{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T06:03:05Z","timestamp":1789970585425,"version":"4.0.1"},"reference-count":42,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Behav. Cogn. Psychother."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\u2018Engaging\u2019 well in psychological therapy is generally associated with more positive clinical outcomes. However, the literature shows little agreement on how to define, conceptualise and measure engagement. Few studies focus primarily on engagement, and those that include engagement measures within other designs rely mainly on single behavioural indicators, such as whether between-session tasks (e.g. \u2018homework\u2019 in cognitive behavioural therapy) were completed, or the number of sessions attended. Although pragmatic, I suggest these indicators do not capture the full sense of what engagement means and that taking a broader perspective is likely to be helpful in advancing research and clinical practice. I present a conceptual model of engagement in psychological therapy that aims to draw together relevant theoretical ideas and combine them with observations from clinical practice. This proposes that engagement can be understood as three distinct facets: engagement with the therapist, engagement with the therapy approach, and the practical, behavioural indicators of engagement. I suggest this offers a comprehensive way to conceptualise and understand engagement that may prove helpful for clinicians and researchers. I aim to advocate for further research in this area and for applying the \u2018empirically grounded clinical interventions\u2019 approach to therapy processes, not just therapy content. This could help further our understanding of the engagement process, which may play a critical role in driving successful therapy outcomes.<\/jats:p>","DOI":"10.1017\/s135246582610143x","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T05:44:56Z","timestamp":1789969496000},"page":"1-8","source":"Crossref","is-referenced-by-count":0,"title":["A model of engagement in psychological therapy"],"prefix":"10.1017","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2851-1315","authenticated-orcid":false,"given":"Graham R.","family":"Thew","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/052gg0110","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Oxford"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"S135246582610143X_ref22","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-9450.1994.tb00934.x"},{"key":"S135246582610143X_ref12","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32133-5"},{"key":"S135246582610143X_ref31","doi-asserted-by":"publisher","DOI":"10.1017\/S1754470X17000186"},{"key":"S135246582610143X_ref40","doi-asserted-by":"publisher","DOI":"10.1016\/S0306-4603(02)00257-5"},{"key":"S135246582610143X_ref41","doi-asserted-by":"publisher","DOI":"10.1002\/jclp.20811"},{"key":"S135246582610143X_ref6","first-page":"e83","article-title":"Interventions for improving adherence to psychological treatments for common mental disorders: a systematic review","volume":"11","author":"Biswal","year":"2024","journal-title":"Cambridge Prisms: Global Mental Health"},{"key":"S135246582610143X_ref9","doi-asserted-by":"publisher","DOI":"10.1002\/cpp.2180"},{"key":"S135246582610143X_ref29","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.110.083733"},{"key":"S135246582610143X_ref36","doi-asserted-by":"publisher","DOI":"10.1017\/S1352465809005281"},{"key":"S135246582610143X_ref38","doi-asserted-by":"publisher","DOI":"10.1017\/S1352465802001029"},{"key":"S135246582610143X_ref39","doi-asserted-by":"publisher","DOI":"10.1017\/S1352465823000590"},{"key":"S135246582610143X_ref20","article-title":"British Muslims\u2019 perceptions of therapy with non-Muslim therapists: a qualitative analysis of survey responses","author":"Hassan","year":"2025","journal-title":"Psychology and Psychotherapy: Theory, Research and Practice."},{"key":"S135246582610143X_ref35","doi-asserted-by":"publisher","DOI":"10.1080\/16506071003675614"},{"key":"S135246582610143X_ref28","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2014.10.003"},{"key":"S135246582610143X_ref33","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-020-02682-1"},{"key":"S135246582610143X_ref1","doi-asserted-by":"publisher","DOI":"10.1017\/S1754470X24000084"},{"key":"S135246582610143X_ref25","first-page":"755","article-title":"Quantity and quality of homework compliance: a meta-analysis of relations with outcome in cognitive behavior therapy","volume":"47","author":"Kazantzis","year":"2016","journal-title":"Behavior Therapy, Special 50th Anniversary Issue: Honoring the Past and Looking to the Future: Updates on Seminal Behavior Therapy Publications on Etiology and Mechanisms of Change"},{"key":"S135246582610143X_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/S0306-4603(01)00217-9"},{"key":"S135246582610143X_ref10","doi-asserted-by":"publisher","DOI":"10.1037\/a0036365"},{"key":"S135246582610143X_ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2014.06.004"},{"key":"S135246582610143X_ref26","doi-asserted-by":"publisher","DOI":"10.1037\/a0034406"},{"key":"S135246582610143X_ref14","doi-asserted-by":"publisher","DOI":"10.1007\/s10608-024-10504-x"},{"key":"S135246582610143X_ref37","volume-title":"Negotiating the Therapeutic Alliance: A Relational Treatment Guide","author":"Safran","year":"2000"},{"key":"S135246582610143X_ref13","doi-asserted-by":"publisher","DOI":"10.1037\/pst0000168"},{"key":"S135246582610143X_ref50","volume-title":"Facilitating Engagement with Homework in CBT with Complex Cases","author":"Thew"},{"key":"S135246582610143X_ref5","doi-asserted-by":"publisher","DOI":"10.1037\/a0016401"},{"key":"S135246582610143X_ref24","doi-asserted-by":"publisher","DOI":"10.1002\/jclp.10239"},{"key":"S135246582610143X_ref7","doi-asserted-by":"publisher","DOI":"10.1111\/papt.12330"},{"key":"S135246582610143X_ref4","article-title":"Predictors of engagement with between-session work in cognitive behavioural therapy (CBT)-based interventions: a mixed-methods systematic review and \u2018best fit\u2019 framework synthesis","author":"Bennion","year":"2024","journal-title":"Cognitive Behaviour Therapy."},{"key":"S135246582610143X_ref27","doi-asserted-by":"publisher","DOI":"10.1111\/papt.12470"},{"key":"S135246582610143X_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2004.05.002"},{"key":"S135246582610143X_ref15","doi-asserted-by":"publisher","DOI":"10.1017\/S1352465810000792"},{"key":"S135246582610143X_ref2","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-023-06083-7"},{"key":"S135246582610143X_ref32","doi-asserted-by":"publisher","DOI":"10.1007\/s10608-010-9297-z"},{"key":"S135246582610143X_ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2008.04.002"},{"key":"S135246582610143X_ref30","doi-asserted-by":"publisher","DOI":"10.1080\/16506073.2013.763286"},{"key":"S135246582610143X_ref19","doi-asserted-by":"publisher","DOI":"10.1111\/bjc.12464"},{"key":"S135246582610143X_ref3","doi-asserted-by":"publisher","DOI":"10.1037\/0033-295X.84.2.191"},{"key":"S135246582610143X_ref23","first-page":"625","article-title":"Homework in cognitive behavioral therapy: a systematic review of adherence assessment in anxiety and depression (2011\u20132016)","volume":"40","author":"Kazantzis","year":"2017","journal-title":"Psychiatric Clinics"},{"key":"S135246582610143X_ref34","first-page":"61","article-title":"An evidence-based framework for cultural adaptation of cognitive behaviour therapy: process, methodology and foci of adaptation","volume":"11","author":"Naeem","year":"2016","journal-title":"World Cultural Psychiatry Research Review"},{"key":"S135246582610143X_ref17","doi-asserted-by":"publisher","DOI":"10.1037\/pst0000172"},{"key":"S135246582610143X_ref18","doi-asserted-by":"publisher","DOI":"10.1037\/a0033403"}],"container-title":["Behavioural and Cognitive Psychotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S135246582610143X","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T05:44:58Z","timestamp":1789969498000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S135246582610143X\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,21]]},"references-count":42,"alternative-id":["S135246582610143X"],"URL":"https:\/\/doi.org\/10.1017\/s135246582610143x","relation":{},"ISSN":["1352-4658","1469-1833"],"issn-type":[{"value":"1352-4658","type":"print"},{"value":"1469-1833","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,21]]}}}