Impact of homework engagement on treatment response to group cognitive-behavioral therapy, yoga, and stress education for generalized anxiety disorder.

Homework is a potential contributor to treatment response in cognitive-behavioral therapy (CBT) for anxiety, but less is known regarding the importance of yoga homework for generalized anxiety disorder (GAD). This study examined the impact of homework engagement on treatment response within a randomized controlled trial (RCT) of 12 weeks of group CBT, Kundalini Yoga (KY), or stress education (SE) in a subsample of 190 adults with GAD (71% female, Mean age = 33 ± 13) who attended ≥2 sessions and submitted ≥1 homework log. Participants in CBT and KY showed greater overall homework engagement than those in SE (ps < .05). Across treatment arms, staff-rated homework compliance (p = .002, OR = 1.74), but not participant-reported days per week engaged in homework (p = .108), predicted clinical response at post-treatment ("response"). Greater staff-rated homework compliance was related to a greater response for those in CBT (p = .005, OR = 2.49) and KY (p = .049, OR = 1.66), but not SE. Greater participant-reported homework days per week was only marginally related to response to CBT (p = .054, OR = 1.71), and was not related to response to KY or SE. These findings highlight the importance of homework engagement in CBT for GAD. More research is needed to further elucidate the role of homework engagement in yoga for GAD.TRIAL REGISTRATION: clinicaltrials.gov: NCT01912287; https://clinicaltrials.gov/ct2/show/NCT01912287.