asking information gathering (e.g., investigative reporting, interviewing, and opinion sampling at school and in the community) brainstorming answers to current problems and puzzling questions inquiry learning (e.g., learning social studies and science by identifying puzzling questions, formulating hypotheses, gathering and interpreting information, generalizing answers, and raising new questions) question-and-answer games and activities (e.g., twenty questions, provocative and confrontational questions) questioning everyday events (e.g., learning about a topic by asking people about how it effects their lives) O.K. That's should be enough to get you going. What's your take on all this? What do you think we all should be telling teachers and parents about homework? Let us hear from you ( [email protected] ). Back to Hot Topic Home Page Hot Topic Home Page --> Table of Contents Home Page Search Send Us Email School Mental Health Project-UCLA Center for Mental Health in Schools WebMaster: Perry Nelson ([email protected])

Opinion | Social-Emotional Learning

If we’re serious about student well-being, we must change the systems students learn in, here are five steps high schools can take to support students' mental health., by tim klein and belle liang     oct 14, 2022.

If We’re Serious About Student Well-Being, We Must Change the Systems Students Learn In

Shutterstock / SvetaZi

This article is part of the collection: Making Sense of K-12 Student Mental Health.

Educators and parents started this school year with bated breath. Last year’s stress led to record levels of teacher burnout and mental health challenges for students.

Even before the pandemic, a mental health crisis among high schoolers loomed. According to a survey administered by the Centers for Disease Control and Prevention in 2019, 37 percent of high school students said they experienced persistent sadness or hopelessness and 19 percent reported suicidality. In response, more than half of all U.S. states mandated that schools have a mental health curriculum or include mental health in their standards .

As mental health professionals and co-authors of a book about the pressure and stress facing high school students, we’ve spent our entire careers supporting students’ mental health. Traditionally, mental health interventions are individualized and they focus on helping students manage and change their behaviors to cope with challenges they’re facing. But while working with schools and colleges across the globe as we conducted research for our book , we realized that most interventions don’t address systemic issues causing mental health problems in the first place.

It’s time we acknowledge that our education systems are directly contributing to the youth mental health crisis. And if we are serious about student well-being, we must change the systems they learn in.

Here are five bold steps that high schools can take to boost mental health.

Limit Homework or Make it Optional

Imagine applying for a job, and the hiring manager informs you that in addition to a full workday in the office, you’ll be assigned three more hours of work every night. Does this sound like a healthy work-life balance? Most adults would consider this expectation ridiculous and unsustainable. Yet, this is the workload most schools place on high school students.

Research shows that excessive homework leads to increased stress, physical health problems and a lack of balance in students' lives. And studies have shown that more than two hours of daily homework can be counterproductive , yet many teachers assign more.

Homework proponents argue that homework improves academic performance. Indeed, a meta-analysis of research on this issue found a correlation between homework and achievement. But correlation isn’t causation. Does homework cause achievement or do high achievers do more homework? While it’s likely that homework completion signals student engagement, which in turn leads to academic achievement, there’s little evidence to suggest that homework itself improves engagement in learning.

Another common argument is that homework helps students develop skills related to problem-solving, time-management and self-direction. But these skills can be explicitly taught during the school day rather than after school.

Limiting homework or moving to an optional homework policy not only supports student well-being, but it can also create a more equitable learning environment. According to the American Psychological Association, students from more affluent families are more likely to have access to resources such as devices, internet, dedicated work space and the support necessary to complete their work successfully—and homework can highlight those inequities .

Whether a school limits homework or makes it optional, it’s critical to remember that more important than the amount of homework assigned, is designing the type of activities that engage students in learning. When students are intrinsically motivated to do their homework, they are more engaged in the work, which in turn is associated with academic achievement.

Cap the Number of APs Students Can Take

Advanced Placement courses give students a taste of college-level work and, in theory, allow them to earn college credits early. Getting good grades on AP exams is associated with higher GPAs in high school and success in college, but the research tends to be correlational rather than causational.

In 2008, a little over 180,000 students took three or more AP exams. By 2018, that number had ballooned to almost 350,000 students .

However, this expansion has come at the expense of student well-being.

Over the years, we’ve heard many students express that they feel pressure to take as many AP classes as possible, which overloads them with work. That’s troubling because studies show that students who take AP classes and exams are twice as likely to report adverse physical and emotional health .

AP courses and exams also raise complex issues of equity. In 2019, two out of three Harvard freshmen reported taking AP Calculus in high school, according to Jeff Selingo, author of “ Who Gets In and Why: A Year Inside College Admissions ,” yet only half of all high schools in the country offer the course. And opportunity gaps exist for advanced coursework such as AP courses and dual enrollment, with inequitable distribution of funding and support impacting which students are enrolling and experiencing success. According to the Center for American Progress, “National data from the Civil Rights Data Collection show that students who are Black, Indigenous, and other non-Black people of color (BIPOC) are not enrolled in AP courses at rates comparable to their white and Asian peers and experience less success when they are—and the analysis for this report finds this to be true even when they attend schools with similar levels of AP course availability.”

Limiting the number of AP courses students take can protect mental health and create a more equitable experience for students.

Eliminate Class Rankings

In a study we conducted about mental health problems among high school girls, we found that a primary driver of stress was their perception of school as a hypercompetitive, zero-sum game where pervasive peer pressure to perform reigns supreme.

Class rankings fuel these cutthroat environments. They send a toxic message to young people: success requires doing better than your peers.

Ranking systems help highly selective colleges decide which students to admit or reject for admission. The purpose of high school is to develop students to their own full potential, rather than causing them to fixate on measuring up to others. Research shows that ranking systems undercut students’ learning and damage social relationships by turning peers into opponents.

Eliminating class rankings sends a powerful message to students that they are more than a number.

Become an Admission Test Objector

COVID-19 ushered in the era of test-optional admissions. De-centering standardized tests in the college application process is unequivocally a good thing. Standardized tests don’t predict student success in college , they only widen the achievement gap between privileged and underprivileged students and damage students' mental health .

Going “test optional” is an excellent first step, but it's not enough.

Even as more colleges have made tests optional, affluent students submit test scores at a higher rate than their lower-income peers and are admitted at higher rates , suggesting that testing still gives them an edge.

High schools must adhere to standardized test mandates, but they don’t have to endorse them. They can become test objectors by publicly proclaiming that these tests hold no inherent value. They can stop teaching to the test and educate parents on why they are doing so. Counseling departments can inform colleges that their school is a test objector so admission teams won’t penalize students.

Of course, students and families will still find ways to wield these tests as a competitive advantage. Over time, the more schools and educators unite to denounce these tests, the less power they will hold over students and families.

Big change starts with small steps.

Stand For What You Value

Critics may argue that such policies might hurt student outcomes. How will colleges evaluate school rigor if we limit AP courses and homework? How will students demonstrate their merits without class rankings and standardized test scores?

The truth is, the best school systems in the world succeed without homework, standardized test scores or an obsession with rigorous courses. And many U.S. schools have found creative and empowering ways to showcase student merit beyond rankings and test scores.

If we aren’t willing to change policies and practices that have been shown to harm students’ well-being, we have to ask ourselves: Do we really value mental health?

Thankfully, it doesn’t have to be an either/or scenario: We can design school systems that help students thrive academically and psychologically.

Belle Liang and Tim Klein are mental health professionals and co-authors of “How To Navigate Life: The New Science of Finding Your Way in School, Career and Life.”

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Barriers Associated with the Implementation of Homework in Youth Mental Health Treatment and Potential Mobile Health Solutions

Brian e. bunnell.

1 Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA

2 Biomedical Informatics Center, College of Medicine, Medical University of South Carolina, Charleston, SC, USA

Lynne S. Nemeth

3 Department of Nursing, College of Nursing, Medical University of South Carolina, Charleston, SC, USA

Leslie A. Lenert

Nikolaos kazantzis.

4 Cognitive Behavior Therapy Research Unit and School of Psychological Sciences, Monash University, Clayton, VIC, Australia

Esther Deblinger

5 Child Abuse Research Education & Service (CARES) Institute, Rowan University School of Osteopathic Medicine, Stratford, New Jersey, USA

Kristen A. Higgins

Kenneth j. ruggiero.

6 Technology Applications Center for Healthful Lifestyles, College of Nursing, Medical University of South Carolina, Charleston, SC, USA

Author Contributions

Associated Data

Background:.

Homework, or between-session practice of skills learned during therapy, is integral to effective youth mental health TREATMENTS. However, homework is often under-utilized by providers and patients due to many barriers, which might be mitigated via m Health solutions.

Semi-structured qualitative interviews were conducted with nationally certified trainers in Trauma Focused Cognitive Behavioral Therapy (TF-CBT; n =21) and youth TF-CBT patients ages 8–17 ( n =15) and their caregivers ( n =12) to examine barriers to the successful implementation of homework in youth mental health treatment and potential m Health solutions to those barriers.

The results indicated that many providers struggle to consistently develop, assign, and assess homework exercises with their patients. Patients are often difficult to engage and either avoid or have difficulty remembering to practice exercises, especially given their busy/chaotic home lives. Trainers and families had positive views and useful suggestions for m Health solutions to these barriers in terms of functionality (e.g., reminders, tracking, pre-made homework exercises, rewards) and user interface (e.g., easy navigation, clear instructions, engaging activities).

Conclusions:

This study adds to the literature on homework barriers and potential m Health solutions to those barriers, which is largely based on recommendations from experts in the field. The results aligned well with this literature, providing additional support for existing recommendations, particularly as they relate to treatment with youth and caregivers.

Introduction

Homework, or between-session practice of skills learned during therapy, is one of the most integral, yet underutilized components of high-quality, evidence-based mental health care ( Kazantzis & Deane, 1999 ). Homework activities (e.g., self-monitoring, relaxation, exposure, parent behavior management) are assigned by providers in-session and completed by patients between sessions with the goal of “practicing” therapeutic skills in the environment where they will be most needed ( Kazantzis, Deane, Ronan, & L’Abate, 2005 ). There are numerous benefits to the implementation of homework during mental health treatment ( Kazantzis et al., 2016 ; Kazantzis, Deane, & Ronan, 2004 ). Homework enables the generalization of skills and behaviors learned during therapy, facilitates treatment processes, provides continuity between sessions, allows providers to better grasp patients’ learning, and strengthens that learning, leading to improved maintenance of treatment gains ( Hudson & Kendall, 2002 ; Scheel, Hanson, & Razzhavaikina, 2004 ). Meta-analytic and systematic reviews have shown that homework use by providers and adherence by patients predict increased treatment engagement, decreased treatment dropout, and medium-to-large effects on improvements in clinical outcomes for use (Cohen’s d =.48–.77) and adherence ( d =.45–.54) ( Hudson & Kendall, 2002 ; Kazantzis, Deane, & Ronan, 2000 ; Kazantzis & Lampropoulos, 2002 ; Kazantzis, Whittington, & Dattilio, 2010 ; Mausbach, Moore, Roesch, Cardenas, & Patterson, 2010 ; Scheel et al., 2004 ; Sukhodolsky, Kassinove, & Gorman, 2004 ). Simply put, 68% vs . 32% of patients can be expected to improve when therapy involves homework ( Kazantzis et al., 2010 ).

Despite its many benefits, homework is implemented with variable effectiveness in mental health treatment. Only 68% of general mental health providers and ~55% of family providers report using homework “often” to “almost always” ( Dattilio, Kazantzis, Shinkfield, & Carr, 2011 ; Kazantzis, Lampropoulos, & Deane, 2005 ). Further, providers report using homework in an average of 57% of sessions, although this rate is higher for CBT practitioners (66%) vs . non-CBT practitioners (48%). Moreover, only 25% of providers report using expert recommended systematic procedures for recommending homework (i.e., specifying frequency, duration, and location; writing down homework assignments for patients) ( Kazantzis & Deane, 1999 ). A national survey revealed that 93% or general mental health providers estimate rates of patient adherence to homework to be low to moderate ( Kazantzis, Lampropoulos, et al., 2005 ), and research studies report low to moderate rates of youth/caregiver adherence during treatment (i.e., ~39–63%; ( Berkovits, O’Brien, Carter, & Eyberg, 2010 ; Clarke et al., 1992 ; Danko, Brown, Van Schoick, & Budd, 2016 ; Dattilio et al., 2011 ; Gaynor, Lawrence, & Nelson-Gray, 2006 ; Helbig & Fehm, 2004 ; Lyon & Budd, 2010 ; Simons et al., 2012 ).

Numerous barriers to the successful implementation of homework during mental health treatment have largely been suggested by experts in the field, rather than specifically measured ( Dattilio et al., 2011 ), and have generally been classified as occurring on the provider-, patient-, task-, and environmental-level ( Kazantzis & Shinkfield, 2007 ). Provider-level barriers can relate to the therapeutic relationship and the degree to which a collaborative approach is used, provider beliefs about homework and the patient’s adherence, and providers’ ability to effectively design homework tasks ( Callan et al., 2012 ; Coon, Rabinowitz, Thompson, & Gallagher-Thompson, 2005 ; Friedberg & Mcclure, 2005 ; Garland & Scott, 2002 ; Kazantzis & Shinkfield, 2007 ). Patient-level barriers can include patient avoidance and symptomatology, negative beliefs toward the task, not understanding the rationale or how to do the task, forgetting, and beliefs about their ability to complete homework tasks. ( Bru, Solholm, & Idsoe, 2013 ; Callan et al., 2012 ; Dattilio et al., 2011 ; Friedberg & Mcclure, 2005 ; Garland & Scott, 2002 ; Hudson & Kendall, 2005 ; Kazantzis & Shinkfield, 2007 ; Leahy, 2002 ). Relatedly, core beliefs central to the patients’ psychopathology can be activated during homework–thereby triggering withdrawal and avoidance patterns ( Kazantzis & Shinkfield, 2007 ). Task-level barriers include poor match between tasks and therapy goals, tasks that are perceived as vague or unclear, tasks that are perceived as too difficult or demanding in terms of time or effort, tasks being viewed as boring, and general aversiveness of the idea of completing homework ( Bru et al., 2013 ; Callan et al., 2012 ; Dattilio et al., 2011 ; Friedberg & Mcclure, 2005 ; Garland & Scott, 2002 ; Hudson & Kendall, 2005 ). Environmental factors have been noted to include practical obstacles, lack of family/caregiver support, dysfunctional home environments, lack of time due to busy schedules, and lack of reward or reinforcement ( Callan et al., 2012 ; Dattilio et al., 2011 ; Hudson & Kendall, 2005 ).

The advancement and ubiquitousness of technologies such as m Health resources (e.g., mobile- and web-based apps) provide a tremendous opportunity to overcome barriers to homework use and adherence and resultantly, improve the quality of mental health treatment. m Health solutions to improve access and quality of care, have been widely investigated, are effective in facilitating behavior change, practical, desired by patients and providers, and available at low cost ( Amstadter, Broman-Fulks, Zinzow, Ruggiero, & Cercone, 2009 ; Boschen & Casey, 2008 ; Donker et al., 2013 ; Ehrenreich, Righter, Rocke, Dixon, & Himelhoch, 2011 ; Hanson et al., 2014 ; Heron & Smyth, 2010 ; Krebs & Duncan, 2015 ; Luxton, McCann, Bush, Mishkind, & Reger, 2011 ; Ruggiero, Saunders, Davidson, Cook, & Hanson, 2017 ). Existing m Health resources include features that can support homework implementation (e.g., voice and SMS reminders and feedback, self-monitoring and assessment, and modules and activities that can be used to facilitate between-session practice; Bakker, Kazantzis, Rickwood, & Rickard, 2016 ; Tang & Kreindler, 2017 ), but these resources were not designed with the express intention of addressing barriers to homework implementation, particularly for youth and family patient populations.

The extant literature on barriers to homework implementation is limited in that it is largely based on expert recommendations. Therefore, the first aim of this study was to explore provider, youth, and caregiver patient perspectives on barriers to the successful implementation of homework during youth mental health treatment. Further, m Health solutions to those barriers have not been explored, especially for youth and family patients. Thus, the second and third aims of this study were to obtain suggestions for m Health solutions to homework barriers and explore perceptions on the benefits and challenges associated with those m Health solutions.

Institutional Review Board approval was obtained prior to enrolling any participants in the study. The approach for this study was based on the constructivist grounded theory, which acknowledges the researcher’s prior knowledge and influence in the process and supports and guides conceptual framework development to understand interrelations between constructs ( Charmaz, 2006 ). This qualitative study used a thematic analysis of semi-structured interviews in a sample of nationally certified trainers in Trauma-Focused Cognitive Behavioral Therapy (TFCBT; Cohen, Mannarino, & Deblinger, 2017 ), youth who had engaged in TF-CBT, and their caregivers. The initial goal was to conduct interviews with 15–20 interviewees in each group to achieve theoretical saturation (i.e., no new information was derived), consistent with a prior study by members of the research team which used similar semi-structured interviews with national TF-CBT trainers ( Hanson et al., 2014 ), and recommendations by Morse (2000) given the relatively narrow scope and clear nature of the study. Interviews were conducted until interviewers and the study lead determined that no new pertinent information was being obtained.

Participants

National trainers..

Twenty-one national trainers in TF-CBT were interviewed. National trainers are mental health providers who completed a 15-month TF-CBT Train-the-Trainer program led by the TF-CBT developers. Trainers work extensively with numerous community mental health providers to problem-solve common barriers to clinical practice and thus, provide a unique perspective on the barriers to successful homework implementation and possible m Health solutions to those barriers. An e-mail invitation was sent to a list of approved TF-CBT trainers. Twenty-four trainers responded to this e-mail, 22 of whom agreed to participate in an interview, one of whom was unreachable after initial scheduling. Interviews were completed with a total of 21 trainers, who received a $25 gift card in compensation for their time.

Trainers had been treating children for an average of 23.29 years ( SD =8.80) and had been training providers for an average of 14.95 years ( SD =8.98). In the year prior to the interview, they led an average of 17 provider trainings ( SD =21.67) and trained roughly 345 providers ( SD =339.90). All trainers were licensed, and the majority were Clinical Psychologists (47.6%) and Social Workers (33.3%). The average age of trainers was 47.48 years ( SD =13.63) and the majority were female (71.4%), white (95.2%), and non-Hispanic/Latino (85.7%; see Table 1 ).

Trainer Demographics

VariableMSD
Age47.4813.63
Years Treating Children23.298.80
Years Training Providers14.958.98
Workshops in Past Year17.0021.67
Providers Trained in Past Year345.52339.90
Estimated % of Providers Experiencing Difficulty with Homework76.40%17.10%
Sex
 Female1571.4
 Male628.6
Race
 White2095.2
 Asian14.8
Ethnicity
 Non-Hispanic/Latino1885.7
 Hispanic/Latino314.3
Discipline
 Physician (MD)14.8
 Clinical Psychologist (PhD, PsyD)1047.6
 Counselor (LPC)14.8
 Social Worker (LCSW, MSW)733.3
 Other29.5
Currently Licensed21100.0

Twelve families were interviewed for this study. Families were included if they had one or more youth between the ages of 8 and 17 years-of-age and a caregiver who had engaged in at least four sessions for TF-CBT. These criteria were chosen because TF-CBT is typically recommended for youth between the ages of 8 and 17 years-of-age and it was estimated that four sessions would have likely allowed for adequate time for patients to have received homework assignments, consistent with the authors’ experience and prior TF-CBT literature ( Deblinger, Pollio, & Dorsey, 2016 ; Scheeringa, Weems, Cohen, Amaya-Jackson, & Guthrie, 2011 ). Families were recruited via advertisements online and at local community mental health clinics, and from a participant pool from a prior study ( Davidson et al., 2019 ). Twenty-nine families initially expressed interest in participating in the study. Six families were ineligible because they had not received TF-CBT and contact was lost with six families after their initial contact. Seventeen families were scheduled for an interview, five of which were unreachable after initially being scheduled, and interviews were completed with 12 families. Written informed consent from caregivers and assent from youth above the age of 15 were obtained in-person for four families and via a telemedicine-based teleconsent platform (i.e., https://musc.doxy.me ) for eight families. Families received a $30 gift card in compensation for their time.

A total of 15 youth who had engaged in TF-CBT, and their caregivers ( n =12; three families had two youth who had received treatment) were interviewed. Six youth were still in treatment at the time of their interview and nine had finished treatment an average of 49 weeks ( SD =42.32) prior to the interview. The average age of youth was 13.20 years ( SD =3.19), roughly half were female (53.3%), the majority were white (80%), and all were non-Hispanic/Latino. The average age of caregivers was 44.83 years ( SD =7.90), 66.7% were female, and all were White and non-Hispanic/Latino. Youth and caregivers rated their comfort with technology, in general, on a 10-point Likert scale (i.e., 1–10) with higher scores representing higher levels of comfort. Youth reported being very comfortable with technology (M=9.62, SD =1.12), as did their caregivers (M=7.83, SD =2.63; see Table 2 ).

Family Demographics

VariableYouth =15Caregivers =12
Age13.203.1944.37.90
Time Since Ending Treatment in Weeks 49.0042.32--
Comfort with Technology9.621.127.832.63
Sex
 Female853.3866.7
 Male746.7433.3
Race
 White1280.012100
 Black/African American213.300.0
 Native American/American Indian16.700.0
Ethnicity
 Non-Hispanic/Latino1510012100
 Hispanic/Latino00.000.0
Education
 High School--18.3
 High School--433.3
 Some College--541.7
 College Degree--325.0

Trauma-Focused Cognitive Behavioral Therapy

TF-CBT is a well-established and widely disseminated mental health treatment ( Cohen et al., 2017 ; Deblinger, Mannarino, Cohen, Runyon, & Steer, 2011 ; Silverman et al., 2008 ; Wethington et al., 2008 ). It is a conjoint youth-caregiver mental health treatment typically conducted over ~12, 90-minute sessions that address nine major treatment components (i.e., P sychoeducation; P arenting Skills; R elaxation Skills; A ffective Expression and Modulation Skills; C ognitive Coping and Processing Skills; T rauma Narration and Processing; I n Vivo Exposure; C onjoint Child Parent Activities; and E nhancing Future Safety and Development). TF-CBT also addresses a broad range of symptom domains including trauma- and stress-related disorders, disruptive behavior disorders/behaviors, depression/depressive symptoms, and anxiety disorders ( Cohen et al., 2017 ). TF-CBT was chosen as a model treatment for this study because of its broad symptom focus, inclusion of treatment components used in a variety of youth mental health treatments, and involvement of youth and their caregivers, offering potential to improve the applicability of the study’s results to a range of youth mental health treatment approaches.

Procedures for Data Collection

Interviews were conducted via telephone for trainers, and either in-person or via telephone for families based on their preference. A postdoctoral fellow and masters-level research assistant conducted the interviews, which were audio-recorded and transcribed using a professional transcription service. Interviews included three major components. The first component included demographic questions. The second included a brief orientation to the goal of the study, which was to develop a new technology-based resource to help providers and patients during the implementation of homework during mental health treatment. The third component included questions that aimed to assess perspectives on barriers to homework implementation, elicit suggestions for m Health solutions to those barriers, and examine perceptions on the benefits and challenges associated with m Health solutions to homework barriers. The average duration of interviews was 41 minutes for trainers and 37 minutes for families. See Supplementary Materials for complete interviews.

Data Analysis

Transcribed interviews were coded using NVivo qualitative analysis software. NVivo was used to identify common themes (nodes) as they related to (1) patient-, provider-, task-, and environmental-barriers to homework implementation, (2) suggestions for m Health solutions to homework barriers, and (3) benefits and challenges associated with m Health homework solutions. Initial and secondary coding passes were conducted to identify and refine theme classifications as they emerged and impose a data-derived hierarchy to the nodes identified. Focused coding was used to refine the coding and ensure that data were coded completely with minimal redundancy ( Miles & Huberman, 1994 ). Themes were initially proposed by the first author and reviewed by an expert in qualitative and mixed methods research (the second author) and an internationally recognized expert in the implementation of homework and related barriers during CBT (the fourth author). Divergent perspectives on theme descriptions ( n =2) and classifications ( n =1) were compared until agreement was reached.

Results are organized by the main topics explored in this study, including: 1) barriers to the successful implementation of homework, coded on provider, patient, task, and environmental levels; 2) potential m Health solutions to those homework barriers; and 3) perceived benefits and challenges of those potential m Health solutions. Results within each of these topics are presented first from the perspectives of trainers and second from the perspectives of families.

Barriers to the Successful Implementation of Homework

Trainer perspectives..

As displayed in Table 3 , trainers identified several barriers to homework implementation on the provider-, patient-, task-, and environmental-level.

Trainer Perspectives on Homework Barriers

LevelsThemesNo. of Trainers Raising ThemeNo. of References to Theme
Provider
Difficulty engaging patients and or discouraged by low engagement1523
Don’t see homework as an integral part of therapy or important1417
Don’t know what to assign1214
Forget1113
Too busy or lack of time1118
Don’t know how to effectively assess and assign homework1114
Don’t effectively assess patient barriers1011
Difficulty individualizing homework to specific patients1013
Difficulty with consistency910
Assignments are too difficult or overwhelming69
Don’t want to distress or put too many demands on the patient67
Difficulty planning ahead for homework56
Lack resources45
Patient
Don’t see homework as an integral part of therapy or important1519
Forget56
Don’t understand the rationale55
Patient avoidance or symptoms45
Don’t understand practical implementation (i.e., when, where, and how)44
Task
Homework is an aversive term77
Assignment does not align with patient values or treatment goals712
Environment
Home life is busy and chaotic; no time1517
Lack of caregiver involvement1318
Lack of reward or reinforcement710

Provider-Level Barriers.

Many trainers felt that providers tend to have difficulty engaging patients in assigned tasks, leading some providers to become discouraged by low levels of engagement. As stated by one trainer,

“I think they recognize that [homework assignments] do have value, but in terms of what I feel, a lot of clinicians are not having success with families completing homework, so it’s diminishing the sense of value…something they’ve tried to put into place and they are not feeling there’s any success in it.”

Trainers also noted that many providers do not see homework as an integral part of therapy. One trainer commented,

“I think there are a lot of concrete barriers, but to me probably the biggest barrier will be the–I think that still to this day [providers] like to think that therapy happens in that one hour.”

Other interrelated difficulties faced by providers related to their capacity to effectively and consistently develop, assess, and assign meaningful and patient-centered homework exercises.

As stated by one trainer,

“I see a lot of that just shooting from the hip, kind of off the cuff, ‘let’s do this,’ but yet, it’s not backed by anything concrete or tangible…I think probably one of the biggest pieces again is the failure on the clinician’s part to follow that up and too often review it at the end of the session.”

Another said,

“I think clinicians don’t always appreciate how hard it is to actually do homework that requires you to make some behavioral change.”

Barriers also related to providers’ time and resources for implementing homework, as conveyed by one trainer’s comment,

“I mean, these people…every minute of every day is filled up with doing, billing, writing, charting, going to meetings, getting supervision, and seeing patients, and then they go home exhausted.”

Patient-Level Barriers.

Many trainers stated that, similar to some providers, patients often do not see homework as an important part of therapy. Put by one trainer,

“I think that some [patients] just feel that coming to the session is enough and that should resolve everything, and that you know, doing homework is just kind of an extra thing…I don’t really need to do it to benefit from the therapy.”

Perhaps relatedly, trainers also noted that patients generally forget to do homework assignments, and often forget why, how, when, and where assignments should be done.

Task-Level Barriers.

Task-level barriers noted by trainers included assignments not always aligning with patient values or treatment goals and that the term ‘homework’ being aversive to patients of all ages. One trainer commented,

“I think it has to be something that [patients] see the value in. And again, we go back to that engagement and them trusting you as well as you explaining to them why this could be helpful…If it didn’t help, we need to change it.”

Another trainer laughed while stating,

“when we use the word homework, we might as well just throw a stink bomb in the room.”

Environmental-Level Barriers.

Finally, on the environmental-level, many trainers suggested that patients’ home lives are busy and chaotic, leaving little-to-no time for homework.

Explained by one trainer,

“I think that for parents…they have many other things in their life; work, parenting, partnerships that they are working on, just day to day chores or things that they have to do in terms of their family or other responsibilities. So, [homework] often feels like, I think for families, to add another thing…it just feels like a lot.”

Associated barriers included limited caregiver involvement and reinforcement for completing homework assignments. One trainer commented,

“So, let’s not forget that the parents need to be encouraged and checked on to make sure the kid is doing it. They have to work at it – It’s not going to just happen. So, helping the parents to see that they’re going to need to work to make sure the kids do it, because again, the kids would rather eat ice-cream than do the work. I mean change is hard.”

Another stated,

“I would say, lack of reinforcement for homework, so maybe for getting what you assign for homework and not reviewing it or the kiddo or the family learning pretty quickly, you know, why do it, because there’s not a lot of support around it. You know, if [patients] don’t get reinforced, whether tangibly or verbally, they may not continue that.”

Family Perspectives.

Families identified several barriers to homework implementation on the patient-, task-, and environmental-level which were similar to many of those noted by national trainers (see Table 4 ).

Family Perspectives on Homework Barriers

LevelsThemesNo. of Families Raising ThemeNo. of References to Theme
Patient
Patient avoidance or symptoms1023
Forget914
Don’t understand practical implementation (i.e., when, where, and how)812
Don’t understand the rationale813
Don’t see homework as an integral part of therapy or important55
Disinterested or don’t care45
Task
Assignment is viewed as boring1012
Assignment does not align with patient values or treatment goals33
Paperwork is inconvenient22
Environment
Home life is busy and chaotic; no time1221
Lack of reward or reinforcement77
Lack of caregiver involvement22
Lack of provider enthusiasm22

Families believed that patients often avoid homework as a result of their symptoms. In other words, the patient’s unhelpful coping strategies are being triggered.

One caregiver commented,

“Sometimes people don’t even want to dig into their feelings even to do the assignment either, you know. It stirs up things. You know, when you’re dealing with feelings, sometimes you don’t want to experience that feeling…you shut down. You don’t want to feel that at that time.”
“When you already have a child that has ADHD or behavior problems, it’s hard to get them motivated and to get them to do these exercises at home.”

Families also felt that patients simply forget to complete homework or bring it to their next session. One child stated,

“That’s my problem, she’ll give me homework, we met once a week, basically, and I would forget it because I’ve got a lot going on, and when I come in and she’s like, ‘Did you do your homework,’ I’m like, ‘Oh man’.”

Similar to trainers, families felt that patients often forget why, how, when and where assignments should be done. As stated by one caregiver,

“I think sometimes it can also be just, like maybe not fully understanding what is being asked of them to do. I know the therapist will ask them in the office, ‘do you understand?’ and of course the kids always go, ‘yes I do, can I go home now’?”

With respect to task-level barriers, most families viewed homework assignments as boring. General consensus from families was that patients–particularly youth– would more often than not just rather be doing something more interesting.

On the environmental level, all families noted that the home-life of patients is busy and chaotic, leaving little perceived time for homework. Everyday responsibilities such as schoolwork, employment, household chores, and familial responsibilities often take precedence. One caregiver stated,

“Well I think it sounds good in the office and then you get home and you just get quite busy and it gets pushed aside.”

Another commented,

“But I know what he’s saying…sometimes seven-and-a-half hours at school and then sometimes his therapy would be an hour-and-a-half. And thank goodness, his teacher was so flexible that on days he has therapy he did not have homework [for school], but he was just so emotionally and physically drained. When he got home, all he wanted to do was just rest or play. Because that’s the therapy, it can be just exhausting.”

Families also believed that that there is often a lack of reinforcement for completing homework assignments.

m Health Solutions to Homework Barriers

Trainer suggestions..

Trainers provided several suggestions for m Health solutions to homework barriers ( Table 5 ). Most trainers felt that reminders and schedules to help patients remember to complete homework assignments would be a crucial feature. One trainer suggested, “Maybe some kind of reminder feature, something that would kind of record into their daily calendars that they use, or an alarm, or something like a daily reminder…set to the times they are most likely to do the homework.”

Trainer Suggestions for m Health Solutions to Homework Barriers

ThemesNo. of Trainers Raising ThemeNo. of References to Theme
Reminders and schedules for patients1626
Reports or activity summaries1624
Behavior and symptom tracking1321
Interactive and fun activities1315
Include a variety of homework activities to choose from1214
Easy to use and easy navigation to relevant resources1119
Resources for caregivers and caregiver engagement1120
Patient centered and developmentally appropriate1017
Reward system1022
Reminders and schedules for providers79
Clear instructions on how to do assignments46
Information on rationale for homework23

Trainers also suggested including reports or activity summaries of homework completion along with behavior and symptom tracking tools. One trainer thoughtfully commented, “If the homework app can somehow help to provide some data on the actual implementation of certain skills during the week that would be very valuable because I think the constructive feedback and the positive feedback that’s offered by therapists about performance of those skills between sessions can be really valuable.”

Trainers suggested including a variety of interactive, fun, and rewarding activities that engage children and caregivers. For example, one trainer stated,

“I think the more interactive you can make it between parent and child and the more of a game you can make it…kids are more likely to do that and to kind of use those skills.” All trainers ( n =21) felt that a text message-based system for reminding patients to complete homework assignments would be beneficial.

Family Suggestions.

Families suggested that the main function of the resource should serve to provide reminders (e.g., text messages or push notifications) for patients to complete homework assignments as well as instructions for how and when they should be completed. Another common suggestion was to include a reward system within the resource to reinforce engagement with homework assignments. Some suggestions for this reward system included coins, experience points, levels, and customizable avatar characters. One child thoughtfully related,

“there could be a digital reward system like stars or gems or something. Then it could be redeemed or something in the therapist’s office. Like I remember it was a while ago, I remember my therapist said if I was able to do something that I was having trouble with, we would have like brownies or something the next visit.”

Families also recommended that the resource include interactive and fun activities. The most common suggestion was to “gamify” homework assignments to make them more fun and interesting to patients. For example, a caregiver noted,

“I think that if you are able to play a game or level up after you did your activity…I don’t think you would have a problem with them doing the activity. They would be so excited to be able to play the game.”

Families providers also recommended reports and activity summaries so that progress could be tracked and reported to providers to be reviewed during the next treatment session ( Table 6 ). All families ( n =12) felt that a text message-based system for reminding patients to complete homework assignments would be beneficial.

Family Suggestions for m Health Solutions to Homework Barriers

ThemesNo. of Families Raising ThemeNo. of References to Theme
Built-in reward system1253
Instructions via video, text, audio1228
Reminders and schedules1224
Interactive and fun activities1018
Reports or activity summaries920
Colorful712
Resources for caregivers and caregiver engagement45
Access without internet45

Benefits and Challenges of m Health Solutions to Homework Barriers

The majority of trainers responded that an m Health solution to homework barriers would increase provider use of ( n =20; 95.2%) and family adherence to ( n =21; 100%) homework during mental health treatment. The majority of trainers also responded that such a resource would positively affect the therapeutic relationship ( n =15; 71.4%), increase treatment efficiency ( n =18; 85.7%), and improve treatment effectiveness ( n =18; 85.7%). Neutral responses were provided by all trainers who did not respond affirmatively to these questions (i.e., no negative responses were provided). Trainers also commented on the potential clinical utility of an m Health homework resource in that it would help providers with tracking and assigning homework and patients with skill development while promoting high levels of engagement in youth patients. Access, comfort with technology, and convenience were also noted benefits (See Table 7 ). One trainer commented,

Trainer Perspectives on Benefits and Challenges relating to m Health Solutions to Homework Barriers No. of Trainers

ThemeSub-themesNo. of Trainers Raising ThemeNo. of References to Theme
Clinical utility1321
Youth like technology and would engage with it911
Would help with keeping track of homework34
Will help youth develop skills and maintain treatment gains34
Will help providers with developing and assigning homework22
Access, comfort, convenience914
Most people have mobile phones providing easy access67
Some providers are really good with
technology
55
Having exercises on the phone would be convenient22
Confidentiality issues1315
Access, comfort1226
Some families may not have access to the technology89
Youth access to device might be restricted46
Providers might not have access to the technology33
Some families may not have internet access33
Some providers are not good with technology33
Some caregivers might not feel comfortable with it22
Negative impacts on therapy1011
Might promote social isolation44
It may add to the provider's administrative load33
Providers will still need to use clinical judgement33
Exercises might not fit with provider preferences11
“I feel like so many people now enjoy so much more doing things on electronics and so definitely in sessions with kids I’m often recommending having a clinician use apps…sometimes technology is the way to really hook families in and engage them.”
“You know everybody has a phone and if we can have some apps where…I mean it’s so exciting to me what you are talking about. I can’t think of a better idea, I really can’t. I mean people always have their phones on them even if you are really, really poor, people tend to have a phone.”

Challenges identified by trainers centered around confidentiality, access and comfort with technology, and potential negative impacts on the therapeutic process. For example, one trainer stated,

“I do not know if people worry about if somebody else saw the app and wondered, ‘oh you are in therapy, oh what happened to you?’ So, some things around privacy issues and confidentiality, but those will be pretty easy to fix.”

The majority of families believed that the an m Health homework resource would make practicing therapy skills at home more fun or interesting ( n =11; 91.7%), would help families practice skills more often ( n =12; 100%), would positively affect the therapeutic relationship ( n =12; 100%), and would improve treatment effectiveness ( n =11; 91.7%). Neutral responses were provided by all families who did not respond affirmatively to these questions (i.e., no negative responses were provided). Families also suggested that an m Health homework resource would have excellent clinical utility, helping to improve communication between providers and families, make treatment and homework more rewarding, encourage more engagement from youth One caregiver commented,

“I think it would encourage the kids to get [homework] done even before the parents. The kids would want to do it on the phone, they love messing with phones.”
“I think by having the reminders, as well as having something there that’s interactive for the kids and the caregivers both. I think it would be a huge help.”

Similar to trainers, challenges noted by families related to confidentiality and some families not having access to the technology or the internet. Additional family perspectives on benefits and challenges are provided in Table 8 .

Family Perspectives on Benefits and Challenges relating to m Health Solutions to Homework Barriers

ThemesSub-themesNo. of Families Raising ThemeNo. of References to Theme
Clinical utility1160
Will lead to better communication between providers and families1021
Would help make treatment and homework more rewarding79
Youth like technology and would engage with it77
Would help families remember to do assignments57
Would help reinforce skills learned in therapy46
Could help to bring families together44
Would help treatment go faster45
Would help families remember why homework is beneficial11
Confidentiality issues1120
Access, comfort915
Some families may not have access to the technology66
Some families may not have internet access44
Some families aren’t good with technology22
Youth access to device might be restricted22
Some families might have concerns about data or storage space11

The aims of this study were to assess barriers to the successful implementation of homework during youth mental health treatment, obtain suggestions for m Health solutions to those barriers, and explore perceptions on the benefits and challenges associated with m Health solutions to homework barriers through semi-structured qualitative interviews with relevant stakeholders. National trainers in TF-CBT provided a unique perspective on the common challenges met by mental health providers and their patients as well as potential solutions to those challenges, particularly given their extensive experience problem-solving common clinical challenges with community mental health providers. Interviews with youth TF-CBT patients and their caregivers provided important perspectives from those most affected by homework barriers in mental health treatment.

Perspectives on Barriers to the Successful Implementation of Homework

Trainer and family perspectives on the various barriers to the successful implementation of homework during mental health treatment aligned well with the heuristic proposed by Kazantzis and Shinkfield (2007) , which classifies barriers as occurring on the provider-, patient-, task-, and environmental-levels. Most of the provider-level barriers noted by trainers were consistent with expert recommendations from the research literature, such as providers’ beliefs relating to homework and patient engagement in homework ( Coon et al., 2005 ; Friedberg & Mcclure, 2005 ; Garland & Scott, 2002 ), difficulty designing homework activities and individualizing them to specific patients ( Kazantzis & Shinkfield, 2007 ), forgetting about homework and running out of time during the session ( Friedberg & Mcclure, 2005 ), difficulty with consistency and not wanting to put too many demands on patients ( Coon et al., 2005 ), and difficulty effectively assessing patient barriers ( Kazantzis & Shinkfield, 2007 ). Experts have proposed a model for practice that directly addresses many of these provider-level barriers by proposing an ideal process for facilitating engagement in homework ( Kazantzis, MacEwan, & Dattilio, 2005 ).

Trainer and family perspectives on the most common patient-level homework barriers were similar and were also consistent with the extant literature. These included patients’ avoidance or symptoms ( Coon et al., 2005 ; Dattilio et al., 2011 ; Friedberg & Mcclure, 2005 ; Garland & Scott, 2002 ; Hudson & Kendall, 2005 ; Leahy, 2002 ), forgetting to complete assignments ( Coon et al., 2005 ; Hudson & Kendall, 2005 ), not understanding when, where, or how to do assignments or the rationale ( Dattilio et al., 2011 ; Friedberg & Mcclure, 2005 ; Garland & Scott, 2002 ), and beliefs about homework tasks and their ability to complete them ( Dattilio et al., 2011 ; Kazantzis & Shinkfield, 2007 ). Interestingly, whereas the most commonly endorsed patient-level barrier by trainers was patients not seeing homework as an integral part of therapy or important, the most commonly endorsed barriers by families included avoidance or symptoms, forgetfulness, and lack of understanding about assignments, reflecting differing views on the more significant barriers faced by patients. This discrepancy in the trainers/providers vs . families’ perspectives regarding between session assignments suggests the importance of therapists’ focusing more time on explaining assignments, discussing potential challenges, emphasizing the benefits of completing assignments in overcoming symptoms/difficulties and ultimately inspiring follow through.

Task-level barriers reported by both trainers and families included assignments not aligning with patient values or treatment goals ( Coon et al., 2005 ; Dattilio et al., 2011 ; Hudson & Kendall, 2005 ). Many trainers reported that the word “homework” is an aversive term to patients, particularly to youth patients. Perhaps relatedly, many families reported that children view homework assignments are boring. Negative associations with homework may be addressed by referring to “homework” as practice assignments, experiments, exercises, or action plans, as recommended by a recent Beck Institute blog post by Drs. Judith Beck and Francine Broder ( Beck & Broder, 2016 ).

Finally, environment-level barriers noted by trainers and families included the home lives of patients being busy and chaotic – leaving little time to complete homework assignments; a lack of caregiver involvement in the case of youth; and a lack of reward or reinforcement for completing homework assignments, all of which have been previously noted ( Bru et al., 2013 ; Coon et al., 2005 ; Dattilio et al., 2011 ; Kazantzis & Shinkfield, 2007 ). In sum, trainer and family perspectives on barriers to the successful implementation of homework were largely consistent with those suggested by experts. Further, there was a general agreement between trainers and families with respect to those barriers. It is important to note the interrelatedness of several barriers within various levels. For example, patients not understanding the importance of homework or seeing it as an integral part of therapy could very much reflect a mismatch in alliance, tasks needed to achieve therapy goals, or a poor therapist rationale and opportunity for client feedback and discussion. Further, a patient’s understanding of the rationale for homework might be dependent on the provider’s skill in its explanation.

Trainers and families provided numerous suggestions for m Health solutions to homework barriers. These functionality and content suggestions included: reminders and schedules to overcome barriers to forgetting; behavior and symptom tracking and reports or activity summaries to assist providers in assessing homework completion; a variety of homework activities to choose from to help providers struggling with developing activities; resources for caregivers to improve caregiver support; and an integrated reward system to make completing homework rewarding and reinforcing for patients. Other suggested features related more to user interface and user experience. For example, interviewees felt that the m Health resource should allow easy navigation to relevant resources; include clear instructions via video, text, and audio to help patients understand and remember how to do assignments; include interactive and fun activities to help make the assignments less boring and less like “homework;” and be patient-centered and developmentally appropriate. Trainers and families also felt that a text message-based system for reminding patients to complete homework assignments would be beneficial, indicating that this approach would provide a good alternative to a purely app-based resource.

As outlined in recent reviews, there are several studies on m Health resources that include the functionality and content features suggested in this study and can also be used to facilitate homework implementation ( Bakker et al., 2016 ; Tang & Kreindler, 2017 ). For example, a number of m Health resources can be used for self-monitoring and symptom tracking, and many have engaging activities that can be used to support between-session learning and skill development in the areas of relaxation, cognitive therapy, imaginal exposure, and parent behavioral management ( Bunnell et al., 2019 ; Jungbluth & Shirk, 2013 ; Kristjánsdóttir et al., 2013 ; Newman, Przeworski, Consoli, & Barr Taylor, 2014 ; Reger et al., 2013 ; Shapiro et al., 2010 ; Whiteside, Ale, Vickers Douglas, Tiede, & Dammann, 2014 ). SMS- and app-based reminders and feedback on progress can also be used to encourage continued engagement in skills practice ( Aguilera & Muñoz, 2011 ; Harrison et al., 2011 ; Reger et al., 2013 ; Wiederhold, Boyd, Sulea, Gaggioli, & Riva, 2014 ). However, as stated previously, most of these resources were not designed with the express intention of addressing barriers to homework implementation, particularly for youth and family patient populations, leaving room for future work in this area.

Trainers and families expressed very positive views on m Health solutions to homework barriers. Trainers felt that m Health would increase provider use and family adherence to homework, positively affect the therapeutic relationship, and increase treatment efficiency and effectiveness. Families felt that it would make practicing therapy skills at home more fun or interesting, help families practice skills more often, positively affect the therapeutic relationship, and improve treatment effectiveness. A potential benefit commonly noted by trainers and families was a high likelihood that youth would engage with the resource given their generally strong interest in technology, and that this would help to reinforce the practice of skills learned during therapy. A particular benefit noted was increased access to helpful resources between-sessions. Trainers and families expressed concerns about issues relating to confidentiality. While they did not view this as a fatal flaw of the resource, they suggested implementing appropriate safeguards to protect patient privacy and clearly explaining data protection to encourage use.

Limitations

There are several limitations to this study. Regarding generalizability of results, the selection of trainers and families interviewed was based on experience with TF-CBT, a specific treatment protocol for childhood trauma. Although interview questions were kept general during interviews, referring to mental health treatment rather than solely to TF-CBT, the views expressed by interviewees may relate more to TF-CBT than other child mental health treatments. However, a strength of this research is that TF-CBT has a broad symptom focus (e.g., PTSD, anxiety, depression, anger, disruptive behavior) and includes treatment components used in numerous youth mental health treatments (e.g., psychoeducation, relaxation, cognitive coping, affective modulation, exposure), which suggests that results would be applicable to a range of child mental health treatments. Additionally, national trainers in TF-CBT have consistent exposure to working closely with community mental health providers and regularly help them to problem-solve common barriers in clinical practice. This added insight into difficulties experienced by numerous mental health providers rather than asking individual providers about their experience. This is a strength of this study but also a potential limitation as not directly measured, thus an assumption. The views of trainers may not be completely representative of the every-day challenges to homework implementation experienced by community mental health providers. Given the small samples size and lack of diversity, the results should be interpreted with caution as they may not reflect the experiences or views of therapists and patients who utilize homework across different treatment approaches, therapy settings, and populations.

With respect to interview questions and results, they tended to focus on barriers and challenges and provided less of an opportunity for trainers and family members to share factors that may have led to successes with homework assignments. Such information could also importantly support the development and presentation of m health solutions by therapists. Relatedly, families were asked about barriers faced by youth and caregivers, and not by providers, which would have provided interesting data on family perspectives on providers’ limitations. Although comfort with technology in general was assessed in youth and caregivers, it was not specified as comfort with m Health, and ratings were not collected from trainers. As such, a potential limitation of this study is that participants’ comfort specifically with mHealth was unknown. Furthermore, this study focused specifically on m Health without a comparison to other low-tech solutions, which might have resulted in inflated levels of interest in m health solutions to homework barriers. A final limitation is that interviews were coded by the first author, and there is potential for variability in coding that was not accounted for (i.e., the same themes might have been classified in different ways). Despite this limitation, themes were reviewed and by an internationally recognized expert in the implementation of homework and related barriers during CBT (the fourth author) and compared until agreement was reached, supporting the derived themes.

Conclusions

This study provides important new information on barriers to the successful implementation of homework during youth mental health treatment, based on perspectives of providers, youth, and caregivers with that treatment experience. This study adds to the literature on these barriers, which has been based largely on recommendations from experts in the field. The results of this study aligned well with this literature, providing additional support for these recommendations. Valuable insights on potential m Health solutions to these homework barriers were also provided. These data are being used to inform the development of an m Health resource that aims to address homework barriers in hopes of improving provider use and patient adherence to homework during youth mental health treatment, with the ultimate goal of improving the quality of care received by patients in community mental health settings.

Supplementary Material

10608_2020_10090_moesm1_esm, acknowledgments.

Compliance with Ethical Standards

Funding. Dr. Bunnell was supported by the National Institute of Mental Health (grant numbers F32 MH108250 and K23 MH118482).

Disclosure of Potential Conflicts of Interest

Conflict of Interest. The authors declare that they have no conflict of interest.

Research Involving Human Participants and/or Animals

Statement of Human Rights.

Ethics approval. All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional Review Board at the Medical University of South Carolina (Pro00047774) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Statement on the Welfare of Animals

Ethical approval. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Psychreg

When Is Homework Stressful? Its Effects on Students’ Mental Health

student online learning

Are you wondering when is homework stressful? Well, homework is a vital constituent in keeping students attentive to the course covered in a class. By applying the lessons, students learned in class, they can gain a mastery of the material by reflecting on it in greater detail and applying what they learned through homework. 

However, students get advantages from homework, as it improves soft skills like organisation and time management which are important after high school. However, the additional work usually causes anxiety for both the parents and the child. As their load of homework accumulates, some students may find themselves growing more and more bored.

Students may take assistance online and ask someone to do my online homework . As there are many platforms available for the students such as Chegg, Scholarly Help, and Quizlet offering academic services that can assist students in completing their homework on time. 

Negative impact of homework

There are the following reasons why is homework stressful and leads to depression for students and affect their mental health. As they work hard on their assignments for alarmingly long periods, students’ mental health is repeatedly put at risk. Here are some serious arguments against too much homework.

No uniqueness

Homework should be intended to encourage children to express themselves more creatively. Teachers must assign kids intriguing assignments that highlight their uniqueness. similar to writing an essay on a topic they enjoy.

Moreover, the key is encouraging the child instead of criticizing him for writing a poor essay so that he can express himself more creatively.

Lack of sleep

One of the most prevalent adverse effects of schoolwork is lack of sleep. The average student only gets about 5 hours of sleep per night since they stay up late to complete their homework, even though the body needs at least 7 hours of sleep every day. Lack of sleep has an impact on both mental and physical health.

No pleasure

Students learn more effectively while they are having fun. They typically learn things more quickly when their minds are not clouded by fear. However, the fear factor that most teachers introduce into homework causes kids to turn to unethical means of completing their assignments.

Excessive homework

The lack of coordination between teachers in the existing educational system is a concern. As a result, teachers frequently end up assigning children far more work than they can handle. In such circumstances, children turn to cheat on their schoolwork by either copying their friends’ work or using online resources that assist with homework.

Anxiety level

Homework stress can increase anxiety levels and that could hurt the blood pressure norms in young people . Do you know? Around 3.5% of young people in the USA have high blood pressure. So why is homework stressful for children when homework is meant to be enjoyable and something they look forward to doing? It is simple to reject this claim by asserting that schoolwork is never enjoyable, yet with some careful consideration and preparation, homework may become pleasurable.

No time for personal matters

Students that have an excessive amount of homework miss out on personal time. They can’t get enough enjoyment. There is little time left over for hobbies, interpersonal interaction with colleagues, and other activities. 

However, many students dislike doing their assignments since they don’t have enough time. As they grow to detest it, they can stop learning. In any case, it has a significant negative impact on their mental health.

Children are no different than everyone else in need of a break. Weekends with no homework should be considered by schools so that kids have time to unwind and prepare for the coming week. Without a break, doing homework all week long might be stressful.

How do parents help kids with homework?

Encouraging children’s well-being and health begins with parents being involved in their children’s lives. By taking part in their homework routine, you can see any issues your child may be having and offer them the necessary support.

Set up a routine

Your student will develop and maintain good study habits if you have a clear and organized homework regimen. If there is still a lot of schoolwork to finish, try putting a time limit. Students must obtain regular, good sleep every single night.

Observe carefully

The student is ultimately responsible for their homework. Because of this, parents should only focus on ensuring that their children are on track with their assignments and leave it to the teacher to determine what skills the students have and have not learned in class.

Listen to your child

One of the nicest things a parent can do for their kids is to ask open-ended questions and listen to their responses. Many kids are reluctant to acknowledge they are struggling with their homework because they fear being labelled as failures or lazy if they do.

However, every parent wants their child to succeed to the best of their ability, but it’s crucial to be prepared to ease the pressure if your child starts to show signs of being overburdened with homework.

Talk to your teachers

Also, make sure to contact the teacher with any problems regarding your homework by phone or email. Additionally, it demonstrates to your student that you and their teacher are working together to further their education.

Homework with friends

If you are still thinking is homework stressful then It’s better to do homework with buddies because it gives them these advantages. Their stress is reduced by collaborating, interacting, and sharing with peers.

Additionally, students are more relaxed when they work on homework with pals. It makes even having too much homework manageable by ensuring they receive the support they require when working on the assignment. Additionally, it improves their communication abilities.

However, doing homework with friends guarantees that one learns how to communicate well and express themselves. 

Review homework plan

Create a schedule for finishing schoolwork on time with your child. Every few weeks, review the strategy and make any necessary adjustments. Gratefully, more schools are making an effort to control the quantity of homework assigned to children to lessen the stress this produces.

Bottom line

Finally, be aware that homework-related stress is fairly prevalent and is likely to occasionally affect you or your student. Sometimes all you or your kid needs to calm down and get back on track is a brief moment of comfort. So if you are a student and wondering if is homework stressful then you must go through this blog.

While homework is a crucial component of a student’s education, when kids are overwhelmed by the amount of work they have to perform, the advantages of homework can be lost and grades can suffer. Finding a balance that ensures students understand the material covered in class without becoming overburdened is therefore essential.

Zuella Montemayor did her degree in psychology at the University of Toronto. She is interested in mental health, wellness, and lifestyle.

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  • Excessive homework negatively impacts mental health, causes unnecessary stress

Opinion Editor Jula Utzschneider writes on the overwhelming chip on every student's shoulder: homework.

Caroline Lou

Opinion Editor Jula Utzschneider writes on the overwhelming chip on every student’s shoulder: homework.

Jula Utzschneider , Opinion Editor November 10, 2021

When the bell rings to end last period every day, I feel a sense of relief. However, this feeling soon wears off as I realize just how much work I have to do after the already-stressful school day ends.

While homework can be beneficial, more often than not, it is assigned excessively and unnecessarily. Teachers give a significant amount of homework, often due the next day. This causes students to spend far too much time doing such assignments and can be detrimental.

A 2013 study conducted at Stanford University found that students in top-performing school districts who spend too much time on homework experience more stress, physical health problems, a lack of balance in their lives and alienation from society. That study, published in The Journal of Experimental Education , suggested that any more than two hours of homework per night is counterproductive. However, students who participated in the study reported doing slightly more than three hours of homework every night.

And, yes, the amount of homework given to students depends on the course level they take. But, with increasingly competitive college acceptance rates (demanding more extracurriculars and college-level classes), many students feel forced to take these more challenging courses. This is a huge problem, especially as teachers give homework only thinking about their own class, not the five or six others students have.

Additionally, when it came to stress, more than 70% of students in the Stanford study said they were “often or always stressed over schoolwork,” with 56% listing homework as a primary stressor. More than 80% of students reported having at least one stress-related symptom (such as headaches, exhaustion, sleep deprivation, weight loss, stomach problems and more) in the past month, and 44% said they had experienced three or more symptoms. 

Less than 1% of the students said homework was not a stressor, demonstrating that the vast majority feel overwhelmed and pressured by the amount of work they receive.

Not to mention, the time spent on these assignments could easily be spent doing something enjoyable. Many students feel forced or obligated to choose homework over practicing other talents or skills, which should never be the case. Teachers should be encouraging these extracurriculars, rather than making it impossible for students to partake in them.

In terms of what teachers can do, it’s quite simple, really. Homework is intended for students to either practice a subject further or to cover topics teachers couldn’t during the allotted class time. It should not be busywork that just wastes a student’s time. 

Teachers should be giving students work that is absolutely necessary (not busy work), and eliminate it altogether where they can. It is extremely important that students not only get through high school but thrive and enjoy it too.

How much time do you spend doing homework on an average school night?

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very true in fact i am writing a essay right now this is resurch

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Children Suffer Mentally and Physically From Astounding Levels of Homework

“…students described the amount of homework each night as “overwhelming,” “unmanageable,” or “more than [they] could handle,””

mental health problems with homework

According to new research, too much homework is associated with academic stress, a lack of balance in children’s lives and even physical health problems.

The new study into 4,317 students at 10 high-performing US high schools questions whether the average of 3 hours homework per night is really justified ( Galloway et al., 2013 ).

The researchers asked students about the work they were doing and discovered that:

“Some of the students described the amount of homework each night as “overwhelming,” “unmanageable,” or “more than [they] could handle,” with one describing the load as “an endless barrage of work.””

One student wrote:

“There’s never a time to rest. There’s always something more you should be doing. If I go to bed before 1:30 I feel like I’m slacking off, or just screwing myself over for an even later night later in the week… There’s never a break. Never.”

The knock-on effects of all this homework were felt in both their sleep quality and their health:

“Many complained that the workload led to sleep deprivation and other health problems. Students described homework as the “main reason” preventing them from getting the recommended 9.25 hr of sleep each night.”

This feedback was supported by measures of the amount of homework students did and their well-being and engagement:

“Students who spent more hours on homework tended to be more behaviorally engaged in school, but were simultaneously more stressed about their school work and tended to reportmore physical symptoms due to stress, fewer hours of sleep on school nights, less ability to get enough sleep, and less ability to make time for friends and family.”

But surely all this homework is necessary and important?

Apparently not:

“…students will often do work they see as “pointless,” “useless,” and “mindless” because their grades will be affected if they do not. This kind of busy work, by its very nature, discourages learning and instead promotes doing homework simply to get points.”

All of this doesn’t mean homework should be banned, but 3 hours a night on average? Seriously?

The authors conclude by saying:

“Given the negative outcomes we find associated with more time spent on homework, our study calls into question the desirability of such diligence and the utility of assigning large quantities of homework in high-performing schools. […] any homework assigned should have a purpose and benefit, and it should be designed to cultivate learning and development.”

It seems the horrible, wasteful, idiotic culture of pointless ‘busywork’ is alive in well in some high schools.

→ Related: 10  Sleep Deprivation Effects.

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Psychologist, Jeremy Dean, PhD is the founder and author of PsyBlog. He holds a doctorate in psychology from University College London and two other advanced degrees in psychology. He has been writing about scientific research on PsyBlog since 2004. View all posts by Dr Jeremy Dean

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How Homework Is Destroying Teens’ Health

Jessica Amabile '24 , Staff Writer March 25, 2022

mental health problems with homework

“[Students] average about 3.1 hours of homework each night,” according to an article published by Stanford .  Teens across the country come home from school, exhausted from a long day, only to do more schoolwork.  They sit at their computers, working on homework assignments for hours on end.  To say the relentless amount of work they have to do is overwhelming would be an understatement.  The sheer amount of homework given has many negative impacts on teenagers.

Students have had homework for decades, but in more recent years it has become increasingly more demanding.  Multiple studies have shown that students average about three hours of homework per night.  The Atlantic mentioned that students now have twice as much homework as students did in the 1990s.  This is extremely detrimental to teens’ mental health and levels of stress.  Students have a lot to do after school, such as spending time with family, extracurricular activities, taking care of siblings or other family members, hanging out with friends, or all of the above.  Having to juggle all of this as well as hours on end of homework is unreasonable because teenagers already have enough to think or worry about.   

According to a student- run survey conducted in Cherry Hill West, students reported that they received the most homework in math, history, and language arts classes.  They receive anywhere from 1 to 4 or more hours of homework every day, but only about 22.7% somewhat or strongly agree that it helps them learn.  Of the students who participated, 63.6% think schools should continue to give out homework sometimes, while 27.3% said they should not give out homework at all.  In an open-ended response section, students had a lot to say.  One student wrote, “I think we should get homework to practice work if we are seen struggling, or didn’t finish work in class. But if we get homework, I think it just shows that the teacher needs more time to teach and instead of speeding up, gives us more work.”  Another added,  “Homework is important to learn the material. However, too much may lead to the student not learning that much, or it may become stressful to do homework everyday.”  Others wrote, “The work I get in chemistry doesn’t help me learn at all if anything it confuses me more,” and “I think math is the only class I could use homework as that helps me learn while world language is supposed to help me learn but feels more like a time waste.”   A student admitted, “I think homework is beneficial for students but the amount of homework teachers give us each day is very overwhelming and puts a lot of stress on kids. I always have my work done but all of the homework I have really changes my emotions and it effects me.”  Another pointed out, “you are at school for most of your day waking up before the sun and still after all of that they send you home each day with work you need to do before the next day. Does that really make sense[?]”

mental health problems with homework

As an article from Healthline mentioned, “Researchers asked students whether they experienced physical symptoms of stress… More than 80 percent of students reported having at least one stress-related symptom in the past month, and 44 percent said they had experienced three or more symptoms.”  If school is causing students physical symptoms of stress, it needs to re-evaluate whether or not homework is beneficial to students, especially teenagers.  Students aren’t learning anything if they have hours of “busy work” every night, so much so that it gives them symptoms of stress, such as headaches, weight loss, sleep deprivation, and so on.  The continuous hours of work are doing nothing but harming students mentally and physically.

mental health problems with homework

The mental effects of homework can be harmful as well.  Mental health issues are often ignored, even when schools can be the root of the problem.  An article from USA Today contained a quote from a licensed therapist and social worker named Cynthia Catchings, which reads, “ heavy workloads can also cause serious mental health problems in the long run, like anxiety and depression.”  Mental health problems are not beneficial in any way to education.  In fact, it makes it more difficult for students to focus and learn.  

Some studies have suggested that students should receive less homework.  To an extent, homework can help students in certain areas, such as math.  However, too much has detrimental impacts on their mental and physical health.  Emmy Kang, a mental health counselor, has a suggestion.  She mentioned, “I don’t think (we) should scrap homework; I think we should scrap meaningless, purposeless busy work-type homework. That’s something that needs to be scrapped entirely,” she says, encouraging teachers to be thoughtful and consider the amount of time it would take for students to complete assignments,” according to USA Today .  Students don’t have much control over the homework they receive, but if enough people could explain to teachers the negative impacts it has on them, they might be convinced.  Teachers need to realize that their students have other classes and other assignments to do.  While this may not work for everything, it would at least be a start, which would be beneficial to students.

The sole purpose of schools is to educate children and young adults to help them later on in life.  However, school curriculums have gone too far if hours of homework for each class are seen as necessary and beneficial to learning.  Many studies have shown that homework has harmful effects on students, so how does it make sense to keep assigning it?  At this rate, the amount of time spent on homework will increase in years to come, along with the effects of poor mental and physical health.  Currently, students do an average of 3 hours of homework, according to the Washington Post, and the estimated amount of teenagers suffering from at least one mental illness is 1 in 5, as Polaris Teen Center stated.  This is already bad enough–it’s worrisome to think it could get much worse.  Homework is not more important than physical or mental health, by any standards.

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How to make school life a little less difficult for kids

Actually useful ways to help children with homework, bullying, and mental health.

by Allie Volpe

An illustration of school supplies: Notebooks, a globe, a laptop, scissors, a pencil, a clock, a planet, a calculator, and geometry tools.

In early 2020, around the onset of Covid-19 lockdowns, Jessica Mungekar noticed her seventh grade honor student, Layla, retreat. “I knew that she felt really uncomfortable and she wanted to fall into the background,” Mungekar says. “She didn’t want to be noticed and I didn’t quite understand it.”

Meanwhile, Layla was keeping the source of her pain secret from her mother: She was being bullied and was struggling with her identity as a biracial teen in a predominantly white town. Layla feared if she told her mom about the extent of the bullying, Jessica would have called the school, making the problem even worse.

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Things came to a head the summer before Layla’s first year of high school when she shared with her mom details of a traumatic event. Layla urged her mother not to make decisions on her behalf in the aftermath. Instead, Jessica went into what she calls “mama bear mode” and made demands of her daughter: Cut off contact with these friends, join these extracurricular activities, you are only allowed out of the house during these hours. Layla felt like her autonomy was being taken away.

Over the course of a few months, mother and daughter worked to repair their relationship and communication. Now, Jessica says she is sure to listen to Layla instead of immediately offering advice, validates her daughter’s feelings, and gives her freedom to express herself. For her part, Layla confides in her mother all the time, even about her dating life. Her friends often seek out Jessica for counsel, too. “She’s become a safe place where people go to get advice,” Layla, now 16, says. “She’s joyous and doesn’t pass judgment.”

Students are faced with a daily barrage of potential stressors: a demanding course load, tricky social dynamics, managing both their time and emotions. In a four-year study designed to estimate the prevalence of mental disorders in kindergarteners through 12th graders, findings showed one in six students exhibited enough symptoms to meet the criteria for one or more childhood mental disorders, such as anxiety disorders and attention-deficit/hyperactivity disorder. According to a 2019 Pew Research Center report, 61 percent of teens said they felt a lot of pressure to get good grades. About 22 percent of 12- to 18-year-old students reported being bullied during the school year in 2019, per a National Center for Education Statistics survey . None of these statistics takes into account the toll of the pandemic, which set students back academically and had negative effects on their mental health .

Once kids leave the house, parents and other adults in their lives have little influence on their students’ school days. Unable to witness or guide children through the difficulties in and out of the classroom, parents often get piecemeal or incomplete views of how their kids spent the last hours, especially if the child is young and can’t adequately verbalize their struggles or frustrations. Signs that a student may be experiencing hardship at school include increased irritability, difficulty sleeping or lack of sleep, and changes in appetite, says Jessica Kendorski , the chair of the school psychology department and professor at the Philadelphia College of Osteopathic Medicine. They may also say they feel sick in order to stay home, when in reality they may be stressed or anxious about school, Kendorski says.

Another indicator of a struggling child includes extreme people-pleasing, says Meredith Draughn , the school counselor at B. Everett Jordan Elementary School in Graham, NC, and the 2023 American School Counselor Association Counselor of the Year. High school students may also exhibit a “freeze” response, Draughn says. “It’s like well, that kid just doesn’t care, right? That kid’s super apathetic,” she says. “What we find when we dig into it more is they’re so overwhelmed by everything that’s happening that they just choose to do nothing because they don’t know how to address it.”

What, then, is the right way to support the students in your life? The tactics will vary based on the age of your child and the issues they’re facing. Regardless of your approach, experts say to always keep your kids in the loop of any decisions you’re making about their emotional and academic success.

Encourage growth mindset tactics for academic achievement

From homework to challenging classes, students experience a number of academic hurdles. Sometimes, they may fail a test or drop the ball on a project. While some students may criticize themselves (“I’m not smart enough”) or claim the material was too difficult, parents should promote a growth mindset : the ability to learn from setbacks, implement new processes, and improve. “You want to praise the effort and the strategies that they used,” Kendorski says. “If they fail something, you want to talk through ‘Why did you fail this? Let’s talk about what you can do to be successful next time.’”

A fixed mindset is one where people believe their skills are set in stone and they have no possibility of improving. When students in his classroom share fixed mindset sentiments like “I can’t do this,” elementary school teacher Josh Monroe is quick to amend the statement: “You can’t do this yet .” The power of yet helps students “understand that you don’t have to know it all right now — and it’s important that you don’t, that’s how you grow,” he says.

While it’s crucial to encourage a growth mindset with students who use negative self-talk, like “I’ll never learn this” or “I’m not good enough,” a fixed mindset can also backfire if you constantly tell a student “You’re so smart,” Kendorski says. “When things start to get really difficult, you might find kids that don’t want to take chances,” she says, “because they think that if I fail, I’m going to lose that ‘I’m so smart’ title.” Instead, she says, focus on accomplishments based on effort and strategies: “I’m really proud of you for organizing a study group with your friends.”

To help ensure your kids get their homework done and prepare for tests, Kendorski encourages a routine: dedicating a time and a place for schoolwork. If your student retains information more effectively if they study for a little bit each day instead of cramming, offer that as an option.

When the kid in your life asks for help with homework and you’re a little rusty on, say, algebra, don’t feel ashamed to admit you don’t know how to solve the problem, Draughn says. Monroe recommends the online educational tool Khan Academy , which features videos that guide both parents and students through all levels of educational concepts and lessons. For additional academic resources, reach out to your student’s teacher who will know about after-school tutoring sessions or extra guidance, Draughn says. “Going to teachers early and often, when help is needed, is the most crucial part of it,” she says, “because there are those programs, but they do fill up pretty quickly.”

Empower students to navigate difficult social situations with confidence

School can be a social minefield, with kids learning how to independently interact with peers and regulate their emotions. If your child shares that they’re being picked on or ostracized in school, Draughn suggests that you first validate their experience and never downplay their emotions. Ask them what level of support they want: Do they think it would be helpful to talk to a school counselor or a teacher? Or do they prefer you to reach out to the teacher directly? In Layla Mungekar’s experience, she would have opted for her mother to not interfere with her social life. “Letting them lead the way on that is important,” Draughn says. “They may say, I feel like I have the tools to handle this — and that’s great. Then you check in. But doing nothing and just not mentioning it again is not going to help anything.”

You might also start counseling your kid on self-advocacy and assertiveness at home, too, Draughn says, helping them identify moments where they should speak out against bad behavior and pointing out trustworthy adults to whom they can report issues, regardless of whether they are on the receiving end or have witnessed another student being bullied. “If someone is making you feel socially or physically unsafe, that’s the time to speak up,” says Tracee Perryman , the author of Elevating Futures: A Model For Empowering Black Elementary Student Success . Again, only reach out to the school yourself after talking it over with your kid.

However, your child may simply be shy and reserved, not the victim of bullying. Perryman says to help build confidence with the kids in your life by reminding them that what they have to say is important and they have valuable interests and insights worth sharing with others.

When it comes to social media, Jessica Mungekar discovered teens will “do what they’re going to do, whether you want them to or not,” she says. It’s better to listen if your child is involved with social media-related conflict, remind them they are not in trouble, and support them as you work to create a plan together. “I think it’s important in this day and age for kids to have social media because otherwise they get [alienated] by their peers,” Layla Mungekar says. “But it’s a lot safer when parents have those conversations, like yeah, this is going to happen and when it does happen, you should feel safe to come to me and not be blamed for that.”

Experts emphasize the transitory nature of school. While it’s crucial for students to apply themselves academically and make strides socially, remind them that one speed bump, fight with a friend, blunder, or bad grade will not drastically alter the trajectory of their lives. “It’s better that I make those mistakes now,” Layla says, “while I have someone there to help me.”

Promote balance to minimize stress

Just like adults, kids can get stressed due to the demands of school and extracurriculars, as well as conflicts with friends and family. If kids are sleeping very late on weekends or too tired to do activities they typically enjoy, like spending time with friends, they might need more balance in their schedules, Perryman says.

Ask your kid directly: “Are you playing T-ball three nights a week because you like it or you feel like you have to?” or “You had three extracurriculars last semester and it was really overwhelming for you. Do you want to pick two for this coming semester?” Draughn suggests. Remind your kid that just because they step away from a hobby now doesn’t mean they can’t come back to it in the future. Make sure students have one weeknight and one weekend day solely devoted to downtime, too, Draughn says. However, don’t discount the fact that sports and other activities can be rejuvenating for kids, even if they’re not resting.

Parents and supportive adults are quick to problem-solve for the kids in their lives, but Kendorski stresses the importance of asking, “Do you want me to listen? Or do you want me to help?” Your child might just want to vent about a tough baseball practice. When Layla wants validation and a hug from her mom, she asks her “to be a waterfall.” When she’s feeling less emotionally charged, then Layla and her mom can problem-solve.

For high-achieving students who may be stressed about grades and college applications, Kendorski suggests asking your kids what story they’re telling themselves about success. For example, they might worry that a bad test grade means they’ll never get into their dream college. Help them map more realistic outcomes by thinking about the absolute worst-case scenario and alternative paths. For example, the worst that could happen if they fail a single test is maybe they get a C for the quarter. But reinforce how if they study and complete all their homework, the likelihood of failing is minimized.

Remember not to make your stress their stress. Children are intuitive and can pick up on how the adults in their lives are feeling, Kendorski says. Instead of turning away from uncomfortable emotions, encourage open communication. If you’re disappointed in a mediocre grade, try saying, “I’m feeling a little bummed about the C on that test, but that’s my issue. I know you work hard and with some more practice, I know you’ll do better next time.”

Parents should always validate their child’s struggles and encourage caring for their mental health. Whether they’re seeking support from a trusted teacher or you think they’d benefit from speaking with a therapist — ask them how they’d feel about chatting with a professional before scheduling an appointment — remind them that “mental health is health,” Draughn says. That matters more than any test score.

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mental health problems with homework

Homework can be bad for your mental health. Should we get rid of it?

  • Teachers are taking to social media apps like TikTok to take a stand against the idea
  • Heavy workloads can be extra stressful for students, especially during the Covid-19 pandemic

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mental health problems with homework

It’s no secret that homework can be a pain. And as students grapple with an ongoing pandemic that has had a wide-range of mental health impacts, is it time schools start listening to their pleas about their workloads?

Some teachers are turning to social media to take a stand against homework.

Tiktok user @misguided.teacher says he doesn’t assign it because the “whole premise of homework is flawed.”

Do students need homework to learn?

For starters, he says he can’t grade work on “even playing fields” when students’ home environments can be vastly different.

“Even students who go home to a peaceful house, do they really want to spend their time on busy work? Because typically that’s what a lot of homework is, it’s busy work,” he says in the video that has garnered 1.6 million likes. “You only get one year to be 7, you only got one year to be 10, you only get one year to be 16, 18.”

Mental health experts agree heavy work loads have the potential do more harm than good for students, especially when taking into account the impacts of the pandemic. But they also say the answer may not be to eliminate homework altogether.

Chinese schoolgirl uses robot to do her homework

Emmy Kang, mental health counselor at Humantold, says studies have shown heavy workloads can be “detrimental” for students and cause a “big impact on their mental, physical and emotional health.”

“More than half of students say that homework is their primary source of stress, and we know what stress can do on our bodies,” she says, adding that staying up late to finish assignments also leads to disrupted sleep and exhaustion.

Cynthia Catchings, a licensed clinical social worker and therapist at Talkspace, says heavy workloads can also cause serious mental health problems in the long run, like anxiety and depression.

And for all the distress homework causes, it’s not as useful as many may think, says Dr. Nicholas Kardaras, a psychologist and CEO of Omega Recovery treatment center.

“The research shows that there’s really limited benefit of homework for elementary age students, that really the school work should be contained in the classroom,” he says.

For older students, Kang says homework benefits plateau at about two hours per night.

Should Hong Kong introduce a zero-homework policy?

“Most students, especially at these high-achieving schools, they’re doing a minimum of three hours, and it’s taking away time from their friends from their families, their extracurricular activities. And these are all very important things for a person’s mental and emotional health.”

Catchings, who taught Primary Three to Secondary 6 for 12 years, says she’s seen the positive effects of a no homework policy while working with students abroad.

“Not having homework was something that I always admired from French students (and) French schools, because that helped students really have time off and disconnect from school,” she says.

The answer may not be to eliminate homework completely, but to be more mindful of the type of work students go home with, suggests Kang, who was a secondary school teacher for 10 years.

“I don’t think (we) should scrap homework, I think we should scrap meaningless, purposeless, busy work-type homework. That’s something that needs to be scrapped entirely,” she says, encouraging teachers to be thoughtful and consider the amount of time it would take for students to complete assignments.

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More than two hours of homework may be counterproductive, research suggests.

Education scholar Denise Pope has found that too much homework has negative impacts on student well-being and behavioral engagement (Shutterstock)

A Stanford education researcher found that too much homework can negatively affect kids, especially their lives away from school, where family, friends and activities matter.   "Our findings on the effects of homework challenge the traditional assumption that homework is inherently good," wrote Denise Pope , a senior lecturer at the Stanford Graduate School of Education and a co-author of a study published in the Journal of Experimental Education .   The researchers used survey data to examine perceptions about homework, student well-being and behavioral engagement in a sample of 4,317 students from 10 high-performing high schools in upper-middle-class California communities. Along with the survey data, Pope and her colleagues used open-ended answers to explore the students' views on homework.   Median household income exceeded $90,000 in these communities, and 93 percent of the students went on to college, either two-year or four-year.   Students in these schools average about 3.1 hours of homework each night.   "The findings address how current homework practices in privileged, high-performing schools sustain students' advantage in competitive climates yet hinder learning, full engagement and well-being," Pope wrote.   Pope and her colleagues found that too much homework can diminish its effectiveness and even be counterproductive. They cite prior research indicating that homework benefits plateau at about two hours per night, and that 90 minutes to two and a half hours is optimal for high school.   Their study found that too much homework is associated with:   • Greater stress : 56 percent of the students considered homework a primary source of stress, according to the survey data. Forty-three percent viewed tests as a primary stressor, while 33 percent put the pressure to get good grades in that category. Less than 1 percent of the students said homework was not a stressor.   • Reductions in health : In their open-ended answers, many students said their homework load led to sleep deprivation and other health problems. The researchers asked students whether they experienced health issues such as headaches, exhaustion, sleep deprivation, weight loss and stomach problems.   • Less time for friends, family and extracurricular pursuits : Both the survey data and student responses indicate that spending too much time on homework meant that students were "not meeting their developmental needs or cultivating other critical life skills," according to the researchers. Students were more likely to drop activities, not see friends or family, and not pursue hobbies they enjoy.   A balancing act   The results offer empirical evidence that many students struggle to find balance between homework, extracurricular activities and social time, the researchers said. Many students felt forced or obligated to choose homework over developing other talents or skills.   Also, there was no relationship between the time spent on homework and how much the student enjoyed it. The research quoted students as saying they often do homework they see as "pointless" or "mindless" in order to keep their grades up.   "This kind of busy work, by its very nature, discourages learning and instead promotes doing homework simply to get points," said Pope, who is also a co-founder of Challenge Success , a nonprofit organization affiliated with the GSE that conducts research and works with schools and parents to improve students' educational experiences..   Pope said the research calls into question the value of assigning large amounts of homework in high-performing schools. Homework should not be simply assigned as a routine practice, she said.   "Rather, any homework assigned should have a purpose and benefit, and it should be designed to cultivate learning and development," wrote Pope.   High-performing paradox   In places where students attend high-performing schools, too much homework can reduce their time to foster skills in the area of personal responsibility, the researchers concluded. "Young people are spending more time alone," they wrote, "which means less time for family and fewer opportunities to engage in their communities."   Student perspectives   The researchers say that while their open-ended or "self-reporting" methodology to gauge student concerns about homework may have limitations – some might regard it as an opportunity for "typical adolescent complaining" – it was important to learn firsthand what the students believe.   The paper was co-authored by Mollie Galloway from Lewis and Clark College and Jerusha Conner from Villanova University.

Clifton B. Parker is a writer at the Stanford News Service .

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Does Homework Cause Stress? Exploring the Impact on Students’ Mental Health

How much homework is too much?

mental health problems with homework

Homework has become a matter of concern for educators, parents, and researchers due to its potential effects on students’ stress levels. It’s no secret students often find themselves grappling with high levels of stress and anxiety throughout their academic careers, so understanding the extent to which homework affects those stress levels is important. 

By delving into the latest research and understanding the underlying factors at play, we hope to curate insights for educators, parents, and students who are wondering whether homework causing stress in their lives?

The Link Between Homework and Stress: What the Research Says

Over the years, numerous studies investigated the relationship between homework and stress levels in students. 

One study published in the Journal of Experimental Education found that students who reported spending more than two hours per night on homework experienced higher stress levels and physical health issues . Those same students reported over three hours of homework a night on average.

This study, conducted by Stanford lecturer Denise Pope, has been heavily cited throughout the years, with WebMD producing the below video on the topic– part of their special report series on teens and stress : 

Additional studies published by Sleep Health Journal found that long hours on homework on may be a risk factor for depression , suggesting that reducing workload outside of class may benefit sleep and mental fitness .

Homework’s Potential Impact on Mental Health and Well-being

Homework-induced stress on students can involve both psychological and physiological side effects. 

1. Potential Psychological Effects of Homework-Induced Stress:

• Anxiety: The pressure to perform well academically and meet homework expectations can lead to heightened levels of anxiety in students. Constant worry about completing assignments on time and achieving high grades can be overwhelming.

• Sleep Disturbances : Homework-related stress can disrupt students’ sleep patterns, leading to sleep anxiety or sleep deprivation, both of which can negatively impact cognitive function and emotional regulation.

• Reduced Motivation: Excessive homework demands could drain students’ motivation, causing them to feel fatigued and disengaged from their studies. Reduced motivation may lead to a lack of interest in learning, hindering students’ overall academic performance.

2. Potential Physiological Effects of Homework-Induced Stress:

• Impaired Immune Function: Prolonged stress could weaken the immune system, making students more susceptible to illnesses and infections.

• Disrupted Hormonal Balance : The body’s stress response triggers the release of hormones like cortisol, which, when chronically elevated due to stress, can disrupt the delicate hormonal balance and lead to various health issues.

• Gastrointestinal Disturbances: Stress has been known to affect the gastrointestinal system, leading to symptoms such as stomachaches, nausea, and other digestive problems.

• Cardiovascular Impact: The increased heart rate and elevated blood pressure associated with stress can strain the cardiovascular system, potentially increasing the risk of heart-related issues in the long run.

• Brain impact: Prolonged exposure to stress hormones may impact the brain’s functioning , affecting memory, concentration, and other cognitive abilities.

The Benefits of Homework

It’s important to note that homework also offers many benefits that contribute to students’ academic growth and development, such as: 

• Development of Time Management Skills: Completing homework within specified deadlines encourages students to manage their time efficiently. This valuable skill extends beyond academics and becomes essential in various aspects of life.

• Preparation for Future Challenges : Homework helps prepare students for future academic challenges and responsibilities. It fosters a sense of discipline and responsibility, qualities that are crucial for success in higher education and professional life.

• Enhanced Problem-Solving Abilities: Homework often presents students with challenging problems to solve. Tackling these problems independently nurtures critical thinking and problem-solving skills.

While homework can foster discipline, time management, and self-directed learning, the middle ground may be to  strike a balance that promotes both academic growth and mental well-being .

How Much Homework Should Teachers Assign?

As a general guideline, educators suggest assigning a workload that allows students to grasp concepts effectively without overwhelming them . Quality over quantity is key, ensuring that homework assignments are purposeful, relevant, and targeted towards specific objectives. 

Advice for Students: How to balance Homework and Well-being

Finding a balance between academic responsibilities and well-being is crucial for students. Here are some practical tips and techniques to help manage homework-related stress and foster a healthier approach to learning:

• Effective Time Management : Encourage students to create a structured study schedule that allocates sufficient time for homework, breaks, and other activities. Prioritizing tasks and setting realistic goals can prevent last-minute rushes and reduce the feeling of being overwhelmed.

• Break Tasks into Smaller Chunks : Large assignments can be daunting and may contribute to stress. Students should break such tasks into smaller, manageable parts. This approach not only makes the workload seem less intimidating but also provides a sense of accomplishment as each section is completed.

• Find a Distraction-Free Zone : Establish a designated study area that is free from distractions like smartphones, television, or social media. This setting will improve focus and productivity, reducing time needed to complete homework.

• Be Active : Regular exercise is known to reduce stress and enhance mood. Encourage students to incorporate physical activity into their daily routine, whether it’s going for a walk, playing a sport, or doing yoga.

• Practice Mindfulness and Relaxation Techniques : Encourage students to engage in mindfulness practices, such as deep breathing exercises or meditation, to alleviate stress and improve concentration. Taking short breaks to relax and clear the mind can enhance overall well-being and cognitive performance.

• Seek Support : Teachers, parents, and school counselors play an essential role in supporting students. Create an open and supportive environment where students feel comfortable expressing their concerns and seeking help when needed.

How Healium is Helping in Schools

Stress is caused by so many factors and not just the amount of work students are taking home.  Our company created a virtual reality stress management solution… a mental fitness tool called “Healium” that’s teaching students how to learn to self-regulate their stress and downshift in a drugless way. Schools implementing Healium have seen improvements from supporting dysregulated students and ADHD challenges to empowering students with body awareness and learning to self-regulate stress . Here’s one of their stories. 

By providing students with the tools they need to self-manage stress and anxiety, we represent a forward-looking approach to education that prioritizes the holistic development of every student. 

To learn more about how Healium works, watch the video below.

About the Author

mental health problems with homework

Sarah Hill , a former interactive TV news journalist at NBC, ABC, and CBS affiliates in Missouri, gained recognition for pioneering interactive news broadcasting using Google Hangouts. She is now the CEO of Healium, the world’s first biometrically powered immersive media channel, helping those with stress, anxiety, insomnia, and other struggles through biofeedback storytelling. With patents, clinical validation, and over seven million views, she has reshaped the landscape of immersive media.

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Schools rethink homework

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Illustration of a trash can being used as a supply cup with pencils, pens, a ruler and scissors inside.

Illustration: Aïda Amer/Axios

Dogs may not have anything to eat, but students could feel less stress if more schools reconsider their homework assignment policies.

Why it matters: Conversations about the value of homework in education have simmered for years, but students' mental health struggles and artificial intelligence have pushed it to the forefront.

  • 37% of 13-year-old students said they had "no homework assigned" on the day before a National Center for Education Statistics survey in 2023.
  • In 2020, that figure was 29%. In 2012, it was 21%.

Case in point: Butterfield Canyon Elementary School in Herriman, Utah, has had a no-homework policy since 2020.

  • "It helps increase the overall social-emotional health of our students because they're not so focused, especially at the elementary level, just on 'academic, academic, academic,'" Jay Eads, the school's principal, told Axios.
  • "They're able to explore other aspects of their life, which they should be doing at this developmental stage."

Zoom out: While students have shown some improvement in mental health metrics since the pandemic, overall wellbeing has not reduced to pre-2020 levels, per the Centers for Disease Control and Prevention.

  • 67% of high school students cited homework load as a major source of stress in a 2020 survey led by Stanford researchers for nonprofit Challenge Success.
  • The percentage increased to 80% among those doing three or more hours of homework daily.

The big picture: The correlation between homework and academic achievement is hard to measure, Stanford education researcher Denise Pope said.

  • With younger students, there's less research showing homework improves academics, Pope said. But reading for pleasure has been linked to higher achievement in those early grades.
  • For older students, decreasing homework loads also helps level the field for employed students or those managing familial responsibilities, Pope said.

The intrigue: Artificial intelligence chat bots can provide homework help. Optimistically, these bots can help students, like a tutor would. Or, just give answers.

  • 19% of teens said they've used ChatGPT to help with their school work, according to a Pew survey this year. Older high school students use it more often.
  • 69% said it's acceptable to use to research new topics; 39% said it's acceptable to use AI to solve math problems; and 20% said it's acceptable to use to write essays.
  • "You want to be able to have kids at least allegedly want to do the work and therefore not turn to AI" for cheating, Pope said. That's especially important given discussions over the value of learning and how AI could help or impede it, she added.

Zoom in: Katie Trowbridge, who taught high school students in Naperville, Illinois, for 23 years, didn't assign homework on the weekends. She saw that as a time to "learn through experiences," she said.

  • As president of Curiosity 2 Create, which provides educators with professional development, she's witnessed teachers become increasingly intentional about assignments.
  • This could mean assigning five math problems instead of 20 — or asking questions to foster creative and critical thinking rather than a simple answer.
  • "Am I giving homework so that I am keeping my administrators happy because I have to give homework?" Trowbridge posed as a hypothetical question. "Or am I giving homework because it is a meaningful exercise that kids need to do in order to establish learning and extend learning?"

What we're watching: A bill passed by California's legislature on Saturday and now awaiting Gov. Gavin Newsom's signature would recommend school districts evaluate the mental and physical health impacts of homework assignments.

  • Assemblymember Pilar Schiavo proposed the bill after her daughter asked her if she could "ban homework" when elected. Schiavo realized the fourth grader's request had some merit.
  • "As a single mom, I only have a couple of hours with my kid at night before they have to go to bed," said Schiavo, whose daughter is now in seventh grade. "Spending most of that struggling to get homework done creates a lot of stress on a family."
  • Homework is on hold for 18-year-old DNC delegate
  • Popular AI homework helper Gauth shares owner with TikTok

Editor's note: The story has been updated to reflect the bill has passed and is awaiting Gov. Gavin Newsom's signature. It has also been updated with additional quotes from Stanford education researcher Denise Pope.

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Biden administration finalizes rules to ensure insurers pay for mental health care 

New rules seek to achieve coverage parity for conditions like depression and addiction.

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Medical bill

By Lev Facher

Sept. 9, 2024

Addiction Reporter

The Biden administration on Monday announced it would finalize a highly anticipated proposal meant to force health insurers to cover mental health care on the same basis as physical health conditions. 

It is the latest salvo in a long-running federal government effort to crack down on insurance plans skimping on treatment for conditions including anxiety, depression, and addiction. 

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Despite longstanding law requiring health insurers to cover mental health as comprehensively as physical health, many Americans — even those with health insurance — still face financial obstacles when seeking care. 

“It’s simple: It shouldn’t be harder for you to get care when you feel depressed than getting care when you have back pain,” Lisa Gomez, the assistant secretary for employee benefits security at the U.S. Department of Labor, said at  a press conference. “It shouldn’t be harder for you to find a provider that can treat your eating disorder than it is to find a provider that can treat your ulcer.”

The finalized regulation follows a proposal that the Health and Human Services, Labor, and Treasury departments first put forward last summer. 

The administration said the new rules will compel insurers to act on analyses they were already required to conduct to ensure they were covering mental health conditions on par with others. 

The rule prohibits plans from using more restrictive prior authorization for mental health than for physical health conditions. It also closes loopholes that exempted insurance plans sponsored by state and local governments from its requirements.

The administration’s new regulation, however, does not include any new enforcement mechanisms. Asked about measures that will force payers to obey the existing and new parity rules, one Biden administration official simply said that health insurers would offer comprehensive behavioral health benefits as a means of staying competitive. 

It is hardly the first time that federal regulators have attempted to penalize insurers believed to be pinching pennies when it comes to mental health coverage. 

Congress first passed the Mental Health Parity Act in 1996. It was largely superseded in 2008 by new legislation named for the first bill’s authors: the late Sens. Paul Wellstone (D-Minn.) and Pete Domenici (R-N.M.), and then updated again in 2020. 

But Biden administration officials said some insurers still fail to comply. 

More than 15 years after the second bill’s passage, “people living with mental health and substance use disorders continue to face greater barriers when seeking benefits for those conditions and disorders under their plan and coverage than when seeking benefits for medical and surgical conditions,” Gomez said. “That’s not fair, it’s not right, and it’s against the law.” 

The Biden administration’s move to finalize the new regulation comes more than a year after it was first proposed. Typically, final rules take effect at least 60 days after they are announced.

While efforts to improve mental health parity generally enjoy bipartisan support, one top Republican issued a statement blasting Biden’s latest effort as a regulatory overreach that will have little impact on patients. 

“For over a year, we’ve been telling the Biden-Harris administration that these rules will not work,” said Rep. Virginia Foxx (R-N.C.), the chair of the House Committee on Education and Labor. “They are too vague and burdensome; they overregulate instead of allowing health plans to build robust networks; and they will increase premiums for employees already facing high health care costs. These rules do nothing to improve mental health care access and instead put paperwork over patients.”

In statements, Biden and Vice President Kamala Harris, the Democratic presidential nominee, cast the action as part of a far broader effort to help Americans access mental health care.  “President Biden and I are committed to ensuring that every person in our country has the mental health care they need to thrive,” Harris said. “That is why we made the largest investment in youth mental health in history and are transforming how mental health is understood, perceived, and treated for all Americans. Today, we are building on this lifesaving and life-changing work by announcing the finalization of a historic rule that will expand mental health care across our nation so more of our loved ones, neighbors, coworkers, and classmates receive the care they deserve.”

STAT’s coverage of chronic health issues is supported by a grant from Bloomberg Philanthropies . Our financial supporters are not involved in any decisions about our journalism.

About the reporting

STAT’s investigation is based on interviews with nearly 100 people around the country, including incarcerated patients and grieving families, prison officials, and legal and medical experts. Reporter Nicholas Florko also filed more than 225 public records requests and combed through thousands of pages of legal filings to tell these stories. His analysis of deaths in custody is based on a special data use agreement between STAT and the Department of Justice.

You can read more about the reporting for this project and the methodology behind our calculations.

The series is the culmination of a reporting fellowship sponsored by the Association of Health Care Journalists and supported by The Commonwealth Fund.

Lev Facher covers the U.S. addiction and overdose crisis.

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Brain's Wiring May Trigger Depression in Some People

brain scans Alzheimer's Parkinsons

Key Takeaways

People with depression are more likely to have a distinct brain pattern

They have a 'salience network' that is 70% to 73% larger than people without depressive symptoms

The salience network is associated with reward processing, and could affect how people feel pleasure and enjoyment

FRIDAY, Sept. 6, 2024 (HealthDay News) -- A distinct brain pattern appears to make some people more likely to develop depression , a new study indicates.

“Deep” functional MRI brain scans revealed that a brain feature called the salience network is nearly twice as large in people with depression than in those without the condition, researchers reported Sept. 4 in the journal Nature .

The salience network is a group of brain regions thought to be involved in reward processing and focusing attention, researchers said.

“Having a larger salience network appears to increase the risk for depression—the effect is an order of magnitude larger than what we usually see in fMRI studies,” said senior researcher Dr. Conor Liston , a professor of psychiatry and neuroscience at Weill Cornell Medicine in New York.

Functional MRI scans identify patterns of activity in the brain by measuring changes in blood flow.

Researchers recruited six people with major depression to undergo repeated fMRI brain scans, and compared their results to those from 37 healthy people.

On average, the depression patients had salience networks that occupied 73% more brain surface compared to those of the control group.

The salience network “being implicated in depression kind of makes sense, because one of the main deficits in depression is anhedonia, which is the inability to feel pleasure and enjoy everyday activities,” said lead researcher Dr. Charles Lynch , an assistant professor of neuroscience at Weill Cornell Medicine.

The research team then looked at previous brain scans from hundreds of other patients, to validate what they’d found in this handful of people with depression.

Researchers found that the salience network was more than 70% larger, on average, in 299 patients with depression, compared to 932 healthy controls.

The data suggest that people with larger salience networks in childhood are more likely to develop depression later in life -- almost as if they were pre-wired for the condition, researchers said.

“For years, many investigators assumed that brain networks look the same in everybody,” Lynch said. “But the findings in this work build on a growing body of research indicating that there are fundamental differences between individuals.”

The team next plans to study the effects of depression treatments on the activity of brain networks, to see how drugs and other therapies work to quell depressive symptoms.

More information

The National Institute of Mental Health has more about depression .

SOURCE: Weill Cornell Medicine, news release, Sept. 4, 2024

What This Means For You

Some people might be pre-wired for depression from childhood, based on their brain development.

Related Stories

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Global Health

Protecting the mental health of refugee children.

Rhitu Chatterjee

Studies show that refugee kids in this country experience higher levels of anxiety, depression and post traumatic stress compared to kids born here. Now, a new effort in Maine is trying to prevent such long term impacts in refugee children – by supporting their families.

Copyright © 2024 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

COMMENTS

  1. Is it time to get rid of homework? Mental health experts weigh in

    Emmy Kang, mental health counselor at Humantold, says studies have shown heavy workloads can be "detrimental" for students and cause a "big impact on their mental, physical and emotional health ...

  2. Is it time to get rid of homework? Mental health experts weigh in

    Cynthia Catchings, a licensed clinical social worker and therapist at Talkspace, says heavy workloads can also cause serious mental health problems in the long run, like anxiety and depression.

  3. Why Homework is Bad: Stress and Consequences

    Why Homework is Bad: Stress and Consequences

  4. Health Hazards of Homework

    Health Hazards of Homework. Pediatrics. A new study by the Stanford Graduate School of Education and colleagues found that students in high-performing schools who did excessive hours of homework "experienced greater behavioral engagement in school but also more academic stress, physical health problems, and lack of balance in their lives.".

  5. Stanford research shows pitfalls of homework

    Stanford research shows pitfalls of homework

  6. Homework Struggles May Not Be a Behavior Problem

    Mental health challenges and neurodevelopmental differences directly affect children's ability to do homework. Understanding what difficulties are getting in the way—beyond the usual explanation ...

  7. PDF Is it time to get rid of homework? Mental health experts weigh in

    Mental health experts weigh in. August 16 2021, by Sara M Moniuszko. It's no secret that kids hate homework. And as students grapple with an ongoing pandemic that has had a wide-range of mental ...

  8. Is homework a necessary evil?

    Is homework a necessary evil?

  9. Homework as a Mental Health Concern

    Homework as a Mental Health Concern. It's time for an in depth discussion about homework as a major concern for those pursuing mental health in schools. So many problems between kids and their families, the home and school, and students and teachers arise from conflicts over homework. The topic is a long standing concern for mental health ...

  10. If We're Serious About Student Well-Being, We Must Change ...

    Research shows that excessive homework leads to increased stress, physical health problems and a lack of balance in students' lives. And studies have shown that more than two hours of daily homework can be counterproductive, yet many teachers assign more.. Homework proponents argue that homework improves academic performance. Indeed, a meta-analysis of research on this issue found a ...

  11. Barriers Associated with the Implementation of Homework in Youth Mental

    Introduction. Homework, or between-session practice of skills learned during therapy, is one of the most integral, yet underutilized components of high-quality, evidence-based mental health care (Kazantzis & Deane, 1999).Homework activities (e.g., self-monitoring, relaxation, exposure, parent behavior management) are assigned by providers in-session and completed by patients between sessions ...

  12. When Is Homework Stressful? Its Effects on Students' Mental Health

    Lack of sleep. One of the most prevalent adverse effects of schoolwork is lack of sleep. The average student only gets about 5 hours of sleep per night since they stay up late to complete their homework, even though the body needs at least 7 hours of sleep every day. Lack of sleep has an impact on both mental and physical health.

  13. Addressing Student Mental Health Through the Lens of Homework Stress

    Keywords: homework, stress, mental health The outcomes of adolescent mental health is a threat to students' health and wellbeing, more so than it ever has been in the modern era. As of 2019, the CDC reported a nearly 40. percent increase in feelings of sadness or hopelessness over the last ten years, and similar.

  14. Excessive homework negatively impacts mental health, causes unnecessary

    This is a huge problem, especially as teachers give homework only thinking about their own class, not the five or six others students have. Additionally, when it came to stress, more than 70% of students in the Stanford study said they were "often or always stressed over schoolwork," with 56% listing homework as a primary stressor ...

  15. Children Suffer Mentally and Physically From Astounding Levels of Homework

    According to new research, too much homework is associated with academic stress, a lack of balance in children's lives and even physical health problems. The new study into 4,317 students at 10 high-performing US high schools questions whether the average of 3 hours homework per night is really justified (Galloway et al., 2013).

  16. How Homework Is Destroying Teens' Health

    How Homework Is Destroying Teens' Health - The Lion's Roar

  17. How to make school life a little less difficult for kids

    When the kid in your life asks for help with homework and you're a little rusty on, say, algebra, don't feel ashamed to admit you don't know how to solve the problem, Draughn says.

  18. Impact of homework time on adolescent mental health: Evidence from

    Additionally, this study explores the moderating effects of teacher support and parent involvement. The results indicate that homework time has a negative effect on adolescent mental health, but only when the amount of time spent on homework exceeds about 1 hour and 15 minutes. Overall, there is a non-linear relationship between homework time ...

  19. Homework can be bad for your mental health. Should we get rid of it?

    Chinese schoolgirl uses robot to do her homework. Emmy Kang, mental health counselor at Humantold, says studies have shown heavy workloads can be "detrimental" for students and cause a "big ...

  20. More than two hours of homework may be counterproductive, research

    More than two hours of homework may be counterproductive ...

  21. Does Homework Cause Stress? Exploring the Impact on Students' Mental Health

    Does Homework Cause Stress? Exploring the Impact on ...

  22. Homework, sleep insufficiency and adolescent neurobehavioral problems

    During the past few decades, mental health problems among adolescents have received considerable attention as a public health concern. ... Thus, it seems plausible that sex may modify the relationships of high homework burden with adolescent mental health problems, or modify the mediation effects of sleep loss in such relationships. ...

  23. Mental health experts warn to watch social media use by teens

    And there's growing consensus that it's a big problem for their mental health. Teenagers spend nearly five hours a day, on average, on social media. And there's growing consensus that it's a big problem for their mental health. Search Query Show Search. Home. WUSF News. WUSF News Home; Local / State; Politics / Issues ...

  24. AI and mental health crisis fuel renewed anti-homework movement

    Why it matters: Conversations about the value of homework in education have simmered for years, but students' mental health struggles and artificial intelligence have pushed it to the forefront. 37% of 13-year-old students said they had "no homework assigned" on the day before a National Center for Education Statistics survey in 2023.

  25. Mental health experts warn to watch social media use by teens

    And there's growing consensus that it's a big problem for their mental health. Mental Health. Mental health experts warn to watch social media use by teens. September 9, 2024 3:46 AM ET.

  26. White House issues rules to push insurers to cover mental health care

    The Biden administration on Monday announced it would finalize a highly anticipated proposal meant to force health insurers to cover mental health care on the same basis as physical health conditions.

  27. Brain's Wiring May Trigger Depression in Some People

    FRIDAY, Sept. 6, 2024 (HealthDay News) -- A distinct brain pattern appears to make some people more likely to develop depression, a new study indicates. "Deep" functional MRI brain scans revealed that a brain feature called the salience network is nearly twice as large in people with depression than in those without the condition, researchers reported Sept. 4 in the journal Nature.

  28. Survivors and mental health experts share what they know about ...

    The risks of ignoring early signs of mental health issues An urgent response to mental health issues arising in children and teens who survive a school shooting, or gun violence in general, is ...

  29. Protecting the mental health of refugee children : NPR

    Protecting the mental health of refugee children Studies show that refugee kids in this country experience higher levels of anxiety, depression and post traumatic stress compared to kids born here ...

  30. Israel in worst-ever mental health crisis amid ongoing war, says

    Buso announced that because "our reality has changed," ministry assistance to HMOs to treat mental health issues will double to about NIS 600 million ($162 million) in 2025.