Effects of Text Message Reporting and Reinforcement on Mental Health Homework Compliance

Abstract

Text messaging may offer a useful tool for shaping psychotherapy homework compliance. Patients may send text messages to report compliance and psychotherapists may respond with text messaged verbal praise. In this analog study, the effects of text message reporting and reinforcement on homework compliance behavior were examined. Ninety-four college students, who agreed to attend two lectures about stress management, were asked to complete a daily, five-minute online relaxation exercise between lectures. Participants were randomly assigned to one of three conditions. In one group, they were not asked to report on completion of the exercise. In the second group, they were asked to report their daily completion of the exercise via text message. They did not receive responses. In the third group, they were asked to send text message reports and they also received text message responses containing praise. Compliance was measured through objective monitoring of online relaxation exercise use. It was expected that receiving text messaged praise would lead to greater homework compliance. It was also anticipated that simply being asked to send text message reports would improve compliance. As predicted, homework compliance was significantly greater in the group that received text messaged praise. However, significant differences were not found between the other two groups. Rapport did not differ between the groups and there was no relationship found between rapport and compliance. Based upon these results, it was concluded that text message reporting with reinforcement may be helpful in improving psychotherapy homework compliance.