homework linked to depression

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'

How Much Homework Is Too Much?

Are schools assigning too much homework.

Posted October 19, 2011

Timothy, a fifth grader, spends up to thirteen hours a day hunched over a desk at school or at home, studying and doing homework. Should his parents feel proud? Now imagine, for comparison's sake, Timothy spending thirteen hours a day hunched over a sewing machine instead of a desk.

Parents have the right to complain when schools assign too much homework but they often don't know how to do so effectively.

Drowning in Homework ( an excerpt from Chapter 8 of The Squeaky Wheel )

I first met Timothy, a quiet, overweight eleven-year-old boy, when his mother brought him to therapy to discuss his slipping grades. A few minutes with Timothy were enough to confirm that his mood, self-esteem , and general happiness were slipping right along with them. Timothy attended one of the top private schools in Manhattan, an environment in which declining grades were no idle matter.

I asked about Timothy's typical day. He awoke every morning at six thirty so he could get to school by eight and arrived home around four thirty each afternoon. He then had a quick snack, followed by either a piano lesson or his math tutor, depending on the day. He had dinner at seven p.m., after which he sat down to do homework for two to three hours a night. Quickly doing the math in my head, I calculated that Timothy spent an average of thirteen hours a day hunched over a writing desk. His situation is not atypical. Spending that many hours studying is the only way Timothy can keep up and stay afloat academically.

But what if, for comparison's sake, we imagined Timothy spending thirteen hours a day hunched over a sewing machine instead of a desk. We would immediately be aghast at the inhumanity because children are horribly mistreated in such "sweatshops." Timothy is far from being mistreated, but the mountain of homework he faces daily results in a similar consequence- he too is being robbed of his childhood.

Timothy's academics leave him virtually no time to do anything he truly enjoys, such as playing video games, movies, or board games with his friends. During the week he never plays outside and never has indoor play dates or opportunities to socialize with friends. On weekends, Timothy's days are often devoted to studying for tests, working on special school projects, or arguing with his mother about studying for tests and working on special school projects.

By the fourth and fifth grade and certainly in middle school, many of our children have hours of homework, test preparation, project writing, or research to do every night, all in addition to the eight hours or more they have to spend in school. Yet study after study has shown that homework has little to do with achievement in elementary school and is only marginally related to achievement in middle school .

Play, however, is a crucial component of healthy child development . It affects children's creativity , their social skills, and even their brain development. The absence of play, physical exercise, and free-form social interaction takes a serious toll on many children. It can also have significant health implications as is evidenced by our current epidemic of childhood obesity, sleep deprivation, low self- esteem, and depression .

A far stronger predictor than homework of academic achievement for kids aged three to twelve is having regular family meals. Family meals allow parents to check in, to demonstrate caring and involvement, to provide supervision, and to offer support. The more family meals can be worked into the schedule, the better, especially for preteens. The frequency of family meals has also been shown to help with disordered eating behaviors in adolescents.

Experts in the field recommend children have no more than ten minutes of homework per day per grade level. As a fifth- grader, Timothy should have no more than fifty minutes a day of homework (instead of three times that amount). Having an extra two hours an evening to play, relax, or see a friend would constitute a huge bump in any child's quality of life.

So what can we do if our child is getting too much homework?

1. Complain to the teachers and the school. Most parents are unaware that excessive homework contributes so little to their child's academic achievement.

2. Educate your child's teacher and principal about the homework research-they are often equally unaware of the facts and teachers of younger children (K-4) often make changes as a result.

3. Create allies within the system by speaking with other parents and banding together to address the issue with the school.

You might also like: Is Excessive Homework in Private Schools a Customer Service Issue?

View my short and quite personal TED talk about Psychological Health here:

Check out my new book, Emotional First Aid: Practical Strategies for Treating Failure, Rejection, Guilt and Other Evreyday Psychological Injuries (Hudson Street Press).

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Copyright 2011 Guy Winch

Follow me on Twitter @GuyWinch

Guy Winch, Ph.D. , is a licensed psychologist and author of Emotional First Aid: Healing Rejection, Guilt, Failure, and Other Everyday Hurts.

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Empowering Progress: Effective Therapy Homework for Depression

The role of therapy homework.

Therapy homework plays a vital role in the treatment of depression, providing individuals with an opportunity to actively engage in their healing process. By completing assignments outside of therapy sessions, individuals can reinforce the concepts learned in therapy, apply new skills, and make progress towards their treatment goals. In this section, we will explore the importance of therapy homework and how it can specifically help with depression.

Understanding the Importance of Homework in Therapy

Homework assignments serve as an extension of therapy and allow individuals to continue their progress beyond the confines of the therapy room. It provides an opportunity for individuals to practice and integrate new insights, coping strategies, and techniques into their daily lives. Through regular engagement with therapy homework, individuals can reinforce the therapeutic work, develop new habits, and enhance their overall well-being.

Therapy homework offers several benefits for individuals with depression. It allows for increased self-awareness, as individuals are encouraged to reflect on their thoughts, emotions, and behaviors. This self-reflection promotes a deeper understanding of oneself and the factors contributing to their depression, enabling individuals to identify patterns and make positive changes.

Additionally, therapy homework empowers individuals by giving them a sense of control and agency in their recovery journey. It fosters a sense of ownership and responsibility for one’s mental health, promoting active participation and engagement in the therapeutic process.

How Therapy Homework Can Help with Depression

Therapy homework can be particularly effective in addressing various aspects of depression. It can help individuals challenge negative thought patterns and develop more adaptive and positive thinking. Cognitive Behavioral Therapy (CBT) worksheets, for example, provide structured exercises to identify and reframe negative thoughts. These worksheets, along with journaling and thought records, allow individuals to track their thoughts and emotions, identify cognitive distortions, and develop healthier thinking patterns.

Behavioral activation exercises are another valuable component of therapy homework for depression. They involve engaging in activities that provide a sense of accomplishment, pleasure, or mastery, even when motivation is low. By gradually increasing participation in enjoyable and fulfilling activities, individuals can combat the inertia often associated with depression and experience an improvement in mood.

By consistently engaging in therapy homework, individuals with depression can experience a sense of progress, growth, and empowerment. However, it’s essential to collaborate with a therapist to develop a personalized homework plan that aligns with individual goals, needs, and preferences. This collaboration ensures that the homework assignments are tailored to the specific challenges and circumstances faced by each individual.

In the following sections, we will explore different types of therapy homework for depression and provide tips for developing a personalized homework plan that maximizes the benefits of therapy.

Types of Therapy Homework for Depression

When it comes to managing depression through therapy,  various types of homework assignments  can be incorporated to enhance the therapeutic process. These assignments aim to reinforce the skills and techniques learned in therapy sessions and provide individuals with opportunities for self-reflection and growth. Here are three common types of therapy homework for depression:

Cognitive Behavioral Therapy (CBT) Worksheets

Cognitive Behavioral Therapy (CBT) is a widely used approach for treating depression. CBT worksheets are valuable homework tools that help individuals identify and challenge negative thought patterns and beliefs. These worksheets typically involve exercises such as identifying automatic negative thoughts, examining evidence for and against these thoughts, and developing more balanced and realistic thinking patterns. CBT worksheets can be used to address distorted thinking commonly associated with depression, such as overgeneralization, personalization, and catastrophizing.

Journaling and Thought Records

Journaling and thought records are effective homework assignments for promoting self-awareness and monitoring thoughts and emotions related to depression. By encouraging individuals to write down their thoughts and feelings, these assignments provide an opportunity to identify negative thinking patterns and emotions that contribute to depressive symptoms. Thought records, in particular, involve documenting a specific negative thought, examining evidence for and against it, and generating alternative, more positive thoughts. Journaling and thought records can be powerful tools for increasing self-reflection and challenging negative self-perceptions.

Behavior Activation Exercises

Behavior activation is a key component of therapy for depression . Homework assignments focused on behavior activation aim to increase engagement in pleasurable and meaningful activities, even when motivation is low. These assignments may involve creating a schedule of daily activities, setting achievable goals, and gradually increasing involvement in enjoyable activities. By actively participating in positive experiences, individuals with depression can counteract the cycle of withdrawal and isolation often associated with the condition.

By incorporating these types of therapy homework into the treatment plan, individuals with depression can actively engage in their own healing process. It is important for therapists to collaborate with their clients, identifying specific goals and areas of focus, to tailor the homework assignments to each individual’s needs and preferences. Consistency, tracking progress, and seeking support are essential for making therapy homework a meaningful and effective part of the journey towards overcoming depression.

For more information on therapy homework assignments and ideas for other areas of focus, visit our articles on  therapy homework assignments  and  therapy homework ideas .

Developing a Personalized Homework Plan

To make the most out of therapy homework for depression, it’s essential to collaborate with your therapist and develop a personalized plan. This plan should be tailored to your specific needs, goals, and areas of focus. By working together with your therapist, you can create a realistic and manageable homework plan that complements your therapy sessions.

Collaborating with Your Therapist

The first step in developing a personalized homework plan is to collaborate with your therapist. Through open and honest communication, express your goals, challenges, and preferences. Your therapist will use their expertise to guide you in selecting appropriate homework assignments that align with your therapy objectives.

Your therapist may suggest specific therapy techniques or resources that can be incorporated into your homework plan. These may include  cognitive behavioral therapy (CBT) worksheets ,  journaling ,  thought records ,  behavior activation exercises , or other relevant tools. By discussing your preferences and comfort level, you can ensure that the chosen homework assignments resonate with you.

Identifying Goals and Areas of Focus

During therapy sessions, you and your therapist will identify specific goals and areas of focus. These goals may include developing coping skills, challenging negative thought patterns, improving self-esteem, or enhancing communication skills. By identifying these goals, you can create homework assignments that directly address the areas you want to work on.

For example, if one of your goals is to challenge negative thought patterns, your therapist may suggest completing CBT worksheets that help you identify and reframe negative thoughts. By integrating these worksheets into your homework plan, you can reinforce the skills learned during therapy sessions and continue working on them independently.

Creating a Realistic and Manageable Plan

When creating your homework plan, it’s crucial to ensure that it is realistic and manageable. Your therapist will help you set realistic expectations and establish a schedule that fits your lifestyle. It’s important to strike a balance between challenging yourself and avoiding overwhelming tasks.

By breaking down larger goals into smaller, achievable tasks, you can maintain motivation and progress steadily. Your therapist may also suggest incorporating self-care activities, relaxation exercises, or mindfulness practices into your homework plan to foster emotional well-being and resilience.

To help you stay organized and track your progress, consider using a journal or a digital tool specifically designed for therapy homework. These tools can help you monitor your assignments, record your thoughts and emotions, and reflect on your progress over time.

Remember, the success of your therapy homework plan depends on your consistency, commitment, and willingness to actively engage in the process. By collaborating with your therapist, identifying goals, and creating a realistic plan, you can maximize the benefits of therapy homework for depression.

Tips for Effective Therapy Homework

To make the most out of therapy homework and enhance the effectiveness of your treatment for depression , it’s important to keep a few key tips in mind. These tips will help you stay on track and maximize the benefits of your therapy sessions.

Consistency and Commitment

Consistency is key when it comes to therapy homework. Make a commitment to regularly engage in your assigned exercises or activities. Set aside dedicated time each day or week to work on your homework. Treat it as a priority and integrate it into your routine. By being consistent and committed, you’ll reinforce the therapeutic progress and build momentum towards achieving your goals.

Tracking Progress and Making Adjustments

Keep track of your progress as you engage in therapy homework. Maintain a record of your experiences, observations, and any changes you notice. This tracking will help you identify patterns and trends, providing valuable insights into your journey. It can be helpful to use a journal or a tracking app to record your thoughts and progress. Regularly review your records with your therapist to assess your growth, make adjustments, and refine your homework plan if necessary.

Seeking Support and Accountability

Seek support and accountability to stay motivated and committed to your therapy homework. Share your goals and progress with a trusted friend, family member, or support group. Consider joining a therapy or coaching community where you can connect with others who are also working on their mental health. Engaging in discussions, sharing experiences, and receiving encouragement from others can provide a sense of support and accountability that keeps you motivated and engaged.

Remember, therapy homework is an integral part of the treatment process for depression. By following these tips for effective therapy homework, you can enhance your progress and experience the full benefits of your therapeutic journey. Stay consistent, track your progress, and seek support to make the most out of your therapy experience.

For more information and resources on therapy homework for various topics, visit our  therapy homework assignments  page.

Overcoming Challenges with Therapy Homework

While therapy homework can be an effective tool for managing depression, it’s important to acknowledge and address the challenges that may arise during the process. Here are some common challenges individuals may encounter when completing therapy homework and strategies for overcoming them.

Addressing Resistance and Motivation Issues

Resistance and lack of motivation can hinder progress when it comes to therapy homework. It’s not uncommon to feel resistant or unmotivated, especially when dealing with the symptoms of depression. However, it’s important to remember that therapy homework plays a significant role in your overall treatment and recovery.

To address resistance and motivation issues, consider the following strategies:

• Explore the underlying reasons : Reflect on why you may be resistant or lacking motivation. Are there specific barriers or fears that need to be addressed? Share your concerns with your therapist to gain a deeper understanding and explore possible solutions.
• Break tasks into smaller steps : Overwhelming tasks can lead to resistance. Break down your therapy homework into smaller, more manageable steps. This can help make the tasks feel less daunting and increase motivation.
• Find intrinsic motivation : Connect with the deeper reasons behind why you want to engage in therapy homework. Remind yourself of the potential benefits, such as improved coping skills or increased self-awareness. Focusing on these intrinsic motivations can help reignite your motivation.

Dealing with Time Constraints

Finding time to complete therapy homework can be challenging, especially when juggling other responsibilities and commitments. However, dedicating time to your therapy homework is essential for making progress in your treatment.

To overcome time constraints, consider the following strategies:

• Prioritize and schedule : Prioritize your therapy homework by scheduling specific times in your daily or weekly routine dedicated solely to completing the tasks. Treat these scheduled times as non-negotiable commitments to yourself and your well-being.
• Break tasks into shorter sessions : If the length of the tasks feels overwhelming, break them into shorter sessions spread out over several days. This can help you fit therapy homework into your schedule more easily.
• Utilize downtime : Identify pockets of time throughout your day that can be used to complete smaller tasks. For example, you can work on journaling exercises during your morning commute or listen to guided meditation during your lunch break.

Modifying Homework to Fit Individual Needs

Therapy homework is not one-size-fits-all, and it’s important to tailor it to your individual needs and preferences. If you find that certain exercises or assignments are not resonating with you or are not producing the desired outcomes, it may be necessary to modify them.

Consider the following strategies for modifying therapy homework:

• Communicate with your therapist : Discuss any challenges or concerns you have with your therapist. They can help modify the homework assignments to better suit your needs and provide alternative options if necessary.
• Explore alternative techniques or activities : If a particular exercise is not effective for you, discuss alternative techniques or activities with your therapist. They may be able to suggest different approaches that align better with your preferences and goals.
• Experiment and adapt : Be open to experimenting with different approaches and techniques. Therapy homework is a collaborative process, and it may take some trial and error to find what works best for you. With the guidance of your therapist, adapt and modify the homework assignments to suit your unique circumstances.

By addressing resistance and motivation issues, managing time constraints, and modifying therapy homework to fit your individual needs, you can overcome challenges and make the most of your treatment. Remember to communicate openly with your therapist, as they are there to support you in your journey toward healing and recovery.

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Associations of time spent on homework or studying with nocturnal sleep behavior and depression symptoms in adolescents from Singapore

• Sing Chen Yeo, MSc Sing Chen Yeo Affiliations Center for Cognitive Neuroscience, Program in Neuroscience and Behavioral Disorders, Duke-NUS Medical School, Singapore Search for articles by this author
• Jacinda Tan, BSc Jacinda Tan Affiliations Center for Cognitive Neuroscience, Program in Neuroscience and Behavioral Disorders, Duke-NUS Medical School, Singapore Search for articles by this author
• Joshua J. Gooley, PhD Joshua J. Gooley Correspondence Corresponding author: Joshua J. Gooley, Center for Cognitive Neuroscience, Neuroscience and Behavioral Disorders Program, Duke-NUS Medical School Singapore, 8 College Road, Singapore 117549, Singapore Contact Affiliations Center for Cognitive Neuroscience, Program in Neuroscience and Behavioral Disorders, Duke-NUS Medical School, Singapore Search for articles by this author

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Type of Homework Completed by Depressed Clients Really Matters

• Post author: padesky.com
• Post published: January 23, 2020
• Post category: Clinical Tip / Research

By Christine A. Padesky, PhD / updated and reprinted from January 6, 2017 email 

CLINICAL TIP: A premature focus on core beliefs in therapy with depressed clients could lead to worsening of symptoms. Keep your focus on behavioral activation and cognitive restructuring.

While CBT homework has been linked to better outcomes and lower relapse, there has been little research on the differential impact of different types of homework practice. Significant findings by Hawley et al. strongly suggest we play close attention to the type of homework used in groups for depression. All clinicians need to update their interventions to ensure they are providing the best evidence based practices with their depressed clients in brief group outpatient therapy.

THE FINDINGS

• Depressed clients in brief group outpatient therapy benefited significantly from Mind Over Mood homework involving behavioral activation or cognitive restructuring via Thought Records. Contrary to other studies, behavioral activation was more effective for clients with mild to moderate depressive symptoms than clients with severe symptoms.
• Homework focusing on core beliefs led to worsening depression symptoms

These empirical findings influenced the rewriting of the 2nd edition of Mind Over Mood which has a reduced emphasis on core beliefs and an increased focus on behavioral activation and cognitive restructuring for depression. This research alerts therapists that a premature focus on core beliefs in therapy with depressed clients could lead to worsening of symptoms. More research in this area will be useful to clarify and test the strength of these findings.

FREE REPRINT AVAILABLE

To read/download the complete article, visit our Clinical Corner Publications page . The Hawley article is in the Depression section.

REFERENCES Greenberger, D., & Padesky, C.A. (2016).  Mind Over Mood: Change How You Feel by Changing the Way You Think . Guilford Press.

Hawley, L. L., Padesky, C. A., Hollon, S. D., Mancuso, E., Laposa, J. M., Brozina, K., & Segal, Z. V. (2017) Cognitive-Behavioral Therapy for Depression Using Mind Over Mood : CBT Skill Use and Differential Symptom Alleviation. Behavior Therapy, 48 (1), pp 29-44.

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13 Helpful Worksheets for Combating Depression

However, when a depressed mood or unbearable sadness is present for a long time – a couple of weeks or months – then it might meet the criteria for depression.

Depression affects over 264 million people worldwide. Between 76% and 85% of those experiencing depression do not seek or receive treatment for their disorder (World Health Organization, 2020a).

This article provides a starting point to understand depressive symptoms and also offers helping professionals resources to assist their patients with recovery.

Please note that the resources provided in this article are not a substitute for treatment from a medical professional. If you are suffering from depression or know someone who is, we recommend you seek help. Guidance is provided at the end of this article.

Before you continue, we thought you might like to download our three Stress & Burnout Prevention Exercises (PDF) for free . These science-based exercises will equip you and those you work with, with tools to manage stress better and find a healthier balance in your life.

This Article Contains:

2 worksheets to help combat depression, handouts for cbt sessions, 2 group therapy worksheets, depression worksheets for teens and youth, 4 worksheets on coping skills, positivepsychology.com’s toolkit resources, a take-home message.

Individuals who experience depression often deal with difficult emotions and engage in unhelpful thought patterns that worsen their depression. One of those responses that is widely recognized is excessive guilt .

Excessive guilt is one of the distinctive symptoms of depression, as it is often exaggerated and experienced out of context (Pulcu, Zahn, & Elliott, 2013).

Typically, individuals with major depressive disorder feel guilty for their emotions and are often upset at themselves for being affected by depression, as they feel they are worthless for being in a depressive state.

One of the most common types of guilt experienced by individuals who have depression is called omnipotent responsibility guilt , which is defined as “taking responsibility for events which may be out of one’s control and feeling guilty about their consequences” (Pulcu et al., 2013, p. 312).

Often, individuals with depression take responsibility for situations they have little or no control over, causing them to feel a sense of overwhelming guilt, even when they had nothing to do with the outcome.

Understanding what parts of a situation you can control or influence is an essential part of seeking treatment for depression. The Control–Influence–Accept Model (Thompson & Thompson, 2008) originated as a means to help people be more productive at work.

However, the basic principles of the model aim to identify pieces of a situation that you can control or influence, as well as aspects of a situation you may have to adapt to or accept.

If these sound like issues you are struggling with, feel free to consult the following worksheets:

1. Control–Influence–Accept Model

This is a good activity for individuals with depression to help break down situations. The model allows better visualization of different aspects of a situation and what specifically can be controlled, instead of worrying about all the possible outcomes.

2. Guilt and Shame: Emotions That Drive Depression

Guilt and shame are two emotions that drive your emotions when depression manifests. This exercise will help you identify guilt and shame that drives your depression and provides suggestions for channeling those emotions to facilitate more positive thinking  patterns.

CBT operates on the principle that emotional reactions and behaviors are influenced by cognitions (Westbrook, Kennerley, & Kirk, 2011).

Our behavior is governed by these cognitions, meaning that someone with anxiety might display more anxious behavior or engage in negative thinking patterns.

When an individual is affected by depression, they can experience cognitive distortions that are negatively biased errors in thinking. When individuals experience automatic thoughts, they are typically consistent with their core beliefs about aspects of themselves, others, and the world (Rnic, Dozois, & Martin, 2016).

Therefore, individuals who are experiencing depressive thoughts or symptomatology tend to have negatively charged core beliefs, which activate negative automatic thoughts. The cycle of negative thinking causes the symptoms of depression to continue and consolidate negative thoughts as part of an individual’s emotional response.

Our worksheet on Unhelpful Thinking Patterns categorizes the unhelpful thinking patterns that are present when someone is experiencing depression. It also provides strategies for individuals to reconstruct their thinking and identify the negative thinking patterns they might engage in.

Because of negative thinking patterns or cognitions, individuals often develop negative beliefs about everyday situations. This may cause them to change their behavior.

This worksheet on Behavioral Experiments to Test Beliefs encourages you to challenge your negative thoughts or beliefs. You are assisted to develop a hypothesis from your beliefs and test whether your negative core beliefs actually come true.

It is a useful worksheet if you are trying to confront negative beliefs about a specific situation, such as going out in social situations, or struggling to leave home. Having a concrete situation will allow you to better challenge the negative thinking patterns you might experience.

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Delivering CBT in a group therapy format is sometimes recommended for those who may benefit from a group to relate to when dealing with symptoms and situations specific to depression.

Individuals may also benefit from group cohesion and can potentially use the group as an arena for challenging their negative thoughts and behavior (Thimm & Antonsen, 2014).

1. Awareness of the mind

One of the most important goals in group therapy is for participants to get comfortable telling their story and learning about themselves. I Am is an introductory activity for people doing group therapy. Filling out the prompts helps them define themselves, specifically their boundaries and strengths.

The ultimate goal of the ‘I Am’ exercise is for the individual to gain an awareness of their own mind. They can then share this activity with other participants so they can all get to know each other better, form a trusting bond, and promote a safe space to discuss their depression.

2. Contributing events

Often, people with depression can identify a series of events that may have contributed to the development or worsening of their condition.

My Depression Story is designed for individuals taking part in group therapy. It encourages participants to make a timeline of their lives, highlighting key moments that have shaped their individual perceptions. It then asks them to do the same thing with their depression so they can better understand what the contributing factors may have been.

By sharing these events with the group, they can determine how depression has affected their perceptions and figure out a healthier way to map out their goals from now on.

According to the World Health Organization (2020b), one in six youths between the ages of 10 and 19 are affected by a mental illness. Moreover, depression is one of the leading causes of illness and disability among adolescents.

Therefore, it is essential to have resources and information for teens and their parents so they can identify the symptoms of depression. If you suspect your teen is experiencing depressive symptoms or you simply want to learn more, read on for resources you could use.

Recognizing the warning signs of depression is one of the most important preventative measures a parent or guardian can take to ensure that their teenager gets the help they need.

Our Depression Fact Sheet for Teenagers is designed to break down the symptoms and behaviors that characterize depression specific to teenagers. It also provides resources for teenagers to consult if they have a friend who is experiencing these symptoms and don’t know what to do.

Teenagers in particular may struggle to put their emotions into words, specifically when they are experiencing depression. This Letter to a Loved One About My Depression activity provides ideas for teenagers to help express their feelings. It even has a template that they can fill in and print if they are having trouble finding the right way to tell a parent or another loved one about their depression.

As discussed in the previous section, confronting negative thoughts is a central part of dealing with depression. The Depressive Thoughts for Teens worksheet acts as a companion to the Unhelpful Thinking Styles  worksheet.

It has specific activities for teenagers to break down their responses to various situations and an example to follow when confronting their negative thoughts. We encourage parents to complete this alongside their teenager to help them identify trigger situations and provide more productive problem-solving solutions.

An important part of facilitating long-term recovery from depression is to encourage coping skills that individuals can implement in their everyday lives when they feel overwhelmed or upset.

Coping strategies “consist of behaviors, primarily management and problem-solving techniques that are implemented to manage stressful situations” (Bautista & Erwin, 2013, p. 687).

Coping skills can either focus on targeting the problem (problem-based) or seek to make yourself feel better when the circumstances are out of your control (emotion-based).

The point of introducing these coping skills is not only to give individuals strategies to fight off depression, but also to discourage the use of unhealthy coping strategies (e.g., drugs, alcohol, avoidance, overeating, or overspending). These are strategies that provide instant gratification  but could have negative consequences if the unhealthy patterns continue.

1. Deep breathing

If you are looking for a technique that is easy to do and free of charge, consider exploring deep breathing. Three Steps to Deep Breathing gives you a quick overview of how to use deep breathing when you are feeling stressed, upset, or overwhelmed.

Our Power of Deep Breathing article also provides more details about how deep breathing can help you overcome stress and anxiety, and introduces practices where deep breathing is commonly used (e.g., yoga, meditation).

2. Coping style

Part of knowing how to implement coping skills into your daily routine is to understand what your coping style is and what strategies might work best for you. This Coping Styles Formulation activity helps individuals work with their therapist to identify the problem that is causing them distress.

By delving deeper into the events and actions that caused the problem, they may be able to better understand what coping style or skills they need to implement, especially if this is a recurring issue that causes distress.

3. Self-care

Another important part of coping is to implement self-care. Self-care is any activity that involves taking care of our mental, emotional, or physical health. Self-care not only leads to improved mood and reduced anxiety, but can also improve your self-esteem (Michael, 2016).

This Self-Care Checkup gives ideas for self-care and allows you to rate how often you engage in each activity. This worksheet also divides self-care into emotional, physical, social, professional, and spiritual self-care. It will reveal which area of your life needs the most attention and help you implement the strategies as needed.

4. Self-love

Additionally, this Self-Love Journal is helpful for daily self-care, as it gives you an opportunity to think about the moments and aspects of yourself that are positive, rather than focusing on more difficult things that are happening.

17 Exercises To Reduce Stress & Burnout

Help your clients prevent burnout, handle stressors, and achieve a healthy, sustainable work-life balance with these 17 Stress & Burnout Prevention Exercises [PDF].

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We have an excellent selection of resources that can assist those battling depression. For therapists, the following masterclasses and worksheets will equip you to be better able to support your clients.

Self-Acceptance Masterclass

The Science of Self-Acceptance Masterclass© is an excellent tool for practitioners and individuals who are struggling with accepting themselves. Often, a strong driver of depression is an individual’s difficulty with loving and accepting themselves for who they are.

This course focuses on building a healthy relationship with yourself first by using science-based activities to help build your self-esteem. This is also an excellent resource for practitioners who have a client who is struggling with depression and low self-esteem.

Meaning & Valued Living Masterclass

This masterclass on Meaning and Valued Living aims to help individuals find meaning in everyday life. People with depression often struggle to find meaning or value in themselves or their everyday actions, as they are caught in a cycle of negative thought patterns and experiences.

This course aims to help them regain a sense of purpose and find value in the contributions they are making, no matter how small or insignificant they may seem.

17 Stress & Burnout Prevention Exercises

If you’re looking for more science-based ways to help others manage stress without spending hours on research and session prep, this collection contains 17 validated stress management tools for practitioners. Use them to help others identify signs of burnout and create more balance in their lives.

Depression can be a difficult condition to overcome, especially when you feel lonely or isolated. Changing your thinking and behavior can be a daunting task, as it is often less intimidating to stick with something you are familiar with, even if it has a negative impact on your daily living.

Reading this article is a great first step to understand depression and struggles with negative thoughts. Be kind to yourself, and remember that every small step you take along your self-improvement journey is an important one and should be celebrated.

Reach out to a professional, close friend, or family member to help you with the next steps. Getting out of the hole is a challenging journey, so asking for help and someone to be on your side is the best decision you can take. You don’t have to do this alone.

If you are struggling with severe symptoms of depression or suicidal thoughts, please call the following number in your respective country:

• USA: National Suicide Prevention Hotline at 988
• UK: Samaritans hotline at 116 123
• The Netherlands: Netherlands Suicide Hotline at 0900 0767
• France: Suicide écoute at 01 45 39 40 00
• Australia: Lifeline at 13 11 14
• Germany: Telefonseelsorge at 0800 111 0 111 or 0800 111 0 222

For a list of other suicide prevention websites, phone numbers, and resources, see this website or consult Open Counseling’s list of International Suicide and Emergency Hotlines . Resources are listed by country, and you can click on the ‘more hotlines’ and ‘in-person counseling’ tabs to get further help.

Please know that there are people who care and treatments that can help.

We hope you enjoyed reading this article. Don’t forget to download our three Stress & Burnout Prevention Exercises (PDF) for free .

• Bautista, R. E., & Erwin, P. A. (2013). Analyzing depression coping strategies of patients with epilepsy: A preliminary study. Seizure , 22 , 686–691.
• Michael, R. (2016, August 10). What self-care is and what it isn’t. Psych Central. Retrieved April 23, 2021, from https://psychcentral.com/blog/what-self-care-is-and-what-it-isnt-2#1
• Pulcu, E., Zahn, R., & Elliott, R. (2013). The role of self-blaming moral emotions in major depression and their impact on social decision making. Frontiers in Psychology , 4 , 310–319.
• Rnic, K., Dozois, D. J. A., & Martin, R. A. (2016). Cognitive distortions, humor styles and depression. Europe’s Journal of Psychology , 12 (3), 348–362.
• Thimm, J. C., & Antonsen, L. (2014). Effectiveness of cognitive behavior group therapy for depression in routine practice. BMC Psychiatry , 14 (292), 1–9.
• Thompson, N., & Thompson, S. (2008). The critically reflective practitioner . MacMillian International Higher Education.
• Westbrook, D., Kennerley, H., & Kirk, J. (2011). An introduction to cognitive behavior therapy: Skills and applications (2nd ed.). SAGE.
• World Health Organization. (2020a). Depression . Retrieved April 21, 2021, from https://www.who.int/news-room/fact-sheets/detail/depression
• World Health Organization. (2020b). Adolescent mental health . Retrieved April 22, 2021, from https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health

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Can Homework Lead to Depression?

Homework is an after-school task that nobody bargained or asked for. It is simply that extra work that every student has to put in over a specific period every day after school. Kids in first grade are known to spend at least 10 minutes on their homework every day; those in high school (particularly the seniors) spend at least two hours on their homework every night. This is not conclusive; the amount of time spent could be higher or lesser, depending on the school, teacher, and the students’ abilities.

According to Sierra’s Homework Policy recommendation, students shouldn’t get more than ten minutes of homework every night and a maximum of fifty minutes of homework per term. While this recommendation is not binding or absolute, it mostly serves as a conceptual guide for teachers and tutors alike. Spending this amount of time on homework every night after a hectic day at school is not in any way fun for students, no matter the age or class. No student enjoys doing homework, especially when it has become a daily routine, and now that homework score is calculated as part of their cumulative score for the term. To ease the homework burden, students can ask for help at 123 Homework service and get it at an affordable price.

Whether homework can lead to or cause depression is an age-long question, and this article aims to explain the ‘if’ and ‘how’ too much homework can cause depression.

Studies have shown that the more time spent on homework means that students are not meeting their developmental needs or imbibing other critical life skills. While focusing on their homework, students are likely to forgo other activities such as participating in hobbies, seeing friends and family, and having meaningful and heart-to-heart conversations with people. Homework steals all the attention and spare time. Eventually, it puts students on the path of social reclusiveness, which would sooner or later tell on their mental and emotional balance.

Also, when a group of Harvard Health researchers asked students whether they experience any physical symptoms of stress like exhaustion, sleep deprivation, headache, weight loss, and stomach ache, over two-thirds of the participating students claim that they cope with anxiety thanks to their use of drugs, alcohol, and marijuana.

A Stanford University study showed that homework affects students’ physical and mental health because at least 56% of students attribute homework to be their primary source of stress. According to the study, too much homework is also a leading cause of weight loss, headache, sleep deprivation, and poor eating habits.

As beneficial as homework is to the students’ academic development, the fact remains that an additional two hours spent on homework after spending around 8 hours in school is too much and could lead to a massive mental breakdown.

Even though research has shown that homework can lead to depression, that doesn’t take away the fact that assignment is the only way to ensure and ascertain that students fully understood what they have learned in class; however, the question remains, is two hours on homework every night not too much?

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Therapist Behaviors as Predictors of Immediate Homework Engagement in Cognitive Therapy for Depression

Laren r. conklin.

a Department of Psychology, The Ohio State University, 1835 Neil Avenue, Columbus OH 43210

Daniel R. Strunk

Andrew a. cooper.

b Department of Psychology, University of Toronto Scarborough, 1265 Military Trail, Toronto, ON M1C1A4, Canada

Homework assignments are an integral part of cognitive therapy (CT) for depression, though facilitating homework engagement in patients with depression can be a challenge. We sought to examine three classes of therapist behaviors as predictors of homework engagement in early sessions of CT: therapist behaviors related to the review of homework, the assignment of homework, and efforts to help patients overcome obstacles to completing homework. In a sample of 66 depressed outpatients participating in CT, therapist behaviors involved in assigning homework predicted both CT-specific homework engagement and more general homework engagement. Therapist behaviors involved in homework review were not predictive of homework engagement. Our findings are consistent with the possibility that therapists’ emphasis of key elements of the homework assignment process enhances patients’ engagement in homework in early sessions of CT.

Homework assignments are an essential part of cognitive therapy (CT) for depression ( Beck, Rush, Shaw, & Emery, 1979 ). In CT, therapists utilize homework to help patients practice using and integrating CT skills into their lives ( Kazantzis & Lampropoulos, 2002 ). Common homework assignments in CT depression include self-monitoring activities to understand the connection between daily activities and mood; recording one’s automatic thoughts and developing alternative responses; and scheduling and engaging in activities to promote a sense of accomplishment or pleasure ( Beck, 1995 ; Beck et al., 1979 ). Patients are encouraged to regularly practice skills learned in therapy through assigned homework; however, the extent to which they engage in homework varies considerably, often falling short of desirable levels ( Kazantzis & Shinkfield, 2007 ).

Previous research has found that patients’ level of engagement with homework during CT is positively related to improvements in depressive symptoms. This relationship has been observed when symptom improvements were assessed over the duration of treatment ( Kazantzis, Deane, & Ronan, 2000 ; Kazantzis et al., 2016 ; Mausbach, Moore, Roesch, Cardenas, & Patterson, 2010 ) and more immediately (i.e., from one session to the next; Conklin & Strunk, 2015 ). However, there is little empirical evidence regarding which therapist behaviors predict homework engagement, in CT or in other treatments. In this study, we examine therapist behaviors that might serve to predict homework engagement. We assess both general homework engagement and engagement with specific types of homework. We use the term homework engagement to refer to the frequency and extent of any homework activities (see Conklin & Strunk, 2015 , for discussion of this conceptualization). It differs conceptually from compliance, which refers to the proportion of homework completed relative to what was assigned (see Primakoff, Epstein, & Covi, 1986 ). In considering candidate therapist behaviors that could predict homework engagement, we drew from both from the empirical evidence available and expert clinical opinion on the subject.

Empirical Evidence

To our knowledge, two previous studies of cognitive behavioral therapies for depression in adults have examined the relation of therapist behaviors and patients’ homework activities ( Bryant, Simons, & Thase, 1999 ; Startup & Edmonds, 1994 ). In first of these studies, Startup and Edmonds (1994) examined the relation of patient ratings of therapist behaviors involved in promoting homework (i.e., providing a rationale, clear description, anticipating problems, and involving the patient in the process) and weekly therapist-rated homework compliance. In their sample of 25 patients in multimodal cognitive behavioral therapy, they failed to find evidence that any therapist behavior was associated with homework compliance. They suggested that ceiling effects in patients’ ratings of therapists may have limited their ability to detect the effects of interest.

In the second study, Bryant and colleagues (1999) examined observer ratings of therapist homework-promoting behaviors at three recorded sessions widely spaced over early, mid, and late-treatment periods in a sample of 26 patients participating in CT. Observers rated the quality of four therapist behaviors: (1) the review of previous homework, (2) the explanation of a rationale for assignments, (3) the clarity and tailoring of assignments to the patient’s reported problems, and (4) how well the therapist sought reactions to the assignment and helped the patient trouble-shoot possible problems that might affect compliance. They found a non-significant trend suggesting a possible relation of their overall measure of homework-related therapist behaviors and homework compliance ( r = .24). An examination of individual items suggested that therapist’s review of the previous session’s homework was significantly positively associated with compliance ( r = .39). After being dichotomized (due to low frequency), an item assessing therapists’ eliciting of reactions to the assignment and trouble-shooting obstacles also showed an association with compliance ( r = .26).

While the focus of the current study is homework in CT for depression in adults, it is worth considering some important findings from the broader homework literature. One important experimental demonstration among behavioral medicine patients found that providing written instructions of the assigned homework led to higher compliance than verbal instructions alone ( Cox, Tisdelle, & Culpert, 1988 ). In a study of depressed adolescents participating in CT, providing a strong rationale and allocating more time to assigning homework predicted subsequent compliance, particularly for those who were initially resistant. Following the first session, therapists’ rationale and eliciting reactions / troubleshooting obstacles predicted compliance among those who had been low in compliance initially ( Jungbluth & Shirk, 2013 ).

Expert Clinical Opinion

While the empirical evidence reviewed above is limited, expert clinicians have offered numerous recommendations and guidelines for improving homework engagement ( Addis & Jacobson, 2000 ; Beck et al., 1979 ; Detweiler & Whisman, 1999 ; Garland & Scott, 2002 ; Kazantzis et al., 2000 ; Kazantzis, Pachana, & Secker, 2003 ; Shelton & Levy, 1981 ; Tompkins, 2002 ). Among the variety of techniques suggested, we discerned three broad categories: (1) therapist behaviors associated with the review of homework; (2) therapist behaviors associated with the assignment of homework; and (3) therapist behaviors related to overcoming obstacles to completing homework assignments.

Although multiple strategies for using homework successfully have been suggested, experts have varied in the extent to which they have emphasized different strategies ( Scheel, Hanson, & Razzhavaikina, 2004 ). When homework has been previously assigned, therapists are encouraged to review those homework assignments at the next session ( Beck et al., 1979 ; Garland & Scott, 2002 ; Kazantzis et al., 2003 ), reinforce the patients’ efforts with praise, and assess the patients’ perceptions of the helpfulness of homework ( Kazantzis et al., 2000 ; Kazantzis et al., 2003 ; Tompkins, 2002 ). Expert clinicians have also emphasized the value of clearly describing and assigning homework. Specific recommendations include: providing a rationale for the homework, devoting time in session to describing how to complete assignments, delineating clear and specific assignments, using in-session practice as needed, and ensuring that patients have a written reminder of their assignments ( Beck et al., 1979 ; Detweiler and Whisman, 1999 ; Garland & Scott, 2002 ; Kazantzis et al., 2000 ; Kazantzis et al., 2003 ; Shelton & Levy, 1981 ; Tompkins, 2002 ). At the beginning of treatment when homework assignments are new to patients, these recommendations may be particularly important. Finally, some experts have recommended working with patients to identify and overcome potential obstacles that might impede homework engagement ( Kazantzis et al., 2000 ; Tompkins, 2002 ). Therapist behaviors related to these three domains (assignment, review, addressing obstacles) were also identified as important to therapists’ competent use of homework by a panel of six experts in CT (see Schmidt, Strunk, DeRubeis, Conklin, & Braun, 2017 ).

In this study, we sought to identify therapist behaviors that may predict homework engagement in early sessions of CT for depression (specifically, in the first five sessions). We focused on early sessions of CT for three reasons: (1) previous research has suggested that much of the therapeutic progress made occurs early in the course of treatment ( Strunk, Brotman, & DeRubeis, 2010 ); (2) we were interested in initial engagement, as we suspected that it is key to establishing a pattern of high levels of engagement throughout treatment; and (3) our assessments of therapist behaviors and homework engagement were labor intensive and therefore required a focused approach. We also planned to build on previous studies in which the authors assessed the relationship between in-session therapist behaviors and patient homework compliance that occurred prior to the next session ( Bryant et al., 1999 ; Startup & Edmonds, 1994 ) by focusing on immediate consequents of therapist behaviors while utilizing a relatively large sample and leveraging repeated assessments to increase power. Based on our review of the existing literature, we evaluated three classes of therapist behaviors described above (viz., reviewing homework, assigning homework, and overcoming homework obstacles). We examine both general homework engagement and engagement with specific types of CT homework. We hypothesized that therapist behaviors in each of these domains would predict homework engagement as observed in patients’ discussions with therapists at the following session.

Participants

CT sessions utilized in this study were drawn from a naturalistic study of 67 adults with major depressive disorder (MDD; see Adler, Strunk, & Fazio, 2015 ; Conklin & Strunk, 2015 ). Because one patient discontinued participation prior to attending a session, the sample was necessarily reduced to 66. CT was provided by four doctoral students who were supervised by the second author (for more information about therapist training and the competence with which CT was provided, see Adler, Strunk, & Fazio [2015] ). Study inclusion criteria were as follows: a diagnosis of current MDD as assessed by the Structured Clinical Interview for the DSM-IV (SCID; First, Spitzer, Gibbon & Williams, 1994) and agreeing to refrain from adding or modifying the dose of any psychiatric medications currently being used over the course of treatment. Individuals were excluded from the study if any of the following were present: Bipolar I or any psychotic disorder; substance dependence in the six months prior to intake; or a primary diagnosis other than MDD if it was judged to require treatment other than CT.

Of the 66 participants, 37 (56%) were female. The mean age was 36.3 ( SD = 13.4, range: 18–69). The racial/ethnic make-up of the sample was 83% Caucasian ( n = 55), 11% African American ( n = 7), 5% Asian American ( n = 3), and 1% were Hispanic/Latino ( n = 1). A majority of the sample (91%) had at least some college education, and 45% had graduated from a four-year college. Two-thirds of the sample (67%, n = 44) were diagnosed as having at least one prior depressive episode, and 61% ( n = 40) of the sample met criteria for one or more co-morbid anxiety disorders, with generalized anxiety disorder being the most common (33%, n = 22). The majority (79%, n = 52) attended the first five sessions, with the remainder of the patients discontinuing treatment prior to session five. All available data from participants were used in analyses.

Homework-Specific Therapist Behavior Scales (HSTBS)

Based on our review of the literature summarized in the introduction, we developed 16 observer-rated HSTBS items to assess three classes of therapist behaviors that may promote homework engagement: Review, Assignment, and Overcoming Obstacles. The first and second authors reviewed this literature and identified key classes of therapist behaviors thought to promote homework engagement. The first author drafted specific items and the second author, who has extensive experience in research utilizing observer ratings of psychotherapy, provided feedback regarding the degree to which the items covered the relevant therapist behaviors as well as suggesting any revisions to facilitate reliable coding of the behaviors by observers. The items were then revised to address these concerns. On the HSTBS, each scale item is rated from zero (not at all) to four (considerable), and then all items on each scale are averaged to create the scale score. In this study, three raters (drawn from a team of 17 raters; see the “ratings of homework-related characteristics” section below for details) used the HSTBS to evaluate each study session; thus, inter-rater reliability for each scale is reported below.

The Assignment scale consists of seven items assessing therapist behaviors thought to be important when assigning homework. The items assess the extent to which: (1) the therapist discussed the rationale for upcoming homework, (2) described how to do the tasks assigned for homework, (3) practiced the skills needed to do the homework, (4) ensured the patient understood how to perform the homework, (5) assigned specific homework, (6) clarified which activities or recommendations were homework assignments, and (7) ensured the patient had a written record of the homework. The Assignment scale had a median Cronbach’s alpha of .67 across sessions. The intraclass correlation coefficient (ICC; adjusted for three raters; see McGraw & Wong, 1996 ) for the Assignment scale was .75.

The Review scale consists of four items assessing therapist behaviors thought to be important in reviewing homework. These items assessed the extent to which therapist: (1) reviewed the homework, (2) involved the patient in reviewing homework, (3) discussed the helpfulness of previous homework, and (4) praised the patient for working on homework. The Review scale had a median Cronbach’s alpha of .76 across sessions. The ICC (adjusted for three raters) for the Review scale was .86.

Finally, the Overcoming Obstacles scale consists of five items assessing therapist behaviors important in ensuring patients would know how to work around possible obstacles to completing homework assignments. Overcoming Obstacles items assessed the extent to which therapists discussed the following with the patient: (1) obstacles that impeded previous homework progress, (2) the ways identified obstacles could be minimized in future homework, (3) the ways possible obstacles to upcoming homework could be worked around, (4) the ways of helping the patient remember to make time to do the homework, and (5) the ways of challenging thoughts that might interfere with the upcoming homework. The Overcoming Obstacles scale had a median Cronbach’s alpha of .75 across sessions. However, the ICC (adjusted for 3 raters) for the Overcoming Obstacles scale was .43. This low ICC may have been due to restriction of range with many zero scores, which was not evident in the other two scales. Because of the low ICC, we limit our presentation of analyses of this scale to basic descriptive statistics and do not present other analyses involving this scale score.

Homework Engagement Scale—General (HES-General; Conklin & Strunk, 2015 )

The HES-General is a three-item observer-rated measure of patients’ between-session homework engagement. The initial evaluation of the HES-General and the HES-CT (described below) were drawn from the same parent dataset ( Conklin & Strunk, 2015 ) as the current study. Three raters (drawn from a team of 19 raters) used the HES-General and HES-CT to rate each session, and inter-rater reliability is reported for each scale below.

The HES-General scale includes the following items: (1) the estimated amount of time the patients spent on homework (time); (2) the frequency with which the patients reported using CT skills when they were sad or upset (frequency); and (3) the estimated effort the patients put into homework assignments (effort). Items were summed so that the range possible on this measure was zero to twelve, with higher scores indicating greater time, greater effort, and more frequent engagement in homework activities between sessions. The HES-General had a median Cronbach’s alpha of .83 across sessions. The ICC for HES-General was .63.

Homework Engagement Scale—CT-Specific (HES-CT; Conklin & Strunk, 2015 )

The HES-CT is a three-item observer-rated scale that assesses the degree to which patients engage in commonly assigned types of CT homework. The homework assessed includes: cognitive homework (primarily thought records), self-monitoring homework (primarily use of a daily activity log), and behavioral homework other than self-monitoring (e.g., practicing assertiveness, planning activities designed to produce a sense of pleasure or mastery). While the HES-CT items were rated on a zero (no engagement) to six (extensive engagement) scale, screening of the items suggested non-normality due to a high percentage of zero values. This is consistent with conventional CT implementation, in which therapists do not typically assign all three types of homework in every session. To reduce the non-normality of the data, the non-zero ratings were recoded. Scores from one to three were coded as a one and scores from four to six were coded a two, thus resulting in scale items with values ranging from zero to two and HES-CT total scores ranging from zero to six. The ICC for HES-CT was .64.

Ratings of CT

Video (or audio) recordings from the first five therapy sessions were coded for this study. Audio recordings were used on occasions where the video quality was too poor for adequate rating or when a video recording was not available. All available recordings were utilized. A total of 288 sessions occurred between session one and five, and recordings of 282 sessions (99%) were available for coding. No recordings were available for sessions taking place via phone ( n = 4) or when a recording device failed ( n = 2).

Ratings of homework-related characteristics

A total of 36 undergraduates were on one of two CT rating teams, and both teams were equivalent with respect to the duration and extent of training. Raters were trained over 10 weeks prior to beginning the rating of study sessions. Training consisted of weekly meetings with the first author to review rating materials and practice making ratings using recordings of CT sessions drawn from an independent study of CT. After the training, raters made study ratings over a subsequent 10 week period. During this period, raters met periodically to discuss any difficulties that had arisen in making study ratings. They also rated clips of CT sessions not from this study to practice making ratings as a group in an effort to reduce any rater drift.

Each study session was rated by three members of each team, with each member rating no more than one session per patient. The averages of raters’ scores were used in analyses. One team ( n = 17) rated therapist behaviors in sessions one through four using the HSTBS. The second team of raters ( n = 19) rated engagement in sessions two through five using the HES-General and HES-CT. To complete their ratings, both teams of raters needed to know what homework had been assigned in the previous session. To provide this information, the second team of raters created a log of homework assignments. Logs for the prior session were provided to aid raters in making their judgments for the current session.

Overall Analytic Strategy

To model the dependence among repeated measures, we conducted primary analyses using the SAS Proc Mixed without specification of random effects. We evaluated four covariance structures (viz., unstructured, compound symmetry, autoregressive, and Toeplitz) and selected the best-fitting covariance structure for each dependent variable examined. The best fitting covariance structure, decided by Akaike’s Information Criterion (AIC), was autoregressive for both the HES-General and HES-CT.

We used repeated measures regression analyses to examine therapist behaviors at each session as predictors of homework engagement at the next session while controlling for homework engagement at the current session. For each of the analyses, lagged engagement scores (viz., engagement scores from sessions 2–5) served as the dependent variable with engagement scores from the previous session entered as a covariate. Thus, engagement at session two served as a covariate in predicting engagement at session three, engagement at session three served as a covariate in predicting engagement at session four, etc. HSTBS scores at sessions one through four were entered simultaneously as predictors in separate models for each homework engagement variable. To aid interpretation, both predictors and dependent variables were standardized to a mean of zero and a standard deviation of one prior to these analyses.

Descriptive Statistics for Therapist Behaviors and Homework

Therapist behaviors involved in homework review would not have occurred in the first session, as homework was not assigned prior to that session. Across the remaining sessions (2 through 5), the Review scale had an average score of 1.90 ( SD = .82). Across sessions 1 through 5, the Assignment scale had an average score of 2.49 ( SD = .58) and the Overcoming Obstacles scale had the numerically lowest average score of .45 ( SD = .54). Review and Assignment, the two scales included in the primary analyses, were moderately positively correlated on average ( r = .26: range: .12 to .47), but this relationship was only significant at one session. 1

Similar to the description provided by Conklin and Strunk (2015) for a subset of this sample, homework was assigned in 99% of the 230 sessions that were rated between sessions one and four. Among the three types of homework we examined, cognitive homework, consisting predominantly of thought records, was most commonly assigned (73% of the sessions). Self-monitoring, involving use of daily activity logs, was the second most frequently assigned homework type (60%). Finally, behavioral homework, which focused on trying new between session activities, was a common, but less frequently assigned type (45%).

Across sessions two through five, patients reported that they completed homework in 88% of sessions. The average amount of total CT-specific homework completed by patients between each session was 1.93 ( SD = .82) out of a possible 6. Breaking these ratings down by the type of homework completed, the average scores indicated that patients completed “some” of each type of homework, which according to the anchors the raters used was equivalent to a partially completed activity log ( M = 1.03, SD = .65), two thought records ( M = .57, SD = .44), and two behavioral tasks ( M = .33, SD = .31).

When examining ratings of general homework engagement (HES-General), patients received an average score of 4.06 ( SD = 1.56) out of 12 points. Broken down by item and interpreting amount based on the scale anchors, average ratings indicate that patients spent approximately 30 minutes on homework ( M = 1.28, SD = .60), “occasionally” used therapy skills when they felt sad or upset ( M = 1.56 SD = .64), and put “some” effort into completing homework assignments ( M = 1.22, SD = .49).

Homework-Related Therapist Behaviors as Predictors of Session-to-Session Homework Engagement

Using a separate model for each dependent variable, we examined both Review and Assignment as predictors of HES-CT and HES-General. For the model of HES-CT scores, the HSTBS Assignment scale significantly predicted homework engagement, t (93) = 3.41, β = .36, p = .001, but the HSTBS Review scale did not, t (93) = .78, β = .10, p = .43. Similarly, for the model of HES-General, the HSTBS Assignment scale emerged as a significant predictor, t (93) = 3.83, β = .41, p = .0002, whereas HSTBS Review scale did not predict HES-General scores, t (93) = −.28, β = −.04, p = .78.

In this study, we examined specific types of therapist behaviors as potential predictors of patients’ session-to-session homework engagement across early sessions of CT for depression. The consistent finding was that the scale aggregating therapist efforts to assign homework was the numerically strongest predictor of homework engagement. Assigning homework predicted both measures of general and CT specific homework engagement. These findings highlight the importance of therapist efforts to encourage patients to practice new skills through their assignment of homework: by providing a compelling rationale, a thorough description of any homework assigned, and ensuring a clear understanding on the part of the patient.

Contrary to expectation, homework review did not predict subsequent homework engagement, neither in the model assessing predictors of general homework engagement nor the model assessing predictors of CT-specific homework engagement. This is in contrast to two previous studies that found some evidence that the competence with which a therapist reviewed homework predicted next session homework compliance ( Bryant et al., 1999 ; Weck et al., 2013 ). The measures and methods used varied considerably from those of the current study, which we suspect played a role in the differing findings. We consider three key differences between previous studies and the current one. First, there was a difference across studies in which sessions were rated. We rated early sessions, whereas Bryant et al. (1999) and Weck et al. (2013) examined sessions spread out across the course of treatment. It is possible that therapists establish a pattern of reviewing homework more frequently for patients who engage in homework regularly. If so, such patterns in later sessions may have contributed to the stronger evidence of a relation of homework review and compliance in studies that included later sessions than our own study. Second, both Bryant et al. and Weck et al. relied on assessments of the competence of homework review. It is unclear how strongly assessments of competence would correlate with measures of the extent to which a therapist engaged in specific behaviors involved in homework review. Finally, rather than homework engagement, authors of both of these previous studies assessed homework compliance. Unlike our assessments of homework engagement, assessments of homework compliance involve measuring the patients’ homework relative to what was assigned. As we have argued previously, this can sometimes lead to high compliance scores when small amounts of homework were completed and low compliance scores when moderate or even relatively high amounts of homework were completed (see Conklin & Strunk, 2015 ).

Limitations

We wish to acknowledge some limitations of this study. First, the Overcoming Obstacles scale exhibited poor inter-rater reliability and was therefore not used in subsequent analyses. As we mentioned, this may have been due to a restriction of range (i.e., a floor effect) that made it difficult for raters to reliably observe the infrequent occasions when therapists exhibited these behaviors. Informed by this evidence that therapist behaviors related to overcoming obstacles may be relatively less frequent or more difficult to identify suggests the need to refine our measure or bolster rater training in future research. Second, our ability to detect the relations of interest depends on both adequate representation of variability in the constructs of interest in the sample as well as the ability of our measures to capture the range of these behaviors. Insofar as some of our measures were created for this study, it is difficult to assess the extent to which this was present. Insofar as larger number of items may enhance a scale’s reliability and validity, one might expect that the Assignment scale would have an advantage over the Review Scale. Nonetheless, it is worth noting the two prior studies that found relationships between homework review and compliance ( Bryant et al.,1999 ; Weck et al., 2013 ) utilized one-item assessments of homework review. Third, therapists involved in the project were therapists in training. The relations we studied may vary as a function of therapist expertise in providing CT. However, evaluations of therapist competence in this study suggested that competence appeared roughly on par with that observed among clinicians providing CT in clinical trials ( Adler, Strunk, & Fazio, 2015 ). Fourth, our decision to focus on early sessions means we do not know whether our findings would generalize across the course of CT. Finally, and most importantly, it is important to note that this study was not experimental. Therefore, we cannot rule out the possibility that our findings might be accounted for by an unmeasured third variable.

Although the use of between-session homework activities has been a key component of CT for depression since its inception ( Beck, Rush, Shaw, & Emery, 1979 ), clinicians have thus far had to largely rely on expert advice and clinical intuition to determine what elements of the homework process are important to emphasize to increase the likelihood that patients complete homework. Should one spend the majority of effort in session reviewing patients’ previous homework and helping them learn from past experience with the homework? Should one instead emphasize the practicing of new skills and ensure that the homework related to those skills is specific and understandable? How one answers these questions plays a key role in determining session structure and flow. We hope that the findings of this study help to facilitate making such decisions on the basis of empirical evidence.

To provide such evidence, we examined the relation of homework assignment and review-related therapist behaviors to general homework engagement and engagement with specific CT homework assignments. Therapist actions involved in assigning homework emerged as the more robust and numerically stronger predictor of both forms of homework engagement. Therefore, helping patients understand the nature of any homework assignments given (by describing the homework clearly, practicing it, ensuring patients have a written record of the assignments, etc.) appears to be a plausible determinant of session-to-session homework engagement. Our findings suggest that homework engagement could be enhanced when therapists emphasize key elements of the homework assignment process in early sessions of CT for depression.

Acknowledgments

We thank our colleagues for making this research possible. Abby D. Adler, Laren R. Conklin, Andrew A. Cooper, Lizabeth A. Goldstein, and Elizabeth T. Ryan served as cognitive therapists and clinical interviewers. Abby D. Adler served as study coordinator. Daniel R. Strunk provided training in and supervision of clinical assessments and cognitive therapy. Special thanks are also due to those who served as raters of therapist behaviors and homework engagement. Without their hard work and dedication, this research would not have been possible.

Funding Source: This project was supported by Award Number TL1RR025753 from the National Center for Research Resources. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center for Research Resources or the National Institutes of Health.

Conflicts of Interest: Laren Conklin, Andrew Cooper, and Daniel Strunk declare that they have no conflicts of interest.

Compliance with Ethical Standards:

Ethical approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. 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.

1 To examine the average relationships between the scales, correlations were calculated separately at each session, then r values were transformed to z scores, averaged across sessions, and finally these z scores were transformed back to r values.

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How are Depression and Motivation Related?

Jan 12, 2022

Lack of motivation can be a struggle for most people on occasion, but for people who suffer from depression this can be an everyday occurance. People with depression can find they lack motivation to complete or partake in the activities of daily life.

A chronic lack of motivation is a common and key symptom of depression. Doctors and clinicians consider lack of motivation a warning sign that their patient may be struggling with depression or another mental health disorder.

The loss of motivation can cause a vicious cycle to occur in a person who is struggling with depression. The person may stop participating in activities and as a result feel guilty for stopping. This can lead to even more lack of motivation and incompleteness of tasks and activities. To break the cycle can be difficult and the individual may find they cannot find motivation on their own.

Symptom of Depression: Loss of Motivation

People who develop depression may notice that their levels of motivation have lessened and tasks that were once easy to complete have become nearly impossible. A characteristic of depression related to lack of motivation is losing interest in activities that you used to enjoy.

Lack of motivation can lead to other common symptoms of depression:

• Having trouble with memory
• Having low energy
• Difficulty concentrating
• Feeling hopeless
• Difficulty making decisions
• Having an empty or low mood

Neurotransmitters Linked To Motivation

Neurotransmitters are chemicals in the brain that nerve cells use to communicate with each other and these messages can help to regulate mood. The key neurotransmitters that are affected by people with depression are dopamine, norepinephrine, and serotonin.

The neurotransmitter that is closely linked to motivation is dopamine . Dopamine’s role in the brain is to create positive feelings and moods associated with reinforcement and reward that help us become motivated to continue with a task. Reduced dopamine levels can contribute to depression and lack of motivation in some individuals.

Finding Motivation When You’re Depressed

To find motivation while you are depressed can be a difficult task. Effective treatments and an individualized treatment plan can help you lessen your depression symptoms and find motivation again.

Here are some additional tactics to try:

• Set achievable goals – Building and executing a large plan to complete goals can be overwhelming especially if you are struggling from depression. Break down large goals into smaller tasks so that you can avoid overwhelming yourself.
• Reward yourself – Whenever you find the motivation to complete a task, reward yourself with something that will bring you enjoyment and give you something to look forward to. This helps to reinforce your motivation and continue with the tasks at hand.
• Build a realistic schedule – Create a schedule for the day that is realistic and does not involve an overwhelming amount of tasks. The schedule can also be made into a checklist that can help you stay on track. Completion of tasks can result in a boost of self-confidence.
• Avoid negative thoughts – Replace your negative thought patterns and negative self-talk with positive affirmations and positive thought patterns.
• Focus on healthy relationships – Socializing with supportive friends and family can help increase your motivation. This support network can also help hold you accountable and assist you with a gentle push to get motivated.

Although these tactics seem simple, for someone struggling with depression these tactics can seem impossible. Additional help may be needed and finding the right treatment that works for your depression is vital in finding recovery.

Brain Therapy TMS

Traditional treatment for depression includes psychotherapy and medication management. If these traditional methods are no longer treating your depression, consider alternative methods. One such alternative method is Transcranial Magnetic Stimulation (TMS).

TMS has been proven to be an effective breakthrough therapy for depression. TMS helps heal specific parts of the brain to improve mental and neuropathic disorders without the use of medication. If you have tried multiple antidepressants with no success, and are looking for alternative treatment methods – don’t hesitate to give Brain Therapy TMS a call to find out what TMS can do for you.

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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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The Hawk Eye

Opinion: Is homework really worth it?

Eyesha Sadiq , Entertainment Editor | September 23, 2022

Eyesha Sadiq

Many students get overwhelmed with the amount of homework they receive, which can cause mental health issues. Around 65% of high school students deal with severe anxiety and 52% are diagnosed with depression.

That’s what the clock said. I was used to it by now. 

I only had one assignment left. I wrote my essays as my eyelids began to blink slower. I was so close to getting those two hours of sleep I knew I needed to survive the next day. I checked my grades: A’s. That was the motivation I needed to feel good. It didn’t matter that my body wasn’t getting the rest it truly needed and it didn’t matter that I didn’t get any social interaction outside of school. It didn’t matter to me to make those essential high school memories. What mattered was that my homework was done and I had my A’s. But was it really worth it?

Many students, such as myself, have after school activities that consist of sports, jobs, clubs and volunteering. Some of those same students also take AP and honors classes. The American education system has made it normal for students to go to school for eight hours, have extracurricular activities and do hours of homework afterward when it should be a time to relax from the day’s activities. On top of that, some students have to take care of their family members when they come home. When will we finally have some time for ourselves? 

“I assign about 30 minutes of homework a night,” AP human geography teacher Kelley Ferguson said. “Where students wind up having more than 30 minutes is if they procrastinate or have tons of extracurricular activities. They are unable to do work one night, [and] then that work gets doubled the next night.” 

I understand that homework is given to students to help them retain daily lessons, and is meant to be beneficial. However, in AP classes, the curriculum can be rigorous, and teachers aren’t able to teach the students everything they need to know before the test. This leads to students getting more homework to compensate for lost teaching time. 

Based on a survey given to approximately 60 Hebron students asking how long they spend on homework a day, 53% said that they spend one hour and 30 minutes or longer on homework. In addition, 53% of students also said that they lose two hours or more of sleep everyday from homework. 

Is this supposed to be the normal expectation for students? I understand students want to earn A’s and an impressive transcript so that they can get into Ivy League colleges, but to what extent should students go to get them? It shouldn’t be at the risk of not sleeping, eating or socializing because it can cause many mental and physical health issues. 

“I believe in homework because that is the opportunity for practice,” chemistry teacher Rachmad Tjachyadi said. “The reason I give homeworks with a lot of problems is because some students may need more and [homework is] trying to meet the different needs of students. Homework should take about 20 to 30 minutes for chemistry and, to me, that is actually what they are going to have to do in college for chemistry.” 

A lot of students struggle with having a social life when all they do is homework. The same survey showed 83% of Hebron students said they do homework on the weekend, and 78% said it stresses them out. Students can miss out on memorable school activities such as football games or dances because they have a test the next day or their homework is due that night. 

Only doing homework in students’ free time can lead to them becoming quickly burnt out and losing motivation for school. According to The Scholarship System , “Academic burnout is a surprisingly common problem, especially among high school seniors.” Having to go to school, write college applications and get ready for graduation makes those seniors burn out in the end.  

Not being able to make these high school memories or have a social life can lead to anxiety, depression or other mental health issues. In high school, around 65% of students deal with severe anxiety and 52% are diagnosed with depression as those students don’t get to have time to be a kid anymore before having to enter adulthood in college. 

Personally, I think homework should not be given on the weekends and be given in more limited amounts on the weekdays through offering more than enough time in class to complete it, simply because that is the time for students to relax and have their own time. They should be able to hangout with their friends, go to football games and do other activities. 

Students shouldn’t need to be worried about what homework is due that night or if they have enough time to study for their next test. Being a kid while you still can is more important than doing homework. 

Senior Eyesha Sadiq is the entertainment editor and this is her second year on the staff. When she’s not in the newsroom, she’s either playing with...

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Layla • Mar 14, 2024 at 4:05 PM

I cannot relate to this as much as you think

Ashwin J • Sep 11, 2023 at 11:15 AM

I agree, many students put in so many hours in their homework including me. One suggestion I find helpful, is to spend time researching effective methods on the network (YouTube, Instagram, TikTok) to find what boosts my productivity and be better at time management. This helps in the long term since it benefits me to finish homework quickly and to also understand the context of the homework’s topic like textbook reading.

nope g beans • May 28, 2023 at 6:14 PM

pls help me im dying from procrastination

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