does homework damage mental health

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

It's no secret that kids hate homework. 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 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."

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 workloads 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.

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  can cause, 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. 

"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 also taught third to 12th graders 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 the French students (and) the French schools, because that was helping the students to really have the time off and really 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 take home, suggests Kang, who was a high 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.

The pandemic made the conversation around homework more crucial 

Mindfulness surrounding homework is especially important in the context of the past two years. Many students will be struggling with mental health issues that were brought on or worsened by the pandemic , making heavy workloads even harder to balance.

"COVID was just a disaster in terms of the lack of structure. Everything just deteriorated," Kardaras says, pointing to an increase in cognitive issues and decrease in attention spans among students. "School acts as an anchor for a lot of children, as a stabilizing force, and that disappeared."

But even if students transition back to the structure of in-person classes, Kardaras suspects students may still struggle after two school years of shifted schedules and disrupted sleeping habits.

"We've seen adults struggling to go back to in-person work environments from remote work environments. That effect is amplified with children because children have less resources to be able to cope with those transitions than adults do," he explains.

'Get organized' ahead of back-to-school

In order to make the transition back to in-person school easier, Kang encourages students to "get good sleep, exercise regularly (and) eat a healthy diet."

To help manage workloads, she suggests students "get organized."

"There's so much mental clutter up there when you're disorganized. ... Sitting down and planning out their study schedules can really help manage their time," she says.

Breaking up assignments can also make things easier to tackle.

"I know that heavy workloads can be stressful, but if you sit down and you break down that studying into smaller chunks, they're much more manageable."

If workloads are still too much, Kang encourages students to advocate for themselves.

"They should tell their teachers when a homework assignment just took too much time or if it was too difficult for them to do on their own," she says. "It's good to speak up and ask those questions. Respectfully, of course, because these are your teachers. But still, I think sometimes teachers themselves need this feedback from their students."

More: Some teachers let their students sleep in class. Here's what mental health experts say.

More: Some parents are slipping young kids in for the COVID-19 vaccine, but doctors discourage the move as 'risky'

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August 16, 2021

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

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 health impacts, is it time schools start listening to their pleas over 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."

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.

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.

"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 also taught third to 12th graders 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 the French students (and) the French schools, because that was helping the students to really have the time off and really 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 high-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.

The pandemic made the conversation around homework more crucial

Mindfulness surrounding homework is especially important in the context of the last two years. Many students will be struggling with mental health issues that were brought on or worsened by the pandemic, making heavy workloads even harder to balance.

"COVID was just a disaster in terms of the lack of structure. Everything just deteriorated," Kardaras says, pointing to an increase in cognitive issues and decrease in attention spans among students. "School acts as an anchor for a lot of children, as a stabilizing force, and that disappeared."

But even if students transition back to the structure of in-person classes, Kardaras suspects students may still struggle after two school years of shifted schedules and disrupted sleeping habits.

"We've seen adults struggling to go back to in-person work environments from remote work environments. That effect is amplified with children because children have less resources to be able to cope with those transitions than adults do," he explains.

'Get organized' ahead of back-to-school

In order to make the transition back to in-person school easier, Kang encourages students to "get good sleep, exercise regularly (and) eat a healthy diet."

To help manage workloads, she suggests students "get organized."

"There's so much mental clutter up there when you're disorganized... sitting down and planning out their study schedules can really help manage their time," she says.

Breaking assignments up can also make things easier to tackle.

"I know that heavy workloads can be stressful, but if you sit down and you break down that studying into smaller chunks, they're much more manageable."

If workloads are still too much, Kang encourages students to advocate for themselves.

"They should tell their teachers when a homework assignment just took too much time or if it was too difficult for them to do on their own," she says. "It's good to speak up and ask those questions. Respectfully, of course, because these are your teachers. But still, I think sometimes teachers themselves need this feedback from their students."

©2021 USA Today Distributed by Tribune Content Agency, LLC.

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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]

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

• 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.

Letters to the Editor

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Does Homework Serve a Purpose?

Finding the right balance between schoolwork and home life..

Posted November 5, 2018 | Reviewed by Ekua Hagan

• What Is Stress?
• Take our Burnout Test
• Find counselling to overcome stress

Homework — a dreaded word that means more work and less play. The mere thought of doing additional work after a seven-hour day (that begins extremely early) can be gruesome. Not to mention, many teens have other commitments after the school day ends.

According to the U.S. Census Bureau, nearly 57 percent of children between the ages of 6 and 17 years old participate in at least one after-school extracurricular activity. And that’s a good thing because youth extracurricular involvement comes with benefits such as boosting academic performance, reducing risky behaviors (i.e., drug use and drinking), promoting physical health, and providing a safe structured environment. However, tag these extracurricular activities onto the end of a school day and you’ll find that many teens don’t get home until it's dark outside.

What about the teen who works a 15- to 20-hour job on top of an extracurricular activity? The US Department of Labor reports that one in five high school students have a part-time job, and those jobs too can come with added benefits. Teens who work often learn the value of a hard-earned dollar. They learn how to manage their money, learn to problem solve, and most importantly, they learn how to work with people. Plus, a job in high school is a great way to add valuable experience to a resume.

With so many after school opportunities available for teens, it can be extremely difficult for them to balance homework with their other commitments. Oftentimes, active kids simply don’t have enough time in a day to get all that’s asked of them finished. When it comes homework, in all my years of working in the public school system, I have never seen a student jump for joy when homework was assigned. Of course, there are some who were anxious to complete the assignment, but that was more to get it off their busy plate. Which brings us to the essential question — does homework serve a purpose?

There are those who stand firm and back the claim that homework does serve a purpose . They often cite that homework helps prepare students for standardized tests, that it helps supplement and reinforce what’s being taught in class, and that it helps teach fundamental skills such as time management , organization, task completion, as well as responsibility (extracurricular activities and work experience can also teach those fundamental skills).

Another argument for homework is that having students complete work independently shows that they can demonstrate mastery of the material without the assistance of a teacher. Additionally, there have been numerous studies supporting homework, like a recent study that shows using online systems to assign math homework has been linked to a statistically significant boost in test scores. So, there you have it: Homework has a lot of perks and one of those involves higher test scores, particularly in math. But don’t form your opinion just yet.

Although many people rally for and support homework, there is another school of thought that homework should be decreased, or better yet, abolished. Those who join this group often cite studies linking academic stress to health risks. For example, one study in the Journal of Educational Psychology showed that when middle school students were assigned more than 90 to 100 minutes of daily homework, their math and science test scores began to decline.

The Journal of Experimental Education published research indicating that when high school students were assigned too much homework, they were more susceptible to serious mental and physical health problems, high-stress levels, and sleep deprivation. Stanford University also did a study that showed more than a couple of hours of homework a night was counterproductive. Think about it — teens spend an entire day at school, followed by extracurricular activities and possibly work, and then they get to end their day with two to three hours of homework. Now that’s a long day! No wonder so many of our teens are sleep-deprived and addicted to caffeine? On average most teens only get about 7.4 hours of sleep per night but according to the American Academy of Pediatrics , they need 8 to 10 hours.

Regardless of where you stand on the homework debate, a few things are certain: If homework is given, it should be a tool that’s used to enhance learning. Also, teachers should take into account the financial requirements of assignments, electronic accessibility, and they should be familiar with student needs as well as their other commitments. For example, not all students have equal opportunities to finish their homework, so incomplete work may not be a true reflection of their ability—it may be the result of other issues they face outside of school.

Many of today's teens are taking college-level courses as early as the ninth and tenth grades. With the push of programs such as Advanced Placement, International Baccalaureate, Early College Programs, and Dual Enrollment, today’s teens are carrying academic loads that surpass past generations. The result of this push for rigor can lead to high levels of stress, exhaustion, sleep deprivation, depression , anxiety , and early burnout . Too many teens are already running on empty. With more than half of teens reporting school and homework as a primary source of their stress, it’s evident that academic pressure is becoming a burden.

On the flip side, not all students spend a lot of time doing homework. What takes one student an hour to complete may take another three hours. Too often educators don’t take this into account when assigning homework. According to the University of Phoenix College of Education teacher survey, high school students can get assigned up to 17.5 hours of homework each week. To top it off, a Today article reported that teachers often underestimate the amount of homework they assign by as much as 50%. Now that’s a huge miscalculation, and our nation's youth have to suffer the consequences of those errors.

There are definitely pros and cons to doing homework. I think the bigger question that educators need to address is, “what’s the purpose of the assignment?” Is it merely a way to show parents and administration what's going on in the class? Is it a means to help keep students' grades afloat by giving a grade for completion or is the assignment being graded for accuracy? Does the assignment enhance and supplement the learning experience? Furthermore, is it meaningful or busywork?

The homework debate will likely continue until we take a good, hard look at our current policies and practices. What side of the line do you stand on when it comes to homework? Perhaps you’re somewhere in the middle?

Please weigh in with your thoughts. I am always eager to hear students’ voices in this discussion. If you are a student, please share what’s on your plate and how much time you spend doing homework each night.

Challenge Success White Paper: http://www.challengesuccess.org/wp-content/uploads/2015/07/ChallengeSuc…

Cooper, H., et al. (meta analysis): https://www.jstor.org/stable/3700582?seq=1#page_scan_tab_contents

Marzano, R., et al.: http://www.marzanocenter.com/2013/01/17/have-you-done-your-homework-on-…

NEA (National Education Association): http://www.nea.org/tools/16938.htm

Pope, Brown, and Miles (2015), Overloaded and Underprepared. (Brief synopsis here: https://www.learningandthebrain.com/blog/overloaded-and-underprepared-s… )

Raychelle Cassada Lohman n , M.S., LPC, is the author of The Anger Workbook for Teens .

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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])

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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

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

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

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

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

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

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

“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

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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Fighting a Losing Battle: Too Much Homework Can Interfere with Learning

Understanding Learning

Our brains are programmed to learn things that are interesting to us and relevant to our lives. You’re more likely, for example, to remember where the aggressive dog who always chases children lives than you are to remember the color pattern on your neighbor’s shirt. Children in particular are primed to learn things that help them better function in their environment. Unfortunately, homework doesn’t pass this test. The overwhelming majority of homework assignments force children to sit down and memorize facts rather than experience their world. Not only does this make information more difficult to learn; it can also decrease your child’s motivation to learn. When learning is made miserable, children associate the thing they’re learning with misery and want to avoid it. This is why tactics such as forced silent reading time or flashcards rarely help children learn math and vocabulary.

The Stressed Brain

Even when homework is well-designed and does foster learning, too much of it can be damaging. Children who have more than one hour of homework each night overwhelmingly report that they feel stressed about their ability to complete their work. Over time, this stress can create real problems for a developing brain. When we are under stress, the brain produces cortisol , which lowers immune function and processing speed. On a short-term basis, cortisol can help us deal with stress. But when the brain is constantly releasing cortisol, development and learning can slow. This is especially damaging for children, whose brains are rapidly laying down neural connections. Even more troubling, excessive doses of cortisol can damage the hippocampus, which plays an important role in memory, inhibition, and spatial reasoning.

Fewer Activities

The value of friendships , extracurricular activities, and relaxation time to children’s intellectual and emotional development has been extensively documented. When homework is overwhelming, however, children are less likely to have the opportunity to participate in these activities. Thus even a child who is left unfazed by excessive homework or who excels in school may suffer as a result of excessive homework because he’s unable to engage in the activities that can help him become a well-rounded adult.

A Better Approach to Homework

Homework can help bridge the gap between home and school, encourage independent learning, and give children who find school stressful an opportunity to learn at home. So what are the characteristics of “good” homework assignments? They include:

• Activities that encourage students to interact with their environment
• Activities that give students flexibility to focus on things they are interested in
• Activities that make learning relevant instead of flashcards and drills
• Reasonable amounts of time spent on homework—no more than one hour for young children and no more than two hours for high schoolers
• Activities that can be completed at home without substantial cost or the purchase of lots of supplies

When choosing a school or classroom for your child, ask about homework and advocate on your child’s behalf when homework becomes excessive. Your child’s stressed mind will thank you, and your child just may end up learning more.

References:

• Gerhardt, S. (2004). Why love matters: How affection shapes a baby’s brain. New York, NY: Brunner-Routledge.
• Harwood, R., Miller, S. A., Vasta, R. (2008). Child psychology: Development in a changing society. Hoboken, NJ: John Wiley & Sons.
• Hirsh-Pasek, K., Golinkoff, R. M., Eyer, D. E. (2004). Einstein never used flash cards: How our children really learn–and why they need to play more and memorize less. Emmaus, PA: Rodale.

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• 22 comments

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This entire school year I have been so frustrated with the amount of homework that my kids are consistently bringing home from school. It kind of makes me question what they are actually doing at school to have this much work to still have to bring home and work on at night. When I ask the teachers they just say it is to reinforce what they are teaching that day. But really? This is hour upon hour of work- the experts say that we need more family time together, but if most families are like ours, it is a struggle to get everything completed in the day, much less feel like we can have any quality down time together. What are we to do?

As a teacher I understand that sometimes parents feel even more overwhelmed by the homework than the students do. But I have to ask that you support us, we are not doing this to punish the students but instead to help them hold onto a concept that we have talked about in class that day.

I would never intentionally give more work to a class than I thought that they could handle, and I welcome any and all conversation with parents when they express that concern.

What bothers me though is when parents bad mouth the teachers and tell the students that they don’t have to do all of that work. That is not fair to the student nor is it fair to the rest of the class who really does manage to get all of their work done. I try to be as productive as possible in class but there are some days when we can’t get it all done and that necessitates the children having to bring home some work to complete.

Suffering parent

As a parent myself, there is no way that a few hours of homework is acceptable. They should be getting their work done in class with the help of their teachers, not bringing all of their work home to do. Home is not a place to make up time lost in class! Twenty minutes tops for a good review is okay. I agree with that. At the same time, that doesn’t mean hours. It’s absolutely unacceptable.

remember having to do tons of homework in high school.things must have only gotten worse ;)

but really,along with seeing what excessive homework does to us,we also need to look at why homework is only increasing.

if you ask me that well it could be because teachers are facing a lot of stress to deliver and they tend to give too much work to ensure the students do work.its like a doctor giving too many doses of a drug to ensure you are cured but in fact it is bad for you.

I think it’s the teachers who need to be reading this, not the parents. Parents know that most of the time their kids are being given way too much to have to do at home. I think that the real diconnect comes with the teachers. Of course if the students get the subject then the work won’t take that long to complete. But if a student is really struggling, this can be hours of homework horror for them.

When I can’t come home and have a concersation with my child because he or she has too much homework to take a break and sit with me for a few minutes, that’s a problem. That’s exactly what is goin on with my son this year. He is in the 10th grade and has barely had time to enjoy himself at all this year because of the amount of homework that he has on a daily basis. Now he is not the best student in school but he tries awfully hard and it makes me angry to think of how much time he gives on this work and yet I don’t necessarily see anyone giving back. I think that if the kids are working this hard then the teachers should at least reciprocate and give him a pat on the back every now and then for being such a hard worker.

Now a days the study competition increases day by day by increasing of progress in all things and today’s age of student have to work out so much on their studies so for the students help there are so much sources of help in studies are being introduce like online study which is easy to subscribe and get help from that.

I am so stressed! I am getting more than 7 pieces of homework each night + studying. Please help!

to help kids for losing homework to record it in phones or anything to keep crack on when kids lose homework.

Who is the author?

I am a high school student and I believe that homework should be required but an extra credit work and that all the grading should be on class participation and class work

high school student

I am a student and I get 4-7 hours of homework per night but I also am doing duke of ed ,scouts and cycling and that takes up most of my time . so I am getting in trouble for not completing homework and not getting enough sleep.as much as homework might help me I still get to much and don’t have time to have a normal teen life.

nun of yuz bisnus

i hate homework

My Spanish teacher who will remain undernamed as X gives excessive Homework. Today is Tuesday, and he says, he wants us to write 0 to 31, then 0 to 100, then 0 to 10000, and finally 0 to 200000 by next week Monday. How excessive and stressful is that.

these really help my techers dont give me and my class mates homework anymore thx

i dont know why children waste time on that like it´s so stesful when i was a kid i forgot what i needed to do because of all the homework and pakeges i needed to do every night

i am getting onlline homework, but i like homework. onlline scholl is just what i need:) its fun:) but not to much cause it ca be dameging:)

homework is pointless just doing hours and hours of review homework should not exist homework is idiotic

Although homework is a waste of time…it’s not like we have a choice, if we don’t get homework done we fail classes.

Homework is so hard and stressful that as soon as my parents tell me to do homework, I knew I was gonna get a headache.

I hate homework! It’s useless because it’s practically the same thing you learned in school, and it’s stressful!

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Notice to users

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

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.

Psychreg is a digital media company and not a clinical company. Our content does not constitute a medical or psychological consultation. See a certified medical or mental health professional for diagnosis.

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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
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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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The Impact of Homework on Student Mental Health

By Happy Sharer

Introduction

Homework is a key part of the educational process. It is often seen as an essential part of learning and helping students to develop important skills. However, there is growing evidence that too much homework can have a negative effect on student mental health. This article will explore the impact of homework on student mental health, examining the correlation between workload and stress levels, analyzing the effects of too much homework on student anxiety, and understanding how homework can lead to depression in students.

Exploring the Impact of Homework on Student Mental Health

Homework has long been seen as an important part of the educational process, but it can also become a source of stress for students. A recent study by the American Psychological Association found that more than two-thirds of students reported feeling overwhelmed by their homework load. The study also found that students who felt overwhelmed were more likely to experience symptoms of depression and anxiety. It is clear that the amount of homework assigned to students can have a significant impact on their mental health.

Examining the Correlation Between Homework and Student Stress Levels

The amount of homework assigned to students can have a direct impact on their stress levels. Too much homework can lead to feelings of frustration and overwhelm, which can then lead to increased stress levels. A study published in the journal Developmental Psychology found that when students had more homework assignments, they experienced higher levels of stress. The study also found that students who had more homework assignments were more likely to report feeling overwhelmed and anxious.

It is also important to consider the relationship between homework and academic performance. Studies have suggested that too much homework can lead to decreased academic performance, which can then lead to increased stress levels. A study published in the Journal of Experimental Education found that when students had more homework, their performance on tests was lower than those with less homework. This suggests that too much homework can lead to increased stress levels, as students feel pressure to perform at a higher level.

In order to reduce homework-related stress, it is important for students to prioritize their work. Planning ahead and breaking down tasks into smaller, more manageable chunks can help students to feel more organized and in control. Taking regular breaks throughout the day can also help students to stay focused and motivated. Finally, it is important to ensure that students are getting enough sleep in order to maintain their energy levels and reduce stress.

Analyzing the Effects of Too Much Homework on Student Anxiety

Too much homework can also lead to increased anxiety levels in students. A study published in the journal Clinical Child and Family Psychology Review found that when students had more homework, they were more likely to experience symptoms of anxiety. The study also found that students with excessive amounts of homework were more likely to report feeling overwhelmed and unable to cope with the workload.

It is important to understand the psychological effects of too much homework on students. Excessive amounts of homework can lead to feelings of frustration and helplessness, which can then lead to increased anxiety levels. Furthermore, students may start to see homework as a burden rather than an opportunity to learn, which can lead to decreased motivation and further feelings of anxiety.

In order to reduce homework-related anxiety, it is important to set realistic goals and expectations. Setting achievable goals and deadlines can help students to stay focused and motivated. It is also important to ensure that students are getting enough rest and taking regular breaks throughout the day. Finally, it is important to talk to teachers and parents about any concerns or worries that students may have about their workload.

Understanding How Homework Can Lead to Depression in Students

Too much homework can also lead to depression in students. A study published in the journal Pediatrics found that when students had more homework, they were more likely to experience symptoms of depression. The study also found that students with excessive amounts of homework were more likely to report feeling overwhelmed, frustrated, and helpless.

It is important to understand the psychological effects of too much homework on students. Excessive amounts of homework can lead to feelings of hopelessness and failure, which can then lead to increased depression levels. Furthermore, students may start to see homework as a chore rather than an opportunity to learn, which can lead to decreased motivation and further feelings of depression.

In order to reduce homework-related depression, it is important to focus on developing positive coping skills. Taking time to relax and practice mindfulness can help students to manage their emotions and stay focused. It is also important to ensure that students are getting enough sleep and taking regular breaks throughout the day. Finally, it is important to talk to teachers and parents about any concerns or worries that students may have about their workload.

Investigating the Relationship Between Homework and Student Self-Esteem

Finally, it is important to consider the relationship between homework and student self-esteem. A study published in the journal Developmental Psychology found that when students had more homework, they were more likely to report feeling inadequate and inferior. The study also found that students with excessive amounts of homework were more likely to report feeling overwhelmed and helpless.

It is important to understand the psychological effects of too much homework on students. Excessive amounts of homework can lead to feelings of worthlessness and failure, which can then lead to decreased self-esteem. Furthermore, students may start to see homework as a burden rather than an opportunity to learn, which can lead to decreased motivation and further feelings of inadequacy.

In order to increase homework-related self-esteem, it is important to focus on developing positive self-talk. Taking time to recognize achievements and celebrate successes can help students to stay motivated and build confidence. It is also important to ensure that students are getting enough rest and taking regular breaks throughout the day. Finally, it is important to talk to teachers and parents about any concerns or worries that students may have about their workload.

In conclusion, it is clear that the amount of homework assigned to students can have a significant impact on their mental health. Too much homework can lead to increased stress levels, anxiety, depression, and decreased self-esteem. It is therefore important to ensure that students are not overloaded with homework and are given the opportunity to learn in a healthy environment. By reducing the amount of homework assigned to students, we can help them to develop important skills without compromising their mental wellbeing.

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Hi, I'm Happy Sharer and I love sharing interesting and useful knowledge with others. I have a passion for learning and enjoy explaining complex concepts in a simple way.

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

How much homework is too much?

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

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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How Homework Is Destroying Teens’ Health

Jessica Amabile '24 , Staff Writer March 25, 2022

“[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[?]”

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.

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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• Find Your Calm: Managing Stress & Anxiety

Stress Symptoms

What Is Stress?

Stress is your body's response to a challenging or demanding situation. When you feel stressed, your body releases certain hormones. Your hormones are chemical signals your body uses to tell your body systems what to do. The hormones your body releases when you're stressed get you ready to meet the challenge or demand in your environment. During the stress response, your body gets ready to flee or fight by increasing your heart rate, breathing rate, and blood pressure.

Not all stress is bad. In small doses, stress can help you accomplish tasks or prevent you from getting hurt. For example, stress is what makes you slam on the brakes to avoid hitting a suddenly stopped car in front of you. That's a good thing.

But people handle stressful situations differently. What stresses you out may be of little concern to someone else. 

Stress can be a short-term response to something that happens once or only a few times or a long-term response to something that keeps happening. Our bodies can usually handle short-term stress without long-term effects. But long-term or chronic stress can make you sick, both mentally and physically.

The first step to managing your stress is to know the symptoms. But recognizing stress symptoms may be harder than you think. Many of us are so used to feeling stressed that we may not know it until we get sick. Read on to learn more about the various symptoms you may have when you're stressed.

Difference between stress and distress

Stress is a normal reaction to challenges in your physical environment or in your perceptions of what's happening around you. Experts consider distress to be stress that is severe, prolonged, or both. Distress is when you feel you’re under more stress than you can handle.

Emotional Stress Symptoms

Mental symptoms of emotional stress include:

• Feeling more emotional than usual, especially feeling grumpy, teary, or angry
• Feeling anxious, overwhelmed, nervous, or on edge
• Feeling sad or depressed
• Feeling restless
• Trouble keeping track of or remembering things
• Trouble getting your work done, solving problems, making decisions, or concentrating 

Physical Stress Symptoms

Symptoms of stress that you might feel in your body include:

• Clenching your jaw and grinding your teeth
• Shoulder, neck, or back pain; general body aches, pains, and tense muscles
• Chest pain, increased heart rate, heaviness in your chest
• Shortness of breath
• Feeling more tired than usual (fatigue)
• Sleeping more or less than usual
• Upset stomach , including diarrhea , constipation , and nausea
• Loss of sexual desire and/or ability
• Getting sick more easily, such as getting colds and infections often

Respiratory distress

This is when you aren't getting enough oxygen or are having to work really hard to breathe. If you or a loved one has symptoms of respiratory distress, you need to call 911 and get to the ER as soon as possible. Signs include:

• Breathing faster than usual
• Color changes of your skin, mouth, lips, or fingernails. A blue color around your mouth, lips, or fingernails usually shows you aren't getting enough oxygen. Your skin may also look pale or gray.
• Grunting when you breath out
• A whistling with each breath (wheezing)
• Nose flaring
• Chest sinking below your neck or under your breastbone with each breath (retractions)
• Increased sweating, especially cold, clammy skin on your forehead
• Leaning forward while sitting to help take deeper breaths

Cognitive Stress Symptoms

Symptoms of stress that affect your mental performance include:

• Trouble getting your work done, solving problems, making decisions, or concentrating
• Feeling less commitment to your work
• Lack of motivation
• Negative thinking

Behavioral Stress Symptoms

Symptoms of behavioral stress include:

• Changes in your eating habits; losing or gaining weight
• Procrastinating and avoiding responsibilities
• Using alcohol, tobacco, or drugs to feel better
• Avoiding your friends and family; isolating yourself from others
• Failing to meet your deadlines
• Increased absences at school or work
• Doing your work more slowly
• Exercising less often

Symptoms of Chronic Stress

Chronic stress is when you experience stress over an extended time. This can have negative effects on your body and your mental state, and it can increase your risk of cardiovascular disease, anxiety, and depression.

In general, the symptoms of chronic stress are the same as those for shorter-term stress. You may not have all these symptoms, but if you have more than three symptoms and they last for a few weeks, you may have chronic stress. Potential symptoms to look for include:

• Aches and pains
• Changes in your sleeping patterns, such as insomnia or sleepiness
• Changes in your social behavior, such as avoiding other people
• Changes in your emotional response to others
• Emotional withdrawal
• Low energy, fatigue
• Unfocused or cloudy thinking
• Changes in your appetite
• Increased alcohol or drug use
• Getting sick more often than usual

Is It Stress or Something Else?

You may be dealing with something more serious than day-to-day stress if you have symptoms over a period of time even though you've tried to cope using healthy mechanisms. Long-term stress is linked to number of mental health disorders, such as:

• Chronic stress
• Substance use disorder
• Disordered eating

It may be time to visit your doctor if you're struggling to cope with the stress in your life or you have mental health problems from long-term stress. They can help you figure out ways of coping in a healthy way or refer you to a mental health professional who can help you.

Posttraumatic Stress Disorder

Posttraumatic stress disorder (PTSD) is mental health condition that you may have after you have or witness a traumatic event, such as a natural disaster, accident, or violence. PTSD overwhelms your ability to cope with new stress. PTSD can lead to symptoms such as intrusive memories, avoidance behaviors, and hyperarousal. 

These symptoms can cause significant problems in your work or relationships. T alk to your doctor or a mental health professional if you've had or witnessed a traumatic event and have disturbing thoughts and feelings about it for more than a month, if your thoughts and feelings are severe, or if you feel like you're having trouble getting your life back on track.

What Are the Consequences of Long-Term Stress?

Ongoing, chronic stress can trigger or worsen many serious health problems, including:

• Mental health problems, such as depression, anxiety, and personality disorders
• Cardiovascular disease, including heart disease , high blood pressure, abnormal heart rhythms, heart attacks, and strokes
• Obesity and other eating disorders
• Menstrual problems
• Sexual dysfunction, such as impotence and premature ejaculation in men and loss of sexual desire in men and women
• Skin and hair problems , such as acne, psoriasis, and eczema, and permanent hair loss
• Gastrointestinal problems, such as GERD, gastritis , ulcerative colitis, and irritable bowel syndrome

Help Is Available for Stress

Stress is a part of life. What matters most is how you handle it. The best thing you can do to prevent stress overload and the health consequences that come with it is to know your stress symptoms.

If you or a loved one is feeling overwhelmed by stress, talk to your doctor. Many symptoms of stress can also be signs of other health problems. Your doctor can evaluate your symptoms and rule out other conditions. If stress is to blame, your doctor can recommend a therapist or counselor to help you better handle your stress.

Stress Takeaways

Stress is your body's response to a challenging or demanding situation. It can affect you physically, mentally, and behaviorally, especially when you have chronic stress. Chronic stress is when you are stressed for an extended time. Chronic stress can make it more likely for you to develop other mental health disorders, such as anxiety or depression. It can also affect your heart health and digestive health. If you're stressed and having trouble coping, it may be time for you to see your doctor or a mental health professional.

Stress FAQs

What can extreme stress cause?

Extreme stress, especially if it's prolonged, can cause emotional distress. And stress from a traumatic event, which is usually extreme, can cause posttraumatic stress disorder (PTSD). These are more serious cases of stress that overwhelm your ability to manage on your own. You may need to get a professional's help to get back on track. If you feel like you're having trouble managing your emotions, talk to your doctor. They can help you or direct you to someone who can help you.

Can stress make you throw up?

Yes, stress can make you throw up. Your digestive system is one of the many systems that stress can affect. In fact, you may have a whole range of other digestive symptoms, such as nausea, pain, and constipation or diarrhea. Not everyone has stress nausea or vomiting, but you may be more prone to it if you have a gastrointestinal condition, such as irritable bowel syndrome (IBS), or you have anxiety or depression.

You may be able to tell if you're stress vomiting if your episode passes when the stress goes away. If it doesn't, then your episode may be caused by something else. It's time to get checked out by your doctor if you have more than a couple of episodes or you can't figure out what's causing them.

Show Sources

Chu, B. Physiology, Stress Reaction , StatPearls Publishing, 2024.

American Psychological Association: "Stress effects on the body."

MedlinePlus: "Stress."

Mayo Clinic: "Stress management," "Emotional exhaustion: When your feelings feel overwhelming," "Post-traumatic stress disorder (PTSD)."

Cleveland Clinic: "Emotional Stress: Warning Signs, Management, When to Get Help," "Stress Nausea: Why It Happens and How To Deal. "

Johns Hopkins Medicine: "Signs of Respiratory Distress."

Helpguide.org: "Stress Symptoms, Signs, and Causes," "Understanding Stress."

Yale Medicine: "Chronic Stress."

Department of Health and Human Services: "Stress and Your Health."

American Institute of Stress: "Effects of Stress."

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Heart-Pounding, Stomach-Knotting: Stress and You

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More From Forbes

Mental health related leaves-of-absence up 300% since 2017.

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Workplace mental health is in sharp decline in 2024 as Job burnout and mental health leaves surge.

New studies show that mental health and well-being are continuing to decline in 2024. According to the National Institute of Mental Health , one in five Americans (57.8 million in 2021) were living with some type of mental illness in 2023, ranging from mild to moderate to severe anxiety and depression. Anxiety is the highest reported mental health disorder in the U.S. with 42.5 million Americans suffering from this illness. Several studies show that burnout is rising and mental health plunging and mental health leaves are going through the roof in 2024.

Lyra Health’s 2024 State of Workforce Mental Health Report finds that nearly four years after Covid-19, employees face a daunting task of managing the aftermath of a global crisis while balancing their work and personal lives. With mounting stressors like inflation, mass layoffs and a feeling of helplessness amid international wars and climate-related disasters, the report concludes that employees need more support.

Study # 1 Job Burnout

According to LinkedIn’s Workforce Confidence survey , four in 10 workers in the U.S. say they are burned out on the job. Project managers have an even higher rate of burn out as those working in healthcare and social services, the report shows. And half of workers in those roles say they’re experiencing burnout, often the result of overwhelming workplace stress without a resolution.

The findings further show that onsite workers are more likely to burn out than hybrid or remote workers, and employees of large corporations are more likely to burn out than those at smaller companies. Younger workers are also more likely to experience burnout than their older peers, and women are more likely to report burnout than their male colleagues.

Study # 2 Workplace Toxicity

Businesssolver’s 2024 Empathy Study surveyed over 3,000 employees, revealing how persistent stigma and workplace toxicity are intensifying the ongoing mental health crisis in today’s workplaces. According to the research, CEOs are burning out alongside their workforce. A staggering 55% of CEOs and 50% of employees have experienced a mental health issue in the past year. And 65% of Gen Z had a mental health issue in the past year. The research finds that, on average, 35% of employees and 52% of CEOs view their company's culture as toxic.

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Employees who stated their workplace is toxic are 47% more likely to cite mental health issues. Likewise, a stigma is present across how employees and CEOs view mental health in the workplace along with potential psychological safety issues that contribute to workplace toxicity while preventing employees from demonstrating empathy among colleagues.

The report says the longer the empathy and mental health stigmas persist in the workplace, the harsher the consequences for business performance and talent retention.

• 88% say they would be willing to stay with their organization if it empathized with their needs
• 70% believe that a company’s financial performance is linked to empathy.
• 65% say it would be easy for them to find a new job if they quit their current organization.
• 52% would even be willing to take slightly less pay for a more empathetic employer.

Study # 3 Mental Health Leaves Of Absence Skyrocketing

ComPsych , the largest provider of employee mental health and absence management services, released new data that shows mental health related leaves of absence continue to skyrocket among U.S. workers. From 2017 to 2023, mental health leaves of absence have increased by 300%. In 2023 alone, mental health related leaves of absence increased by 33% over the prior year. In 2023, women took nearly seven in ten (69%) of all mental health related leaves of absence. Millennial women accounted for one-third (33%) of 2023 mental health related leaves of absence, followed by Gen X women, who accounted for 30%.

More than one in ten (11%) of all leaves of absence were due to mental health, representing a 22% increase in mental health leaves versus those taken in the first quarter of 2023. As in earlier ComPsych data , this trend is being driven by female workers. While women accounted for 69% of all mental health leaves of absence in 2023, in Q1 of 2024, that number ticked up even higher to 71%. More Americans took mental health related leaves of absence in Q1 of 2024 than those for accidents, cancer, Covid-19, heart disease and heart attack combined.

“Our data shows that millennial and Gen X women are most likely to need a mental health related leave of absence,” says Richard A. Chaifetz, founder, CEO and chairman of ComPsych. “HR teams must invest in resources and programming that relates to issues commonly faced by these demographics: from the pressures of managing teams, the stress of buying a home for the first time, acclimating back at work as a new parent or worrying about care for aging relatives.”

Chaifetz concludes, “As the leader in the integration of mental health and leave administration, we have a unique view into how these two areas intersect. It’s clear that proactively investing in employee mental health is a key strategy for HR teams trying to mitigate the cost and impact of employee leaves of absence.”

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