problem solving therapy ceu

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Kaiser Permanente Mental Health Training programs offers continuing education seminars intended for internal employees and those involved in the Mental Health Training program. Explore the archive of seminars to learn more.

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Supervision

 Unified Protocol: A Transdiagnostic CBT for Emotional Disorders

Presenter: Todd Farchione, PHD

Addiction: A Futuristics Perspective

Presenter: Omar Manejwala, MD

Addressing Trauma and its Comorbidities via Transdiagnostic Treatment

Presenter: Daniel Gros PhD

Adult Autism Spectrum Disorder Assessment and Diagnosis

Presenter: Thomas Crawford, PhD

An Experiential Approach to Clinical Supervision: Latest Updates

Presenter: Carol Falender, PhD; Edward Shafranske, PhD, ABPP

Attachment and Emotion Regulation: Brain-Based Strategies and Intervention

Presenter: John B. Arden, PhD, ABPP

Brief Cognitive Behavioral Therapy for Suicide Prevention

Presenter: Craig Bryan, PsyD

Building Stress Resilience and Hope for Our New Era

Presenter: Elissa Epel, Ph.D., M.S., M.Phil.

Calling In, Not Calling Out

Presenter: Loretta J. Ross

Clinical Supervision : Selected Topics

Presenter: Carol Falender, PHD

Co-Occurring Substance Abuse and Psychiatric Disorders

Presenter: Keith Nelson, LCSW

Cognitive Behavior Therapy for Pediatric Anxiety Disorders

Presenter: Michael A. Tompkins, PhD, ABPP

Cultural Considerations in Mental Health Treatment for Ethnic Minority Populations

Presenter: Stanley Sue, PhD

Cultural Considerations in Supervision

Presenter: Nadine J. Kaslow, PhD, ABPP

Culturally Responsive Care: Integration of an Anti-Oppressive Framework

Presenter: Danielle Cottonham Mason, PhD

Culture-Responsive Treatment and Using Evidence-Based Treatments with Ethnic Minority Populations

Presenter: Stanley Huey, PhD

Cutting Edge Treatment

Presenter: Dacher Keltner, PHD

Dialectical Behavior Therapy Groups for Youth & Adults with ASD? YES!

Presenter: Doreen Samelson Ed.D, MSCP, Catalight Foundation, Lindsey Sneed MS, BSBA, LBA, Catalight Foundation, Erin Shurtlef LCSW, BHM, KP

Don’t be Fooled by the “Quotes” “TR”: The DSM-5-TR is Far More Than a Text Revision

Presenter: Greg Neimeyer, PhD

DOPAMINE: A Practical Approach to Compulsive Overconsumption in a Reward-Overloaded World

Presenter: Anna Lembke MD

Eating Disorders 101

Presenter: Jennifer Lombardi, LMFT

Effective, Brief Interventions for Treating Children and Adolescents

Presenter: Robert Friedberg, PhD, ABPP

Epic Hyperspace Training

Presenter: Casey Brodhead, PsyD

No credits offered

Ethical Considerations and Dilemmas for Therapists

Presenter: Jacob Appel, MD, JD, MPH

Ethical, Legal, and Professional Issues in Psychotherapy

Presenter: Thomas Plante PHD ABPP

Evaluating and Treating OCD

Presenter: Sandra Capaldi, Psy. D

Evidence-Based Practices for Clinical Supervision

Presenter: Richard Sears, PsyD, PhD, MBA, ABPP

Finding Meaning: The Sixth Stage of Grief

Presenter: David Kessler FACHE

Focused Acceptance and Commitment Therapy (FACT)

Presenter: Patricia J. Robinson, PhD

Gender Affirmative Care for Transgender, Non-Binary, Gender Expansive Youth and Their Families: The Basics and Beyond

Presenter: Shawn V. Giammattei, PhD

Harnessing Mindfulness to Combat Cravings, Anxiety, and Addiction in Mental Health Practice

Presenter: Judson Brewer, MD, PHD

Helping People Living with Suicidal Intensity: Risk Formulation, Support and Healing with Confidence and Compassion

Presenter: Sally Spencer-Thomas PsyD, MNM

Integrating Deliberate Practice into Clinical Supervision

Presenter: Steven M. Sultanoff, Ph.D.

Integrating Tridiuum Into Clinical Practice

Presenter: Matthew Holland, PsyD

Interdisciplinary Pain Management & Psychosocial Considerations for Evaluation and Treatment of Pain

Presenter: Ravi Prasad, PhD

Interpersonal Neurobiology: The Social Brain and the Embodied Relational Mind

Presenter: Dan Siegel, MD

Interventional Psychiatry: Why Now?

Presenter: Nolan Williams, MD

Introduction to Prolonged Exposure Therapy for PTSD (2 of 2)

Presenter: Sandy Capaldi, Psy. D

Introduction to Prolonged Exposure Therapy for PTSD Part 1 of 2

Introduction to Tridiuum

Joyful Movement

Presenter: Kelly McGonigal, PhD

Learning from Expert Supervisors in Action 

Presenter: Arpana G. Inman PHD ABPP

Making Mindfulness Stick with Children and Teens

Presenter: Christopher Willard, PsyD

Mind Altering and Abusable Drugs as Antidepressants: The Good, the Bad and the Ugly

Presenter: Alan Schatzberg, MD

Mind Brain Gene

Mind-Brain-Gene: The Integration of Psychotherapy

Presenter: John Arden, PhD ABPP

Mindfulness-Oriented Recovery Enhancement: A Neuroscience Based Therapy for Chronic Pain and Addiction

Presenter: Eric Garland PhD, LCSW

Modular Approach to Therapy for Children with Anxiety, Depression, Trauma, or Conduct Problems

Presenter: Bruce Chorpita, PhD; Adam Bernstein, PhD

Regional Speaker SeriesSupervision

Multicultural Supervision: Framework, Techniques, and Challenges

Presenter: Nadine J Kaslow, PhD, ABPP

New Frontiers in Psychedelics and Mental Health

Presenter: Allison Feduccia, PhD

Overview of Cognitive Processing Therapy (CPT) for Traumatic Stress Disorders

Presenter: Dr. Patricia Resick, PhD, ABPP

Posttraumatic Growth: Possibilities for Transformation, Richard Tedeschi Ph.D.

Presenter: Richard Tedeschi Ph.D.

Problem Solving Therapy

Presenter: Dawn Hasemann, Ph.D.

Prolonged Exposure Therapy (PE) in the Treatment of Posttraumatic Stress Disorder

Presenter: Barbara O. Rothbaum PhD

Psychedelics: How They Work and What the Future Holds for Them

Presenter: Robin Carhart-Harris, PhD

Racial Healing: Practical Activities to Help You Challenge Privilege, Confront Systemic Racism, and Engage in Collective Healing

Presenter: Anneliese Singh, PhD, LPC

Racially Sensitive Supervision

Presenter: Kenneth V. Hardy, PhD

Risk Assessment

Presenter: Kris Velasco, LCSW

Solution Focus Approach

Presenter: Elliott Connie, MA, LPC

Solution Focused Therapy for Couples

Stolen Focus: Why You Can’t Pay Attention-and How to Think Deeply Again

Presenter: Johann Hari

Strategies for Handling Problems and Having Difficult Conversations in Clinical Supervision

Presenter: George B. Haarman, Psy.D., LMFT

Telebehavioral Health Training

Presenter: Jeff Murray, PsyD

TeleSupervision: Building Bridges in a Digital Era

Presenter: Arpana G. Inman PHD, ABPP

The “WOW” Effect: How Awe and Wonder Make Us Happier, Healthier, and More Connected

Presenter: Jonah Paquette, PsyD

The Chatbot Cannot Replace You: Using Digital Technologies to Expand Your Positive Impact on Mental Health

Presenter: Page Anderson, PHD ABPP

The Efficacy and Effectiveness of Treatment for PTSD with Prolonged Exposure Therapy (PE)

Presenter: Edna Foa, PhD

The Hidden Challenge: Strategies to Address Substance Use Disorders in Your Clinical Practice

Presenter: Thomas E. Freese PhD

The Joyful Brain

The Power of Mindful Self-Compassion

Presenter: Kristin Neff, PhD

The Practice of Tele-Mental Health and Use of Social Media: Ethical, Legal, and Clinical Issues for Practitioners

Presenter: Jeffrey E. Barnett PsyD, ABPP

The Upward Spiral: Connecting Neuroscience to the Clinical Treatment of Anxiety, Depression and Related Disorders

Presenter: Alex Korb, Ph.D.

The Use of Popular Culture Characters, Humor, and Improvisation in CBT with Youth

Presenter: Robert Friedberg PhD, ABPP

Trauma and PTSD Relief Therapy

Presenter: Bessel A. van der Kolk M.D.

Treating Patients with Eating Disorders: A Psychiatric Perspective

Presenter: Maryrose Bauschka, MD, CEDS

Treatment Applications of Neuroscience, Psychoneuroimmunology, & Epigenetics

Unified Protocol for Transdiagnostic Treatment of Emotional Disorders

Presenter: Shannon Sauer-Zavala, PhD

What All Clinicians Need to Know About Eating Disorders and Their Treatment

Presenter: Ovidio Bermudez, MD, FAAP, FSAHM, FAED, F.iaedp, CEDS

When Medicine Interacts with Psychology: A Closer Look at Bariatric Psychology

Presenter: Maryam Hafezi, MA, MS, PsyD

Working with Highly Conflictual Families and Couples

Presenter: Jeffrey Zimmerman, PhD ABPP

Problem-Solving Therapy

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In Problem-Solving Therapy , Drs. Arthur Nezu and Christine Maguth Nezu demonstrate their positive, goal-oriented approach to treatment. Problem-solving therapy is a cognitive–behavioral intervention geared to improve an individual's ability to cope with stressful life experiences. The underlying assumption of this approach is that symptoms of psychopathology can often be understood as the negative consequences of ineffective or maladaptive coping.

Problem-solving therapy aims to help individuals adopt a realistically optimistic view of coping, understand the role of emotions more effectively, and creatively develop an action plan geared to reduce psychological distress and enhance well-being. Interventions include psychoeducation, interactive problem-solving exercises, and motivational homework assignments.

In this session, Christine Maguth Nezu works with a woman in her 50s who is depressed and deeply concerned about her son's drug addiction. Dr. Nezu first assesses her strengths and weaknesses and then helps her to clarify the problem she is facing so she can begin to move toward a solution.

The overarching goal of problem-solving therapy (PST) is to enhance the individual's ability to cope with stressful life experiences and to foster general behavioral competence. The major assumption underlying this approach, which emanates from a cognitive–behavioral tradition, is that much of what is viewed as "psychopathology" can be understood as consequences of ineffective or maladaptive coping behaviors. In other words, failure to adequately resolve stressful problems in living can engender significant emotional and behavioral problems.

Such problems in living include major negative events (e.g., undergoing a divorce, dealing with the death of a spouse, getting fired from a job, experiencing a major medical illness), as well as recurrent daily problems (e.g., continued arguments with a coworker, limited financial resources, diminished social support). How people resolve or cope with such situations can, in part, determine the degree to which they will likely experience long-lasting psychopathology and behavioral problems (e.g., clinical depression, generalized anxiety, pain, anger, relationship difficulties).

For example, successfully dealing with stressful problems will likely lead to a reduction of immediate emotional distress and prevent long-term psychological problems from occurring. Alternatively, maladaptive or unsuccessful problem resolution, either due to the overwhelming nature of events (e.g., severe trauma) or as a function of ineffective coping attempts, will likely increase the probability that long-term negative affective states and behavioral difficulties will emerge.

Social Problem Solving and Psychopathology

According to this therapy approach, social problem solving (SPS) is considered a key set of coping abilities and skills. SPS is defined as the cognitive–behavioral process by which individuals attempt to identify or discover effective solutions for stressful problems in living. In doing so, they direct their problem-solving efforts at altering the stressful nature of a given situation, their reactions to such situations, or both. SPS refers more to the metaprocess of understanding, appraising, and adapting to stressful life events, rather than representing a single coping strategy or activity.

Problem-solving outcomes in the real world have been found to be determined by two general but partially independent processes—problem orientation and problem-solving style.

Problem orientation refers to the set of generalized thoughts and feelings a person has concerning problems in living, as well as his or her ability to successfully resolve them. It can either be positive (e.g., viewing problems as opportunities to benefit in some way, perceiving oneself as able to solve problems effectively), which serves to enhance subsequent problem-solving efforts, or negative (e.g.,viewing problems as a major threat to one's well-being, overreacting emotionally when problems occur), which functions to inhibit attempts to solve problems.

Problem-solving style refers to specific cognitive–behavioral activities aimed at coping with stressful problems. Such styles are either adaptive, leading to successful problem resolution, or dysfunctional, leading to ineffective coping, which then can generate myriad negative consequences, including emotional distress and behavioral problems. Rational problem solving is the constructive style geared to identify an effective solution to the problem and involves the systematic and planful application of specific problem-solving tasks. Dysfunctional problem-solving styles include (a) impulsivity/carelessness (i.e., impulsive, hurried, and incomplete attempts to solve a problem), and (b) avoidance (i.e.,avoiding problems, procrastinating, and depending on others to solve one's problems).

Important differences have been identified between individuals characterized as "effective" versus "ineffective" problem solvers. In general, when compared to effective problem solvers, persons characterized by ineffective problem solving report a greater number of life problems, more health and physical symptoms, more anxiety, more depression, and more psychological maladjustment. In addition, a negative problem orientation has been found to be associated with negative moods under both routine and stressful conditions, as well as pessimism, negative emotional experiences, and clinical depression. Further, persons with negative orientations tend to worry and complain more about their health.

Problem-Solving Therapy Goals

PST teaches individuals to apply adaptive coping skills to both prevent and cope with stressful life difficulties. Specific PST therapy objectives include

enhancing a person's positive orientation
fostering his or her application of specific rational problem-solving tasks (i.e., accurately identifying why a situation is a problem, generating solution alternatives, conducting a cost-benefit analysis in order to decide which ideas to choose to include as part of an overall solution plan, implementing the solution, monitoring its effects, and evaluating the outcome)
reducing his or her negative orientation
minimizing one's tendency to engage in dysfunctional problem-solving style activities (i.e., impulsively attempting to solve the problem or avoiding the problem)

PST interventions involve psychoeducation, interactive problem-solving training exercises, practice opportunities, and homework assignments intended to motivate patients to apply the problem-solving principles outside of the therapy sessions.

PST has been shown to be effective regarding a wide range of clinical populations, psychological problems, and the distress associated with chronic medical disorders. Scientific evaluations have focused on unipolar depression, geriatric depression, distressed primary-care patients, social phobia, agoraphobia, obesity, coronary heart disease, adult cancer patients, adults with schizophrenia, mentally retarded adults with concomitant psychiatric problems, HIV-risk behaviors, drug abuse, suicide, childhood aggression, and conduct disorder.

Moreover, PST is flexible with regard to treatment goals and methods of implementation. For example, it can be conducted in a group format, on an individual and couples basis, as part of a larger cognitive–behavioral treatment package, over the phone, as well as on the Internet. It can also be applied as a means of helping patients to overcome barriers associated with successful adherence to other medical or psychosocial treatment protocols (e.g., adhering to weight-loss programs, diabetes regulation).

Arthur M. Nezu, PhD, ABPP, is currently professor of psychology, medicine, and community health and prevention at Drexel University in Philadelphia. He is one of the codevelopers of a cognitive–behavioral approach to teaching social problem-solving skills and has conducted multiple RCTs testing its efficacy across a variety of populations. These populations include clinically depressed adults, depressed geriatric patients, adults with mental retardation and concomitant psychopathology, distressed cancer patients and their spousal caregivers, individuals in weight-loss programs, breast cancer patients, and adult sexual offenders.

Dr. Nezu has contributed to more than 175 professional and scientific publications, including the books Solving Life's Problems: A 5-Step Guide to Enhanced Well-Being , Helping Cancer Patients Cope: A Problem-Solving Approach , and Problem-Solving Therapy: A Positive Approach to Clinical Intervention . He also codeveloped the self-report measure Social Problem-Solving Inventory—Revised . Dr. Nezu is on numerous editorial boards of scientific and professional journals and a member of the Interventions Research Review Committee of the National Institute of Mental Health.

An award-winning psychologist, he was previously president of the Association for Advancement of Behavior Therapy, the Behavioral Psychology Specialty Council, the World Congress of Behavioral and Cognitive Therapies, and the American Board of Cognitive and Behavioral Psychology. He is a fellow of the American Psychological Association, the Association for Psychological Science, the Society for Behavior Medicine, the Academy of Cognitive Therapy, and the Academy of Cognitive and Behavioral Psychology. Dr. Nezu was awarded the diplomate in Cognitive and Behavioral Psychology from the American Board of Professional Psychology and currently serves as a trustee of that board.

He has been in private practice for over 25 years, and is currently conducting outcome studies to evaluate the efficacy of problem-solving therapy to treat depression among adults with heart disease.

Christine Maguth Nezu, PhD, ABPP, is currently professor of psychology, associate professor of medicine, and director of the masters programs in psychology at Drexel University in Philadelphia. She previously served as director of the APA-accredited Internship/Residency in Clinical Psychology, as well as the Cognitive–Behavioral Postdoctoral Fellowship Program, at the Medical College of Pennsylvania/Hahnemann University.

She is the coauthor or editor of more than 100 scholarly publications, including 15 books. Her publications cover a wide range of topics in mental health and behavioral medicine, many of which have been translated into a variety of foreign languages.

Dr. Maguth Nezu is currently the president-elect of the American Board of Professional Psychology, on the board of directors for the American Board of Cognitive and Behavioral Psychology, and on the board of directors for the American Academy of Cognitive and Behavioral Psychology. She is the recipient of numerous grant awards supporting her research and program development, particularly in the area of clinical interventions. She serves as an accreditation site visitor for APA for clinical training programs and is on the editorial boards of several leading psychology and health journals.

Dr. Maguth Nezu has conducted workshops on clinical interventions and case formulation both nationally and internationally. She is currently the North American representative to the World Congress of Cognitive and Behavioral Therapies. She holds a diplomate in Cognitive and Behavioral Psychology from the American Board of Professional Psychology and has been active in private practice for more than 20 years.

Her current areas of interest include the treatment of depression in medical patients, the integration of cognitive and behavioral therapies with patients' spiritual beliefs and practices, interventions directed toward stress, coping, and health, and cognitive behavior therapy and problem-solving therapy for individuals with personality disorders.

D'Zurilla, T. J., & Nezu, A. M. (2007). Problem-solving therapy: A positive approach to clinical intervention (3rd ed.). New York: Springer Publishing Co.
D'Zurilla, T. J., Nezu, A. M., & Maydeu-Olivares, A. (2002). Social Problem-Solving Inventory—Revised (SPSI-R): Technical manual . North Tonawanda, NY: Multi-Health Systems.
Nezu, A. M. (2004). Problem solving and behavior therapy revisited. Behavior Therapy, 35 , 1–33.
Nezu, A. M., & Nezu, C. M. (in press). Problem-solving therapy. In S. Richards & M. G. Perri (Eds.), Relapse prevention for depression . Washington, DC: American Psychological Association.
Nezu, A. M., Nezu, C. M., & Clark, M. (in press). Problem solving as a risk factor for depression. In K. S. Dobson & D. Dozois (Eds.), Risk factors for depression . New York: Elsevier Science.
Nezu, A. M., Nezu, C. M., & Perri, M. G. (2006). Problem solving to promote treatment adherence. In W. T. O'Donohue & E. Livens (Eds.), Promoting treatment adherence: A practical handbook for health care providers (pp. 135–148). New York: Sage Publications.
Nezu, A. M., Nezu, C. M., & D'Zurilla, T. J. (2007). Solving life's problems: A 5-step guide to enhanced well-being . New York: Springer Publishing Co.
Nezu, A. M., Nezu, C. M., Friedman, S. H., Faddis, S., & Houts, P. S. (1998). Helping cancer patients cope: A problem-solving approach . Washington, DC: American Psychological Association.
Nezu, C. M., D'Zurilla, T. J., & Nezu, A. M. (2005). Problem-solving therapy: Theory, practice, and application to sex offenders. In M. McMurran & J. McGuire (Eds.), Social problem solving and offenders: Evidence, evaluation and evolution (pp. 103–123). Chichester, UK: Wiley.
Nezu, C. M., Palmatier, A., & Nezu, A. M. (2004). Social problem-solving training for caregivers. In E. C. Chang, T. J. D'Zurilla, & L. J. Sanna (Eds.), Social problem solving: Theory, research, and training (pp. 223–238). Washington, DC: American Psychological Association.
Cognitive–Behavioral Relapse Prevention for Addictions G. Alan Marlatt
Cognitive–Behavioral Therapy With Donald Meichenbaum Donald Meichenbaum
Depression With Older Adults Peter A. Lichtenberg
Depression Michael D. Yapko
Emotion-Focused Therapy for Depression Leslie S. Greenberg
Relapse Prevention Over Time G. Alan Marlatt
Behavioral Interventions in Cognitive Behavior Therapy: Practical Guidance for Putting Theory Into Action, Second Edition Richard F. Farmer and Alexander L. Chapman
Experiences of Depression: Theoretical, Clinical, and Research Perspectives Sidney J. Blatt
Preventing Youth Substance Abuse: Science-Based Programs for Children and Adolescents Edited by Patrick Tolan, José Szapocznik, and Soledad Sambrano

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What Is Problem-Solving Therapy?

Verywell / Madelyn Goodnight

Problem-Solving Therapy Techniques

How effective is problem-solving therapy, things to consider, how to get started.

Problem-solving therapy is a brief intervention that provides people with the tools they need to identify and solve problems that arise from big and small life stressors. It aims to improve your overall quality of life and reduce the negative impact of psychological and physical illness.

Problem-solving therapy can be used to treat depression , among other conditions. It can be administered by a doctor or mental health professional and may be combined with other treatment approaches.

At a Glance

Problem-solving therapy is a short-term treatment used to help people who are experiencing depression, stress, PTSD, self-harm, suicidal ideation, and other mental health problems develop the tools they need to deal with challenges. This approach teaches people to identify problems, generate solutions, and implement those solutions. Let's take a closer look at how problem-solving therapy can help people be more resilient and adaptive in the face of stress.

Problem-solving therapy is based on a model that takes into account the importance of real-life problem-solving. In other words, the key to managing the impact of stressful life events is to know how to address issues as they arise. Problem-solving therapy is very practical in its approach and is only concerned with the present, rather than delving into your past.

This form of therapy can take place one-on-one or in a group format and may be offered in person or online via telehealth . Sessions can be anywhere from 30 minutes to two hours long.

Key Components

There are two major components that make up the problem-solving therapy framework:

Applying a positive problem-solving orientation to your life
Using problem-solving skills

A positive problem-solving orientation means viewing things in an optimistic light, embracing self-efficacy , and accepting the idea that problems are a normal part of life. Problem-solving skills are behaviors that you can rely on to help you navigate conflict, even during times of stress. This includes skills like:

Knowing how to identify a problem
Defining the problem in a helpful way
Trying to understand the problem more deeply
Setting goals related to the problem
Generating alternative, creative solutions to the problem
Choosing the best course of action
Implementing the choice you have made
Evaluating the outcome to determine next steps

Problem-solving therapy is all about training you to become adaptive in your life so that you will start to see problems as challenges to be solved instead of insurmountable obstacles. It also means that you will recognize the action that is required to engage in effective problem-solving techniques.

Planful Problem-Solving

One problem-solving technique, called planful problem-solving, involves following a series of steps to fix issues in a healthy, constructive way:

Problem definition and formulation : This step involves identifying the real-life problem that needs to be solved and formulating it in a way that allows you to generate potential solutions.
Generation of alternative solutions : This stage involves coming up with various potential solutions to the problem at hand. The goal in this step is to brainstorm options to creatively address the life stressor in ways that you may not have previously considered.
Decision-making strategies : This stage involves discussing different strategies for making decisions as well as identifying obstacles that may get in the way of solving the problem at hand.
Solution implementation and verification : This stage involves implementing a chosen solution and then verifying whether it was effective in addressing the problem.

Other Techniques

Other techniques your therapist may go over include:

Problem-solving multitasking , which helps you learn to think clearly and solve problems effectively even during times of stress
Stop, slow down, think, and act (SSTA) , which is meant to encourage you to become more emotionally mindful when faced with conflict
Healthy thinking and imagery , which teaches you how to embrace more positive self-talk while problem-solving

What Problem-Solving Therapy Can Help With

Problem-solving therapy addresses life stress issues and focuses on helping you find solutions to concrete issues. This approach can be applied to problems associated with various psychological and physiological symptoms.

Mental Health Issues

Problem-solving therapy may help address mental health issues, like:

Chronic stress due to accumulating minor issues
Complications associated with traumatic brain injury (TBI)
Emotional distress
Post-traumatic stress disorder (PTSD)
Problems associated with a chronic disease like cancer, heart disease, or diabetes
Self-harm and feelings of hopelessness
Substance use
Suicidal ideation

Specific Life Challenges

This form of therapy is also helpful for dealing with specific life problems, such as:

Death of a loved one
Dissatisfaction at work
Everyday life stressors
Family problems
Financial difficulties
Relationship conflicts

Your doctor or mental healthcare professional will be able to advise whether problem-solving therapy could be helpful for your particular issue. In general, if you are struggling with specific, concrete problems that you are having trouble finding solutions for, problem-solving therapy could be helpful for you.

Benefits of Problem-Solving Therapy

The skills learned in problem-solving therapy can be helpful for managing all areas of your life. These can include:

Being able to identify which stressors trigger your negative emotions (e.g., sadness, anger)
Confidence that you can handle problems that you face
Having a systematic approach on how to deal with life's problems
Having a toolbox of strategies to solve the issues you face
Increased confidence to find creative solutions
Knowing how to identify which barriers will impede your progress
Knowing how to manage emotions when they arise
Reduced avoidance and increased action-taking
The ability to accept life problems that can't be solved
The ability to make effective decisions
The development of patience (realizing that not all problems have a "quick fix")

Problem-solving therapy can help people feel more empowered to deal with the problems they face in their lives. Rather than feeling overwhelmed when stressors begin to take a toll, this therapy introduces new coping skills that can boost self-efficacy and resilience .

Other Types of Therapy

Other similar types of therapy include cognitive-behavioral therapy (CBT) and solution-focused brief therapy (SFBT) . While these therapies work to change thinking and behaviors, they work a bit differently. Both CBT and SFBT are less structured than problem-solving therapy and may focus on broader issues. CBT focuses on identifying and changing maladaptive thoughts, and SFBT works to help people look for solutions and build self-efficacy based on strengths.

This form of therapy was initially developed to help people combat stress through effective problem-solving, and it was later adapted to address clinical depression specifically. Today, much of the research on problem-solving therapy deals with its effectiveness in treating depression.

Problem-solving therapy has been shown to help depression in:

Older adults
People coping with serious illnesses like cancer

Problem-solving therapy also appears to be effective as a brief treatment for depression, offering benefits in as little as six to eight sessions with a therapist or another healthcare professional. This may make it a good option for someone unable to commit to a lengthier treatment for depression.

Problem-solving therapy is not a good fit for everyone. It may not be effective at addressing issues that don't have clear solutions, like seeking meaning or purpose in life. Problem-solving therapy is also intended to treat specific problems, not general habits or thought patterns .

In general, it's also important to remember that problem-solving therapy is not a primary treatment for mental disorders. If you are living with the symptoms of a serious mental illness such as bipolar disorder or schizophrenia , you may need additional treatment with evidence-based approaches for your particular concern.

Problem-solving therapy is best aimed at someone who has a mental or physical issue that is being treated separately, but who also has life issues that go along with that problem that has yet to be addressed.

For example, it could help if you can't clean your house or pay your bills because of your depression, or if a cancer diagnosis is interfering with your quality of life.

Your doctor may be able to recommend therapists in your area who utilize this approach, or they may offer it themselves as part of their practice. You can also search for a problem-solving therapist with help from the American Psychological Association’s (APA) Society of Clinical Psychology .

If receiving problem-solving therapy from a doctor or mental healthcare professional is not an option for you, you could also consider implementing it as a self-help strategy using a workbook designed to help you learn problem-solving skills on your own.

During your first session, your therapist may spend some time explaining their process and approach. They may ask you to identify the problem you’re currently facing, and they’ll likely discuss your goals for therapy .

Keep In Mind

Problem-solving therapy may be a short-term intervention that's focused on solving a specific issue in your life. If you need further help with something more pervasive, it can also become a longer-term treatment option.

Get Help Now

We've tried, tested, and written unbiased reviews of the best online therapy programs including Talkspace, BetterHelp, and ReGain. Find out which option is the best for you.

Shang P, Cao X, You S, Feng X, Li N, Jia Y. Problem-solving therapy for major depressive disorders in older adults: an updated systematic review and meta-analysis of randomized controlled trials . Aging Clin Exp Res . 2021;33(6):1465-1475. doi:10.1007/s40520-020-01672-3

Cuijpers P, Wit L de, Kleiboer A, Karyotaki E, Ebert DD. Problem-solving therapy for adult depression: An updated meta-analysis . Eur Psychiatry . 2018;48(1):27-37. doi:10.1016/j.eurpsy.2017.11.006

Nezu AM, Nezu CM, D'Zurilla TJ. Problem-Solving Therapy: A Treatment Manual . New York; 2013. doi:10.1891/9780826109415.0001

Owens D, Wright-Hughes A, Graham L, et al. Problem-solving therapy rather than treatment as usual for adults after self-harm: a pragmatic, feasibility, randomised controlled trial (the MIDSHIPS trial) . Pilot Feasibility Stud . 2020;6:119. doi:10.1186/s40814-020-00668-0

Sorsdahl K, Stein DJ, Corrigall J, et al. The efficacy of a blended motivational interviewing and problem solving therapy intervention to reduce substance use among patients presenting for emergency services in South Africa: A randomized controlled trial . Subst Abuse Treat Prev Policy . 2015;10(1):46. doi:doi.org/10.1186/s13011-015-0042-1

Margolis SA, Osborne P, Gonzalez JS. Problem solving . In: Gellman MD, ed. Encyclopedia of Behavioral Medicine . Springer International Publishing; 2020:1745-1747. doi:10.1007/978-3-030-39903-0_208

Kirkham JG, Choi N, Seitz DP. Meta-analysis of problem solving therapy for the treatment of major depressive disorder in older adults . Int J Geriatr Psychiatry . 2016;31(5):526-535. doi:10.1002/gps.4358

Garand L, Rinaldo DE, Alberth MM, et al. Effects of problem solving therapy on mental health outcomes in family caregivers of persons with a new diagnosis of mild cognitive impairment or early dementia: A randomized controlled trial . Am J Geriatr Psychiatry . 2014;22(8):771-781. doi:10.1016/j.jagp.2013.07.007

Noyes K, Zapf AL, Depner RM, et al. Problem-solving skills training in adult cancer survivors: Bright IDEAS-AC pilot study . Cancer Treat Res Commun . 2022;31:100552. doi:10.1016/j.ctarc.2022.100552

Albert SM, King J, Anderson S, et al. Depression agency-based collaborative: effect of problem-solving therapy on risk of common mental disorders in older adults with home care needs . The American Journal of Geriatric Psychiatry . 2019;27(6):619-624. doi:10.1016/j.jagp.2019.01.002

By Arlin Cuncic, MA Arlin Cuncic, MA, is the author of The Anxiety Workbook and founder of the website About Social Anxiety. She has a Master's degree in clinical psychology.

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This course will be an ongoing training that will be held over multiple dates and times throughout 2021. We will introduce and train Behavioral Consultants in Problem Solving Therapy (PST). PST is an evidence based model that utilizes the same short term brief intervention model as the Behavioral Health Consultant model we are currently utilizing to address depression in Primary Care and Specialty Clinic settings. Training will include an introduction to PST as well as education on the seven stages of PST, how to implement this into your problem solving process and worksheets and tools to use with patients.

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Problem-Solving Therapy (PST) is a flexible and adaptable approach to assist individuals in coping with a wide-range of problems. There is increasing evidence to demonstrate its effectiveness for a variety of populations and settings. This training will provide participants with an overview of the evidence and then focus on how it is delivered to service recipients in the Full Service Partnership (FSP) programs across LA County. The training will walk through the treatment strategy to include assessment, application of PST, psycho-education, use of PST Toolkits, and tips for adaptation. The training will provide participants with opportunities to apply PST through the use of clinical vignettes and problem-solving scenarios. The focus is on practical tools that practitioners can use in the field with those who struggle to solve simple and complex problems. The tools discussed and provided can be used as part of a larger PST structured treatment plan or on an as-needed basis. Participants can expect to understand the core tenets of PST and be able to apply PST skills upon completion of the training. Recorded on November 1 & 3, 2022.

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10 Best Problem-Solving Therapy Worksheets & Activities

Cognitive science tells us that we regularly face not only well-defined problems but, importantly, many that are ill defined (Eysenck & Keane, 2015).

Sometimes, we find ourselves unable to overcome our daily problems or the inevitable (though hopefully infrequent) life traumas we face.

Problem-Solving Therapy aims to reduce the incidence and impact of mental health disorders and improve wellbeing by helping clients face life’s difficulties (Dobson, 2011).

This article introduces Problem-Solving Therapy and offers techniques, activities, and worksheets that mental health professionals can use with clients.

Before you continue, we thought you might like to download our three Positive Psychology Exercises for free . These science-based exercises explore fundamental aspects of positive psychology, including strengths, values, and self-compassion, and will give you the tools to enhance the wellbeing of your clients, students, or employees.

This Article Contains:

What is problem-solving therapy, 14 steps for problem-solving therapy, 3 best interventions and techniques, 7 activities and worksheets for your session, fascinating books on the topic, resources from positivepsychology.com, a take-home message.

Problem-Solving Therapy assumes that mental disorders arise in response to ineffective or maladaptive coping. By adopting a more realistic and optimistic view of coping, individuals can understand the role of emotions and develop actions to reduce distress and maintain mental wellbeing (Nezu & Nezu, 2009).

“Problem-solving therapy (PST) is a psychosocial intervention, generally considered to be under a cognitive-behavioral umbrella” (Nezu, Nezu, & D’Zurilla, 2013, p. ix). It aims to encourage the client to cope better with day-to-day problems and traumatic events and reduce their impact on mental and physical wellbeing.

Clinical research, counseling, and health psychology have shown PST to be highly effective in clients of all ages, ranging from children to the elderly, across multiple clinical settings, including schizophrenia, stress, and anxiety disorders (Dobson, 2011).

Can it help with depression?

PST appears particularly helpful in treating clients with depression. A recent analysis of 30 studies found that PST was an effective treatment with a similar degree of success as other successful therapies targeting depression (Cuijpers, Wit, Kleiboer, Karyotaki, & Ebert, 2020).

Other studies confirm the value of PST and its effectiveness at treating depression in multiple age groups and its capacity to combine with other therapies, including drug treatments (Dobson, 2011).

The major concepts

Effective coping varies depending on the situation, and treatment typically focuses on improving the environment and reducing emotional distress (Dobson, 2011).

PST is based on two overlapping models:

Social problem-solving model

This model focuses on solving the problem “as it occurs in the natural social environment,” combined with a general coping strategy and a method of self-control (Dobson, 2011, p. 198).

The model includes three central concepts:

Social problem-solving
The problem
The solution

The model is a “self-directed cognitive-behavioral process by which an individual, couple, or group attempts to identify or discover effective solutions for specific problems encountered in everyday living” (Dobson, 2011, p. 199).

Relational problem-solving model

The theory of PST is underpinned by a relational problem-solving model, whereby stress is viewed in terms of the relationships between three factors:

Stressful life events
Emotional distress and wellbeing
Problem-solving coping

Therefore, when a significant adverse life event occurs, it may require “sweeping readjustments in a person’s life” (Dobson, 2011, p. 202).

Enhance positive problem orientation
Decrease negative orientation
Foster ability to apply rational problem-solving skills
Reduce the tendency to avoid problem-solving
Minimize the tendency to be careless and impulsive

D’Zurilla’s and Nezu’s model includes (modified from Dobson, 2011):

Initial structuring Establish a positive therapeutic relationship that encourages optimism and explains the PST approach.
Assessment Formally and informally assess areas of stress in the client’s life and their problem-solving strengths and weaknesses.
Obstacles to effective problem-solving Explore typically human challenges to problem-solving, such as multitasking and the negative impact of stress. Introduce tools that can help, such as making lists, visualization, and breaking complex problems down.
Problem orientation – fostering self-efficacy Introduce the importance of a positive problem orientation, adopting tools, such as visualization, to promote self-efficacy.
Problem orientation – recognizing problems Help clients recognize issues as they occur and use problem checklists to ‘normalize’ the experience.
Problem orientation – seeing problems as challenges Encourage clients to break free of harmful and restricted ways of thinking while learning how to argue from another point of view.
Problem orientation – use and control emotions Help clients understand the role of emotions in problem-solving, including using feelings to inform the process and managing disruptive emotions (such as cognitive reframing and relaxation exercises).
Problem orientation – stop and think Teach clients how to reduce impulsive and avoidance tendencies (visualizing a stop sign or traffic light).
Problem definition and formulation Encourage an understanding of the nature of problems and set realistic goals and objectives.
Generation of alternatives Work with clients to help them recognize the wide range of potential solutions to each problem (for example, brainstorming).
Decision-making Encourage better decision-making through an improved understanding of the consequences of decisions and the value and likelihood of different outcomes.
Solution implementation and verification Foster the client’s ability to carry out a solution plan, monitor its outcome, evaluate its effectiveness, and use self-reinforcement to increase the chance of success.
Guided practice Encourage the application of problem-solving skills across multiple domains and future stressful problems.
Rapid problem-solving Teach clients how to apply problem-solving questions and guidelines quickly in any given situation.

Success in PST depends on the effectiveness of its implementation; using the right approach is crucial (Dobson, 2011).

Problem-solving therapy – Baycrest

The following interventions and techniques are helpful when implementing more effective problem-solving approaches in client’s lives.

First, it is essential to consider if PST is the best approach for the client, based on the problems they present.

Is PPT appropriate?

It is vital to consider whether PST is appropriate for the client’s situation. Therapists new to the approach may require additional guidance (Nezu et al., 2013).

Therapists should consider the following questions before beginning PST with a client (modified from Nezu et al., 2013):

Has PST proven effective in the past for the problem? For example, research has shown success with depression, generalized anxiety, back pain, Alzheimer’s disease, cancer, and supporting caregivers (Nezu et al., 2013).
Is PST acceptable to the client?
Is the individual experiencing a significant mental or physical health problem?

All affirmative answers suggest that PST would be a helpful technique to apply in this instance.

Five problem-solving steps

The following five steps are valuable when working with clients to help them cope with and manage their environment (modified from Dobson, 2011).

Ask the client to consider the following points (forming the acronym ADAPT) when confronted by a problem:

Attitude Aim to adopt a positive, optimistic attitude to the problem and problem-solving process.
Define Obtain all required facts and details of potential obstacles to define the problem.
Alternatives Identify various alternative solutions and actions to overcome the obstacle and achieve the problem-solving goal.
Predict Predict each alternative’s positive and negative outcomes and choose the one most likely to achieve the goal and maximize the benefits.
Try out Once selected, try out the solution and monitor its effectiveness while engaging in self-reinforcement.

If the client is not satisfied with their solution, they can return to step ‘A’ and find a more appropriate solution.

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Positive self-statements

When dealing with clients facing negative self-beliefs, it can be helpful for them to use positive self-statements.

Use the following (or add new) self-statements to replace harmful, negative thinking (modified from Dobson, 2011):

I can solve this problem; I’ve tackled similar ones before.
I can cope with this.
I just need to take a breath and relax.
Once I start, it will be easier.
It’s okay to look out for myself.
I can get help if needed.
Other people feel the same way I do.
I’ll take one piece of the problem at a time.
I can keep my fears in check.
I don’t need to please everyone.

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PST practitioners have many different techniques available to support clients as they learn to tackle day-to-day or one-off trauma.

5 Worksheets and workbooks

Problem-solving self-monitoring form.

Ask the client to complete the following:

Describe the problem you are facing.
What is your goal?
What have you tried so far to solve the problem?
What was the outcome?

Reactions to Stress

It can be helpful for the client to recognize their own experiences of stress. Do they react angrily, withdraw, or give up (Dobson, 2011)?

The Reactions to Stress worksheet can be given to the client as homework to capture stressful events and their reactions. By recording how they felt, behaved, and thought, they can recognize repeating patterns.

What Are Your Unique Triggers?

Helping clients capture triggers for their stressful reactions can encourage emotional regulation.

When clients can identify triggers that may lead to a negative response, they can stop the experience or slow down their emotional reaction (Dobson, 2011).

The What Are Your Unique Triggers ? worksheet helps the client identify their triggers (e.g., conflict, relationships, physical environment, etc.).

Problem-Solving worksheet

Imagining an existing or potential problem and working through how to resolve it can be a powerful exercise for the client.

Use the Problem-Solving worksheet to state a problem and goal and consider the obstacles in the way. Then explore options for achieving the goal, along with their pros and cons, to assess the best action plan.

Getting the Facts

Clients can become better equipped to tackle problems and choose the right course of action by recognizing facts versus assumptions and gathering all the necessary information (Dobson, 2011).

Use the Getting the Facts worksheet to answer the following questions clearly and unambiguously:

Who is involved?
What did or did not happen, and how did it bother you?
Where did it happen?
When did it happen?
Why did it happen?
How did you respond?

2 Helpful Group Activities

While therapists can use the worksheets above in group situations, the following two interventions work particularly well with more than one person.

Generating Alternative Solutions and Better Decision-Making

A group setting can provide an ideal opportunity to share a problem and identify potential solutions arising from multiple perspectives.

Use the Generating Alternative Solutions and Better Decision-Making worksheet and ask the client to explain the situation or problem to the group and the obstacles in the way.

Once the approaches are captured and reviewed, the individual can share their decision-making process with the group if they want further feedback.

Visualization

Visualization can be performed with individuals or in a group setting to help clients solve problems in multiple ways, including (Dobson, 2011):

Clarifying the problem by looking at it from multiple perspectives
Rehearsing a solution in the mind to improve and get more practice
Visualizing a ‘safe place’ for relaxation, slowing down, and stress management

Guided imagery is particularly valuable for encouraging the group to take a ‘mental vacation’ and let go of stress.

Ask the group to begin with slow, deep breathing that fills the entire diaphragm. Then ask them to visualize a favorite scene (real or imagined) that makes them feel relaxed, perhaps beside a gently flowing river, a summer meadow, or at the beach.

The more the senses are engaged, the more real the experience. Ask the group to think about what they can hear, see, touch, smell, and even taste.

Encourage them to experience the situation as fully as possible, immersing themselves and enjoying their place of safety.

Such feelings of relaxation may be able to help clients fall asleep, relieve stress, and become more ready to solve problems.

We have included three of our favorite books on the subject of Problem-Solving Therapy below.

1. Problem-Solving Therapy: A Treatment Manual – Arthur Nezu, Christine Maguth Nezu, and Thomas D’Zurilla

This is an incredibly valuable book for anyone wishing to understand the principles and practice behind PST.

Written by the co-developers of PST, the manual provides powerful toolkits to overcome cognitive overload, emotional dysregulation, and the barriers to practical problem-solving.

Find the book on Amazon .

2. Emotion-Centered Problem-Solving Therapy: Treatment Guidelines – Arthur Nezu and Christine Maguth Nezu

Another, more recent, book from the creators of PST, this text includes important advances in neuroscience underpinning the role of emotion in behavioral treatment.

Along with clinical examples, the book also includes crucial toolkits that form part of a stepped model for the application of PST.

3. Handbook of Cognitive-Behavioral Therapies – Keith Dobson and David Dozois

This is the fourth edition of a hugely popular guide to Cognitive-Behavioral Therapies and includes a valuable and insightful section on Problem-Solving Therapy.

This is an important book for students and more experienced therapists wishing to form a high-level and in-depth understanding of the tools and techniques available to Cognitive-Behavioral Therapists.

For even more tools to help strengthen your clients’ problem-solving skills, check out the following free worksheets from our blog.

Case Formulation Worksheet This worksheet presents a four-step framework to help therapists and their clients come to a shared understanding of the client’s presenting problem.
Understanding Your Default Problem-Solving Approach This worksheet poses a series of questions helping clients reflect on their typical cognitive, emotional, and behavioral responses to problems.
Social Problem Solving: Step by Step This worksheet presents a streamlined template to help clients define a problem, generate possible courses of action, and evaluate the effectiveness of an implemented solution.

If you’re looking for more science-based ways to help others enhance their wellbeing, check out this signature collection of 17 validated positive psychology tools for practitioners. Use them to help others flourish and thrive.

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While we are born problem-solvers, facing an incredibly diverse set of challenges daily, we sometimes need support.

Problem-Solving Therapy aims to reduce stress and associated mental health disorders and improve wellbeing by improving our ability to cope. PST is valuable in diverse clinical settings, ranging from depression to schizophrenia, with research suggesting it as a highly effective treatment for teaching coping strategies and reducing emotional distress.

Many PST techniques are available to help improve clients’ positive outlook on obstacles while reducing avoidance of problem situations and the tendency to be careless and impulsive.

The PST model typically assesses the client’s strengths, weaknesses, and coping strategies when facing problems before encouraging a healthy experience of and relationship with problem-solving.

Why not use this article to explore the theory behind PST and try out some of our powerful tools and interventions with your clients to help them with their decision-making, coping, and problem-solving?

We hope you enjoyed reading this article. Don’t forget to download our three Positive Psychology Exercises for free .

Cuijpers, P., Wit, L., Kleiboer, A., Karyotaki, E., & Ebert, D. (2020). Problem-solving therapy for adult depression: An updated meta-analysis. European P sychiatry , 48 (1), 27–37.
Dobson, K. S. (2011). Handbook of cognitive-behavioral therapies (3rd ed.). Guilford Press.
Dobson, K. S., & Dozois, D. J. A. (2021). Handbook of cognitive-behavioral therapies (4th ed.). Guilford Press.
Eysenck, M. W., & Keane, M. T. (2015). Cognitive psychology: A student’s handbook . Psychology Press.
Nezu, A. M., & Nezu, C. M. (2009). Problem-solving therapy DVD . Retrieved September 13, 2021, from https://www.apa.org/pubs/videos/4310852
Nezu, A. M., & Nezu, C. M. (2018). Emotion-centered problem-solving therapy: Treatment guidelines. Springer.
Nezu, A. M., Nezu, C. M., & D’Zurilla, T. J. (2013). Problem-solving therapy: A treatment manual . Springer.

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The Effectiveness of Problem-Solving Therapy for Primary Care Patients' Depressive and/or Anxiety Disorders: A Systematic Review and Meta-Analysis

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Background: There is increasing demand for managing depressive and/or anxiety disorders among primary care patients. Problem-solving therapy (PST) is a brief evidence- and strength-based psychotherapy that has received increasing support for its effectiveness in managing depression and anxiety among primary care patients.

Methods: We conducted a systematic review and meta-analysis of clinical trials examining PST for patients with depression and/or anxiety in primary care as identified by searches for published literature across 6 databases and manual searching. A weighted average of treatment effect size estimates per study was used for meta-analysis and moderator analysis.

Results: From an initial pool of 153 primary studies, 11 studies (with 2072 participants) met inclusion criteria for synthesis. PST reported an overall significant treatment effect for primary care depression and/or anxiety ( d = 0.673; P < .001). Participants' age and sex moderated treatment effects. Physician-involved PST in primary care, despite a significantly smaller treatment effect size than mental health provider only PST, reported an overall statistically significant effect ( d = 0.35; P = .029).

Conclusions: Results from the study supported PST's effectiveness for primary care depression and/or anxiety. Our preliminary results also indicated that physician-involved PST offers meaningful improvements for primary care patients' depression and/or anxiety.

Anxiety Disorders
Depressive Disorder
Mental Health
Primary Health Care
Problem Solving
Psychotherapy

Depressive and anxiety disorders are the 2 leading global causes of all nonfatal burden of disease 1 and the most prevalent mental disorders in the US primary care system. 2 ⇓ – 4 The proportion of primary care patients with a probable depressive and/or anxiety disorder ranges from 33% to 80% 2 , 5 , 6 ; primary care patients also have alarmingly high levels of co-/multi-morbidity of depressive, anxiety, and physical disorders. 7 Depression and anxiety among primary care patients contribute to: poor compliance with medical advice and treatment 8 ; deficits in patient–provider communication 9 ; reduced patient engagement in healthy behaviors 10 ; and decreased physical wellbeing. 11 , 12 Given the high prevalence of primary care depression and anxiety, and their detrimental effects on the qualities of primary care treatments and patients' wellbeing, it is important to identify effective interventions suitable to address primary care depression and anxiety.

Primary care patients with depression and/or anxiety are often referred out to specialty mental health care. 13 , 14 However, outcomes from these referrals are usually poor due to patients' poor adherence and their resistance to mental health treatment 15 , 16 . Therefore, it is critical to identify effective mental health interventions that can be delivered in primary care for patients' depression and/or anxiety. 17 , 18 During the past decade, a plethora of clinical trials have investigated different mental health interventions for depression and anxiety delivered in primary care. One of the most promising interventions that has received increasing support for managing depression and anxiety in primary care is Problem-Solving Therapy (PST).

Holding that difficulties with problem solving make people more susceptible to depression, PST is a nonpharmacological, competence-based intervention that involves a step-by-step approach to constructive problem solving. 19 , 20 Developed from cognitive-behavioral-therapy, PST is a short-term psychotherapy approach delivered individually or in group settings. The generic PST manual 19 contains 14 training modules that guides PST providers working with patients from establishing a therapeutic relationship to identifying and understanding patient-prioritized problems; from building problem-solving skills to eventually solving the problems. Focused on patient problems in the here-and-now, a typical PST treatment course ranges from 7 to 14 sessions and can be delivered by various health care professionals such as physicians, clinical social workers or nurse practitioners. Because the generic PST manual outlines the treatment formula in detail, providers may deliver PST after receiving 1 month of training. For example, 1 feasibility study on training residents in PST found that residents can provide fidelious PST after 7 weeks' training and reach moderate to high competence after 3 years of practicing PST. 21 PST also has a self-help manual available to clients when needed.

PST is a well-established, evidence-based intervention for depression in specialty mental health care and is receiving greater recognition for its effectiveness in treating depression and anxiety in primary care. Systematic and meta-analytic reviews of PST for depression consistently reported moderate to large treatment effects, ranging from d = 0.4 to d = 1.15. 22 ⇓ – 24 Several clinical trials indicated PST's clinical effectiveness in alleviating anxiety as well. 25 , 26 Most importantly, PST has been adapted for primary care settings (PST-PC) and can be delivered by a variety of health care providers with fewer number of sessions and shorter session length. These unique features make PST(-PC) an ideal psychotherapy for depressive and/or anxiety disorders in primary care.

Previous reviews of PST focused on its effectiveness for depression care, but with little attention to PST's effect on anxiety or comorbid depression anxiety. In addition, to our knowledge, no previous reviews of PST have focused on managing depressive and/or anxiety disorders in primary care. Although research demonstrates that PST has a strong evidence base for treating depression and/or anxiety in specialty mental health care settings, more research is needed to determine whether PST remains effective for treating depressive and/or anxiety disorders when delivered in primary care. To address this gap, we conducted a systematic review and meta-analysis on the effectiveness of PST for treating depressive and/or anxiety disorders with primary care patients.

Search Strategies

This review included searches in 6 electronic databases (Academic Search Complete, CINAHL, Medline, PsychINFO, PUBMED, and the Cochrane Library/Database) and 3 professional Web sites (Academy of Cognitive Therapy, IMPACT, Anxiety and Depression Association of America) for primary care depression and anxiety studies published between January 1900 and September 2016. We also E-mailed major authors of PST studies for feedback and input. Search terms of title and/or abstract searches included: [“PST” or “Problem-Solving Therapy” or “Problem Solving Therapy” or “Problem Solving”] AND [“Depression” or “Depressive” or “Anxiety” or “Panic” or “Phobia”] AND [“primarycare” or “primary care” or “PCP” or “Family Medicine” or “Family Doctor”]. We supplemented the procedure described above with a manual search of study references.

Eligibility Criteria

For inclusion in analyses, a study needed to be 1) a randomized-controlled-trial of 2) PST for 3) primary care patients' 4) depressive and/or anxiety disorders. For studies that examined face-to-face, in-person PST, the intervention must be delivered in primary care for inclusion. If studies examined tele-PST (eg, telephone delivery, video conferencing, computer-based), the intervention must be connected to patients' primary care services for a study to be included. For example, when a primary care physician prescribed computer-based PST at home for their patients, the study met inclusion criteria (as it was still considered managing depression “in primary care” in the present review). However, studies would be excluded if a primary care physician referred patients to an external mental health intervention. Finally, studies must document and report sufficient statistical information for calculating effect size for inclusion in the final analysis.

Data Abstraction and Coding

Two authors (AZ and JES) reviewed an initial pool of 153 studies and agreed to remove 65 studies based on title and 68 studies based on abstract, resulting in 20 studies for full-text review. To develop the final list, we excluded 6 studies after closer review of full-text and consultation with a third reviewer who is an established PST researcher. Lastly, we excluded 2 studies due to 1) a study with a design that blurred the effect of PST with other treatments and 2) unsuccessful contact with a study author to request data needed for calculating effect size. We used a final sample of 11 studies for meta-analysis. The PRISMA chart is presented in Figure 1 .

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Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) chart of literature search for Problem-solving therapy (PST) studies for treating primary care patients' depression and/or anxiety.

Statistical Analysis

This study conducted meta-analysis with the following procedures: 1) calculated a weighted average of effect size estimates per study for depression and anxiety separately (to ensure independence) 27 ; 2) synthesized an overall treatment effect estimate using fixed- or random-effects model based on a heterogeneity statistic (Q-statistic) 28 ; and 3) performed univariate meta-regression with a mixed-effects model for moderator analysis. 29 Although other more advanced statistical approaches allow inclusion of multiple treatment effect size estimates per study for data synthesis, like the Generalized Least Squares method 30 or the Robust Variance Estimation method 31 , this study employed a typical approach because of the relatively small sample and absence of study information required to conduct more advanced methods. Following procedures outlined by Cooper and colleagues 32 , we conducted all analyses with R software. 33 We chose to conduct analyses in R, rather than software specific to meta-analysis (eg, RevMan), because R allowed for more flexibility in statistical modeling (eg, small sample size correction). 34 Sensitivity analysis using Robust Variance Estimation did not significantly alter results estimated with the typical approach. And so this study presents results from only the typical approach for purposes of parsimony and clarity.

Publication Bias, Risk of Bias and Quality of Studies

To detect publication bias, we used a funnel plot of effect size estimates graphed against their standard errors for visual investigation. To evaluate risk of bias, we used the Cochrane Collaboration's tool for assessing risk of bias in randomized trials 35 and the Quality Assessment of Controlled Intervention Studies to evaluate study quality. 36

Primary Studies

Eleven PST studies for primary care depression and/or anxiety reported a total sample size of 2072 participants. Participants' age averaged 50.1 and ranged from 24.5 to 71.8 years old. Ten studies reported participants' sex with an average of 35.6% male participants across all studies. Seven studies (63.6%) reported participants' racial background with most identified as non-Hispanic white (83.6%). Other racial/ethnic groups were poorly reported for meaningful summary. Five studies used active medication as a comparison, including 3 studies that used both active medication and placebo medication. The rest compared PST with treatment-as-usual while 2 studies used active control group (eg, video education material). Four studies involved physicians in some component of intervention delivery. PCPs provided PST in 2 studies; supervised and collaborated with depression care manager in 1 study, and collaborated with a primary care nurse in another. Ten studies reported an average of 6 PST sessions ( M = 6.1) ranging from 3 to 12 sessions. All but 1 study (n = 10) used individual PST and 2 studies used tele-health modalities to provide PST. All studies used standardized measures of depression and anxiety. Examples of the most common measures included: PHQ-9, CES-D, HAM-D, and BDI-II. Table 1 presents a detailed description of study characteristics.

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Study Characteristics for Problem-Solving Therapy as Intervention for Treating Depression and/or Anxiety Among Primary Care Patients ( n = 11)

Publication Bias, Risk of Bias, and Quality of Studies

The funnel plot ( Figure 2 ) did not indicate any clear sign of publication bias. Risk of bias ( Table 4 ) indicated an overall acceptable risk across studies included for review with blinding of participants and personnel, blinding of outcome assessment and incomplete outcome data most vulnerable to risk of bias. Quality of study assessment ( Table 5 ) indicated an overall satisfactory study quality with over half of studies (n = 6) achieving ratings of “Good” study quality.

Funnel Plot for Publication Bias in Problem-solving therapy (PST) Studies for Treating Primary Care Patients' Depression an/or Anxiety.

Meta-analysis and moderator analysis

Figure 3 presents a forest plot of treatment effects per study, including depression and anxiety measures. Table 3 presents subgroup analysis of overall treatment effect by moderator and Table 2 presents the results of meta-analysis and moderator analysis. Meta-analysis revealed an overall significant treatment effect of PST for primary care depression and/or anxiety ( d = 0.67; P < .001). Further investigation revealed no significant difference between the mean treatment effect of PST for depression versus anxiety in primary care ( d ( diff .) = −0.25; P = .317) while subgroup analysis revealed the overall treatment effect for anxiety was not significant ( d = 0.35; P = .226). Age was found to be a significant moderator (β 1 = 0.02; P = .012) for treatment outcomes, indicating that for each unit increase in participants' age, the overall treatment effect for primary are depression and/or anxiety are expected to increase by 0.02 (standard deviations). Neither participants' ethnic or racial backgrounds nor marital status significantly moderated the overall treatment outcome.

Forest Plot of PST Treatment Effect Size Estimates for Treating Primary Care Patients' Depression and/or Anxiety per Study.

PST for Treating Primary Care Patients' Depression and/or Anxiety; Results of Univariate Meta-regression

Results of Subgroup Analysis of Overall Treatment Effect (by Moderator) of PST for Treating Primary Care Patients' Depression and/or Anxiety

PST for Treating Primary Care Patients' Depression and/or Anxiety; Results of the Cochrane Collaboration's Tool for Assessing Risk of Bias *

Quality Assessment of Controlled PST Intervention Studies for Primary Care Patients' Depression and/or Anxiety ( n =11)

The overall treatment effect was not moderated by any treatment characteristics including: treatment modality (individual vs group PST), delivery methods (face-to-face vs tele-health PST), number of PST sessions and length of individual PST sessions. Subgroup analysis indicated an overall significant treatment effect of in-person PST ( d = 0.72; P < .001) but not of tele-PST ( d = 0.53; P = .097). However, the difference between the 2 was not statistically significant.

PST providers background and primary care physician's involvement significantly moderated the overall treatment effect size. Master's-level providers reported an overall treatment effect ( d = 1.57; P < .001) significantly higher than doctoral-level providers ( d = −1.33; P = .007). Both physician-involved and nonphysician involved PST reported significant overall treatment effect of PST for depression and/or anxiety in primary care ( d = 1.06; P < .001 and d = 0.35; P = .029, respectively). Moderator analysis further revealed that PST without physician involvement reported significantly greater treatment effects compared with physician-involved PST in primary care ( d = −0.71; P = .005). Results of subgroup and moderator analyses indicated that while the difference (in treatment effect) between physician and nonphysician involved PST in primary care were statistically significant, physician-involved PST was also statistically significant, thus practically meaningful.

Results of the study demonstrated a statistically significant overall treatment effect in outcomes of depression and/or anxiety for primary care patients receiving PST compared with patients in control groups. The outcome type—depression versus anxiety—failed to moderate treatment effect; only PST for depression reported a significant overall effect size. This could indicate that many studies primarily targeted depression and included anxiety measures as secondary outcomes. For this reason, we expect to find a greater treatment effect for primary care depression. It was unsurprising that treatment characteristics failed to moderate treatment effect size because most primary studies used PST-PC or its modified version; there was insufficient variation between studies (and moderators), yielding insignificant moderating coefficients.

Although delivery method did not moderate treatment effect reported in studies included in this review, significant effect was only reported by studies using face-to-face in-person PST but not by those with tele-PST modalities (n = 2). Although evidence for the effectiveness of tele-PST is established or increasing in a variety of settings 37 ⇓ – 39 most PST studies for primary care patients have used face-to-face, in-person PST. Our study further supported the use of face-to-face in-person PST for treating depression and anxiety among primary care patients. We recognize, however, that current and projected shortages in specialty mental health care provision, felt acutely in subspecialties such as geriatric mental health, necessitate more trials with PST tele-health modalities. 40

It is salient to note that, while nonphysician-involved PST studies reported significantly greater treatment effect than those involving physicians, PCP-involved studies also reported an overall significant effect size. Closer examination indicated that studies with physician-involved PST were either delivered by physicians or other nonmental health professionals (eg, registered nurses or depression care managers). Lack of sufficient PST training might explain the difference in treatment effect sizes being statistically significant. Yet, the fact that physician-involved PST studies reported an overall statistically significant effect size for primary care depression and/or anxiety suggested a meaningful treatment effect for clinical practice. When faced with a shortage of mental health professionals (eg, psychologists, clinical social workers, licensed professional counselors), our findings suggest physician-led or -supervised PST interventions could still improve primary care patients' depression and/or anxiety. Researchers are encouraged to further examine the treatment effect of PST delivered by mental health professionals in collaboration with primary care physicians.

This study has several weaknesses that are inherent to meta-analyses. There is no way to assure we included all studies despite adopting a comprehensive search and coding strategy (ie, file drawer problem). Second, while all studies in this meta-analysis seemed to have satisfactory methodological rigor, it is possible that internal biases within some studies may influence results. This study takes a quantitative meta-analysis approach which inherently neglects other study designs and methodologies that also provide valuable information about the effectiveness, feasibility, and acceptability of PST for treating primary care patients with depression. To ensure independence of data, this study used a weighted average of effect size estimates per study in synthesizing an overall treatment effect and conducting moderator analysis. While sensitivity analysis did not reveal significant differences from the reported results, we will not know for sure how our choice of statistical method might affect the results.

Acknowledgments

The authors are grateful to Dr. Namkee Choi, Professor and the Louis and Ann Wolens Centennial Chair in Gerontology at the University of Texas at Austin Steve Hicks School of Social Work, for her mentorship and insightful comments during preparation of the manuscript.

This article was externally peer reviewed.

Funding: none.

Conflict of interest: none declared.

Ethics Review: This is a systematic review and meta-analysis based on de-identified aggregate study data. No human participants or animals were involved in this study. No ethics review was required.

To see this article online, please go to: http://jabfm.org/content/31/1/139.full .

Received for publication July 5, 2017.
Revision received September 14, 2017.
Accepted for publication September 27, 2017.
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Global health reciprocal innovation to address mental health and well-being: strategies used and lessons learnt
Psychologic Treatment of Depression Compared With Pharmacotherapy and Combined Treatment in Primary Care: A Network Meta-Analysis
Brief behaviour change strategies for distressed patients in primary care
Interventions Must Be Realistic to Be Useful and Completed in Family Medicine

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Behavioral Activation (BA) is often a component of Cognitive Behavioral Therapy (CBT) and Problem-Solving Treatment (PST), but has also been shown to be a stand-alone evidence-based intervention to treat depression and anxiety in a primary care environment. Research shows that BA significantly improves patient outcomes in a wide range of settings and patient populations.

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Problem-Solving Therapy: How It Works & What to Expect

Author: Lydia Antonatos, LMHC

Lydia Angelica Antonatos LMHC

Lydia has over 16 years of experience and specializes in mood disorders, anxiety, and more. She offers personalized, solution-focused therapy to empower clients on their journey to well-being.

Problem-solving therapy (PST) is an intervention with cognitive and behavioral influences used to assist individuals in managing life problems. Therapists help clients learn effective skills to address their issues directly and make positive changes. PST is used in various settings to address mental health concerns such as depression, anxiety, and more.

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What Is Problem-Solving Therapy?

Problem-solving therapy (PST) is based on a model that the body, mind, and environment all interact with each other and that life stress can interact with a person’s predisposition for developing a mental condition. 2 Within this context, PST contends that mental, emotional, and behavioral struggles stem from an ongoing inability to solve problems or deal with everyday stressors. Therefore, the key to preventing health consequences and improving quality of life is to become a better problem-solver. 3 , 4

The problem-solving model has undergone several revisions but upholds the value of teaching people to become better problem-solvers. Overall, the goal of PST is to provide individuals with a set of rational problem-solving tools to reduce the impact of stress on their well-being.

The two main components of problem-solving therapy include: 3 , 4

Problem-solving orientation: This focuses on helping individuals adopt an optimistic outlook and see problems as opportunities to learn from, allowing them to believe they can solve problems.
Problem-solving style: This component aims to provide people with constructive problem-solving tools to deal with different life stressors by identifying the problem, generating/brainstorming solution ideas, choosing a specific option, and implementing and reviewing it.

Techniques Used in Problem-Solving Therapy

PST emphasizes the client, and the techniques used are merely conduits that facilitate the problem-solving learning process. Generally, the individual, in collaboration and support from the clinician, leads the problem-solving work. Thus, a strong therapeutic alliance sets the foundation for encouraging clients to apply these skills outside therapy sessions. 4

Here are some of the most relevant guidelines and techniques used in problem-solving therapy:

Creating Collaboration

As with other psychotherapies, creating a collaborative environment and a healthy therapist-client relationship is essential in PST. The role of a therapist is to cultivate this bond by conveying a genuine sense of commitment to the client while displaying kindness, using active listening skills, and providing support. The purpose is to build a meaningful balance between being an active and directive clinician while delivering a feeling of optimism to encourage the client’s participation.

This tool is used in all psychotherapies and is just as essential in PST. Assessment seeks to gather facts and information about current problems and contributing stressors and evaluates a client’s appropriateness for PST. The problem-solving therapy assessment also examines a person’s immediate issues, problem-solving attitudes, and abilities, including their strengths and limitations. This sets the groundwork for developing an individualized problem-solving plan.

Psychoeducation

Psychoeducation is an integral component of problem-solving therapy and is used throughout treatment. The purpose of psychoeducation is to provide a client with the rationale for problem-solving therapy, including an explanation for each step involved in the treatment plan. Moreover, the individual is educated about mental health symptoms and taught solution-oriented strategies and communication skills.

This technique involves verbal prompting, like asking leading questions, giving suggestions, and providing guidance. For example, the therapist may prompt a client to brainstorm or consider alternatives, or they may ask about times when a certain skill was used to solve a problem during a difficult situation. Coaching can be beneficial when clients struggle with eliciting solutions on their own.

Shaping intervention refers to teaching new skills and building on them as the person gradually improves the quality of each skill. Shaping works by reinforcing the desired problem-solving behavior and adding perspective as the individual gets closer to their intended goal.

In problem-solving therapy, modeling is a method in which a person learns by observing. It can include written/verbal problem-solving illustrations or demonstrations performed by the clinician in hypothetical or real-life situations. A client can learn effective problem-solving skills via role-play exercises, live demonstrations, or short-film presentations. This allows individuals to imitate observed problem-solving skills in their own lives and apply them to specific problems.

Rehearsal & Practice

These techniques provide opportunities to practice problem-solving exercises and engage in homework assignments. This may involve role-playing during therapy sessions, practicing with real-life issues, or imaginary rehearsal where individuals visualize themselves carrying out a solution. Furthermore, homework exercises are an important aspect when learning a new skill. Ongoing practice is strongly encouraged throughout treatment so a client can effectively use these techniques when faced with a problem.

Positive Reinforcement & Feedback

The therapist’s task in this intervention is to provide support and encouragement for efforts to apply various problem-solving skills. The goal is for the client to continue using more adaptive behaviors, even if they do not get it right the first time. Then, the therapist provides feedback so the client can explore barriers encountered and generate alternate solutions by weighing the pros and cons to continue working toward a specific goal.

Use of Analogies & Metaphors

When appropriate, analogies and metaphors can be useful in providing the client with a clearer vision or a better understanding of specific concepts. For example, the therapist may use diverse skills or points of reference (e.g., cooking, driving, sports) to explain the problem-solving process and find solutions to convey that time and practice are required before mastering a particular skill.

What Can Problem-Solving Therapy Help With?

Although problem-solving therapy was initially developed to treat depression among primary care patients, PST has expanded to address or rehabilitate other psychological problems, including anxiety , post-traumatic stress disorder , personality disorders , and more.

PST theory asserts that vulnerable populations can benefit from receiving constructive problem-solving tools in a therapeutic relationship to increase resiliency and prevent emotional setbacks or behaviors with destructive results like suicide. It is worth noting that in severe psychiatric cases, PST can be effectively used when integrated with other mental health interventions. 3 , 4

PST can help individuals challenged with specific issues who have difficulty finding solutions or ways to cope. These issues can involve a wide range of incidents, such as the death of a loved one, divorce, stress related to a chronic medical diagnosis, financial stress , marital difficulties, or tension at work.

Through the problem-solving approach, mental and emotional distress can be reduced by helping individuals break down problems into smaller pieces that are easier to manage and cope with. However, this can only occur as long the person being treated is open to learning and able to value the therapeutic process. 3 , 4

Lastly, a large body of evidence has indicated that PST can positively impact mental health, quality of life, and problem-solving skills in older adults. PST is an approach that can be implemented by different types of practitioners and settings (in-home care services, telemedicine, etc.), making mental health treatment accessible to the elderly population who often face age-related barriers and comorbid health issues. 1 , 5, 6

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Problem-Solving Therapy Examples

Due to the versatility of problem-solving therapy, PST can be used in different forms, settings, and formats. Following are some examples where the problem-solving therapeutic approach can be used effectively. 4

People who suffer from depression often evade or even attempt to ignore their problems because of their state of mind and symptoms. PST incorporates techniques that encourage individuals to adopt a positive outlook on issues and motivate individuals to tap into their coping resources and apply healthy problem-solving skills. Through psychoeducation, individuals can learn to identify and understand their emotions influence problems. Employing rehearsal exercises, someone can practice adaptive responses to problematic situations. Once the depressed person begins to solve problems, symptoms are reduced, and mood is improved.

The Veterans Health Administration presently employs problem-solving therapy as a preventive approach in numerous medical centers across the United States. These programs aim to help veterans adjust to civilian life by teaching them how to apply different problem-solving strategies to difficult situations. The ultimate objective is that such individuals are at a lower risk of experiencing mental health issues and consequently need less medical and/or psychiatric care.

Psychiatric Patients

PST is considered highly effective and strongly recommended for individuals with psychiatric conditions. These individuals often struggle with problems of daily living and stressors they feel unable to overcome. These unsolved problems are both the triggering and sustaining reasons for their mental health-related troubles. Therefore, a problem-solving approach can be vital for the treatment of people with psychological issues.

Adherence to Other Treatments

Problem-solving therapy can also be applied to clients undergoing another mental or physical health treatment. In such cases, PST strategies can be used to motivate individuals to stay committed to their treatment plan by discussing the benefits of doing so. PST interventions can also be utilized to assist patients in overcoming emotional distress and other barriers that can interfere with successful compliance and treatment participation.

Benefits of Problem-Solving Therapy

PST is versatile, treating a wide range of problems and conditions, and can be effectively delivered to various populations in different forms and settings—self-help manuals, individual or group therapy, online materials, home-based or primary care settings, as well as inpatient or outpatient treatment.

Here are some of the benefits you can gain from problem-solving therapy:

Gain a sense of control over your life
Move toward action-oriented behaviors instead of avoiding your problems
Gain self-confidence as you improve the ability to make better decisions
Develop patience by learning that successful problem-solving is a process that requires time and effort
Feel a sense of empowerment as you solve your problems independently
Increase your ability to recognize and manage stressful emotions and situations
Learn to focus on the problems that have a solution and let go of the ones that don’t
Identify barriers that may hinder your progress

How to Find a Therapist Who Practices Problem-Solving Therapy

Finding a therapist skilled in problem-solving therapy is not any different from finding any qualified mental health professional. This is because many clinicians often have knowledge in cognitive-behavioral interventions that hold similar concepts as PST.

As a general recommendation, check your health insurance provider lists, use an online therapist directory , or ask trusted friends and family if they can recommend a provider. Contact any of these providers and ask questions to determine who is more compatible with your needs. 3 , 4

Are There Special Certifications to Provide PST?

Therapists do not need special certifications to practice problem-solving therapy, but some organizations can provide special training. Problem-solving therapy can be delivered by various healthcare professionals such as psychologists, psychiatrists, physicians, mental health counselors, social workers, and nurses.

Most of these clinicians have naturally acquired valuable problem-solving abilities throughout their career and continuing education. Thus, all that may be required is fine-tuning their skills and familiarity with the current and relevant PST literature. A reasonable amount of understanding and planning will transmit competence and help clients gain insight into the causes that led them to their current situation. 3 , 4

Questions to Ask a Therapist When Considering Problem-Solving Therapy

Psychotherapy is most successful when you feel comfortable and have a collaborative relationship with your therapist. Asking specific questions can simplify choosing a clinician who is right for you. Consider making a list of questions to help you with this task.

Here are some key questions to ask before starting PST:

Is problem-solving therapy suitable for the struggles I am dealing with?
Can you tell me about your professional experience with providing problem-solving therapy?
Have you dealt with other clients who present with similar issues as mine?
Have you worked with individuals of similar cultural backgrounds as me?
How do you structure your PST sessions and treatment timeline?
How long do PST sessions last?
How many sessions will I need?
What expectations should I have in working with you from a problem-solving therapeutic stance?
What expectations are required from me throughout treatment?
Does my insurance cover PST? If not, what are your fees?
What is your cancellation policy?

How Much Does Problem-Solving Therapy Cost?

The cost of problem-solving therapy can range from $25 to $150 depending on the number of sessions required, severity of symptoms, type of practice, geographic location, and provider’s experience level. However, if your insurance provider covers behavioral health, the out-of-pocket costs per session may be much lower. Medicare supports PST through professionally trained general health practitioners. 1

What to Expect at Your First PST Session

During the first session, the therapist will strive to build a connection and become familiar with you. You will be assessed through a clinical interview and/or questionnaires. During this process, the therapist will gather your background information, inquire about how you approach life problems, how you typically resolve them, and if problem-solving therapy is a suitable treatment for you. 3 , 4

Additionally, you will be provided psychoeducation relating to your symptoms, the problem-solving method and its effectiveness, and your treatment goals. The clinician will likely guide you through generating a list of the current problems you are experiencing, selecting one to focus on, and identifying concrete steps necessary for effective problem-solving. Lastly, you will be informed about the content, duration, costs, and number of therapy sessions the therapist suggests. 3 , 4

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Is Problem-Solving Therapy Effective?

Extensive research and studies have shown the efficacy of problem-solving therapy. PST can yield significant improvements within a short amount of time. PST is also useful for addressing numerous problems and psychological issues. Lastly, PST has shown its efficacy with different populations and age groups.

One meta-analysis of PST for depression concluded that problem-solving therapy was as efficient for reducing symptoms of depression as other types of psychotherapies and antidepressant medication. Furthermore, PST was significantly more effective than not receiving any treatment. 7 However, more investigation may be necessary about PST’s long-term efficacy in comparison to other treatments. 5,6

How Is PST Different From CBT & SFT?

Problem-solving, cognitive-behavioral, and solution-focused therapy belong to the cognitive-behavioral framework, sharing a common goal to modify thoughts, aptitudes, and behaviors to improve mental health and quality of life.

Problem-Solving Therapy Vs. Cognitive-Behavioral Therapy

Cognitive behavioral therapy (CBT) is a short-term psychosocial treatment developed under the premise that how we think affects how we feel and behave. CBT addresses problems arising from maladaptive thought patterns and seeks to challenge and modify these to improve behavioral responses and overall well-being. CBT is the most researched approach and preferred treatment in psychotherapy due to its effectiveness in addressing various problems like anxiety, sleep disorders, substance abuse, and more.

Like CBT, PST addresses mental, emotional, and behavioral issues. However, PST may provide a better balance of cognitive and behavioral elements.

Another difference between these two approaches is that PST mostly focuses on faulty thoughts about problem-solving orientation and modifying maladaptive behaviors that specifically interfere with effective problem-solving. Usually, PST is used as an integrated approach and applied as one of several other interventions in CBT psychotherapy sessions.

Problem-Solving Therapy Vs. Solution-Focused Therapy

Solution-focused therapy (SFT) , like PST, is a goal-directed, evidence-based brief therapeutic approach that encourages optimism, options, and self-efficacy. Similarly, it is also grounded on cognitive behavioral principles. However, it differs from problem-solving therapy because SFT is a semi-structured approach that does not follow a step-by-step sequential format. 8

SFT mainly focuses on solution-building rather than problem-solving, specifically looking at a person’s strengths and previous successes. SFT helps people recognize how their lives would differ without problems by exploring their current coping skills. Community mental health, inpatient settings, and educational environments are increasing the use of SFT due to its demonstrated efficacy. 8

Final Thoughts

Problem-solving therapy can be an effective treatment for various mental health concerns. If you are considering treatment, ask your doctor for recommendations or conduct your own research to learn more about this approach and other options available.

Additional Resources

To help our readers take the next step in their mental health journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy is compensated for marketing by the companies included below.

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For Further Reading

12 Strategies to Stop Using Unhealthy Coping Mechanisms
Depression Therapy: 4 Effective Options to Consider
CBT for Depression: How It Works, Examples, & Effectiveness

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Online psychiatry, sometimes called telepsychiatry, platforms offer medication management by phone, video, or secure messaging for a variety of mental health conditions. In some cases, online psychiatry may be more affordable than seeing an in-person provider. Mental health treatment has expanded to include many online psychiatry and therapy services. With so many choices, it can feel overwhelming to find the one that is right for you.

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Beaudreau, S. A., Gould, C. E., Sakai, E., & Terri Huh, J. W. (2017). Problem-Solving Therapy. In N. A. Pachana (Ed.), Encyclopedia of geropsychology : with 148 figures and 100 tables . Singapore: Springer.

Broerman, R. (2018). Diathesis-Stress Model. In T. Shackleford & V. Zeigler-Hill (Eds.), Encyclopedia of Personality and Individual Differences (Living Edition, pp. 1–3). Springer, Cham. https://doi.org/10.1007/978-3-319-28099-8_891-1

Mehmet Eskin. (2013). Problem solving therapy in the clinical practice . Elsevier.

Nezu, A. M., Nezu, C. M., & D’Zurilla, T. J. (2013). Problem-Solving Therapy A Treatment Manual . Springer Publishing Company.

Cuijpers, P., et al. (2018). Problem-solving therapy for adult depression: An updated meta-analysis. European Psychiatry 48 , 27–37. https://doi.org/10.1016/j.eurpsy.2017.11.006

Kirkham, J. G., Choi, N., & Seitz, D. P. (2015). Meta-analysis of problem-solving therapy for the treatment of major depressive disorder in older adults. International Journal of Geriatric Psychiatry , 31 (5), 526–535. https://doi.org/10.1002/gps.4358

Bell, A. C., & D’Zurilla, T. J. (2009). Problem-solving therapy for depression: A meta-analysis. Clinical Psychology Review , 29 (4), 348–353. https://doi.org/10.1016/j.cpr.2009.02.003

Proudlock, S. (2017). The Solution Focused Way Incorporating Solution Focused Therapy Tools and Techniques into Your Everyday Work . Routledge.

Nezu, A. M., Nezu, C. M., & Gerber, H. R. (2019). (Emotion‐centered) problem‐solving therapy: An update. Australian Psychologist , 54 (5), 361–371. https://doi.org/10.1111/ap.12418

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Problem-Solving Therapy: Definition, Techniques, and Efficacy
What Conditions Does Problem Solving Therapy Treat?
Collaborative Problem Solving
Collaborative Problem Solving Essential Foundation

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Problem Solving Treatment (PST)
Problem-Solving Treatment (PST) is a brief form of evidence-based treatment that was originally developed in Great Britain for use by medical professionals in primary care. It is also known as Problem-Solving Treatment - Primary Care (PST-PC). PST has been studied extensively in a wide range of settings and with a variety of providers and patient populations.
Problem Solving Therapy
Problem Solving Therapy. Dawn Hasemann, Ph.D. is currently the Program Manager (BHM2) for Kaiser Permanente's Virtual ADAPT program in Livermore and San Leandro. Dawn has been a manager and therapist with the Virtual ADAPT program since its doors opened in 2020. Before joining the Virtual ADAPT program, Dawn worked at the Kaiser Fremont ...
Problem Solving Treatment (PST) Training
The AIMS Center offers trainings in Problem Solving Treatment (PST). This brief, evidence-based approach has been proven effective with various patient populations - including those from differing cultural backgrounds. PST aims to increase self-efficacy by teaching the patient problem solving techniques to empower them to solve life issues ...
Tier 2: Problem Solving Treatment Certification
Full Problem Solving Treatment (PST) Certification typically requires between 19 and 22 hours of participant time. Upon completion of all training requirements listed below, participants receive certification as a PST practitioner. ... Up to 13 CE credits are available for social workers and psychologists. View a detailed course overview. All ...
PDF Problem Solving Therapy
CONTINUING EDUCATION DAY 1: 5.5 CONTACT HOURS / DAY 2: 3 CONTACT HOURS PSYCHOLOGISTS: Psychologists - APA: ... Problem Solving Therapy (PST) is an evidence-based treatment intended to break the cycle between overwhelming life stressors and symptoms of depression, anxiety, or distress. PST has been found to be effective for a wide range of ...
PDF Session 2 Problem-Solving Therapy
Problem-Solving Therapy (PST) is an evidenced-based intervention to facilitate behavioral changes through a variety of skill training. PST identifies strategies to ... of continuing education and meeting a soulmate. Compared to two of her sisters who have successful careers and happy families, Fang expressed that she was disappointed ...
Continuing Education Seminar Library
Kaiser Permanente Mental Health Training programs offers continuing education seminars intended for internal employees and those involved in the Mental Health Training program. Explore the archive of seminars to learn more. ... Problem Solving Therapy. Presenter: Dawn Hasemann, Ph.D. 2 CE. Regional Speaker Series. Prolonged Exposure Therapy (PE ...
Problem-Solving Therapy
Problem-solving therapy is a cognitive-behavioral intervention geared to improve an individual's ability to cope with stressful life experiences. The underlying assumption of this approach is that symptoms of psychopathology can often be understood as the negative consequences of ineffective or maladaptive coping.
Problem-Solving Therapy: Definition, Techniques, and Efficacy
Problem-solving therapy is a brief intervention that provides people with the tools they need to identify and solve problems that arise from big and small life stressors. It aims to improve your overall quality of life and reduce the negative impact of psychological and physical illness. Problem-solving therapy can be used to treat depression ...
Problem Solving (full course)
Problem Solving (free course) $0.00. PWEBS (full course) $27.50. Self-Monitoring (full course) $7.25. PracticeWise is dedicated to improving human health and welfare through the use of evidence and information technology to advance behavioral health care. PracticeWise strives to apply scientific principles in all its endeavors and to pursue ...
Problem Solving Therapy
This course will be an ongoing training that will be held over multiple dates and times throughout 2021. We will introduce and train Behavioral Consultants in Problem Solving Therapy (PST). PST is an evidence based model that utilizes the same short term brief intervention model as the Behavioral Health Consultant model we are currently utilizing to address depression in
Problem Solving Treatment
Objectives. At the conclusion of this training course the participant will be able to: Review problem-solving treatment techniques and application for patients diagnosed with depression/anxiety. Describe the goals of problem solving treatment. List the steps of problem solving treatment. Apply concepts to patient specific scenarios.
Cognitive Behavioral Therapy: Overview, Strategies, And ...
This means that CBT is a reliable therapy found to work well in real-world settings for a host of problems and presentations. This learning material is designed for psychologists, social workers, mental health counselors, and marriage and family therapists who wish to improve their CBT practice to be more effective with their difficult to treat ...
Problem-Solving Therapy (PST)
CE credits: Not currently offered Presented by: DMH + UCLA Public Mental Health Partnership. Featuring: Danielle Cameron, LCSW, MSW. ... Problem-Solving Therapy (PST) is a flexible and adaptable approach to assist individuals in coping with a wide-range of problems. There is increasing evidence to demonstrate its effectiveness for a variety of ...
PDF Problem Solving Treatment (PST) Training and Certification
roblem Solving Treatment (PST) Training and CertificationProblem Solving Treatment (PST) is a brief, evidence-based approach that is effective with a majority of patient pop. lations and including patients of many different cultures. PST teaches and empowers depressed patients to solve the here-and-now problems contrib.
10 Best Problem-Solving Therapy Worksheets & Activities
We have included three of our favorite books on the subject of Problem-Solving Therapy below. 1. Problem-Solving Therapy: A Treatment Manual - Arthur Nezu, Christine Maguth Nezu, and Thomas D'Zurilla. This is an incredibly valuable book for anyone wishing to understand the principles and practice behind PST.
The Effectiveness of Problem-Solving Therapy for Primary Care Patients
Background: There is increasing demand for managing depressive and/or anxiety disorders among primary care patients. Problem-solving therapy (PST) is a brief evidence- and strength-based psychotherapy that has received increasing support for its effectiveness in managing depression and anxiety among primary care patients. Methods: We conducted a systematic review and meta-analysis of clinical ...
Problem-solving therapy: A treatment manual.
Problem-solving therapy: A treatment manual. Springer Publishing Co. Abstract. The purpose of this book is to serve as a detailed treatment manual and to delineate general intervention strategies of contemporary problem-solving therapy (PST), that are required to effectively conduct this intervention approach.
(Emotion‐centered) problem‐solving therapy: An update.
Problem‐solving therapy (PST) is a psychosocial intervention, typically considered to be a member of the cognitive and behaviour therapies family, and is based on a biopsychosocial, diathesis‐stress model of psychopathology. The overarching goal of this approach is to promote the successful adoption of adaptive problem‐solving attitudes and the effective implementation of certain ...
Parenting, Teaching and Treating Challenging Kids: The Collaborative
MaMHCA, and its agent, MMCEP has been designated by the Board of Allied Mental Health and Human Service Professions to approve sponsors of continuing education for licensed mental health counselors in the Commonwealth of Massachusetts for licensure renewal, in accordance with the requirements of 262 CMR 3.00.
Behavioral Activation (BA) Training
Behavioral Activation (BA) Training. Behavioral Activation (BA) is a brief evidence-based behavioral intervention for use in primary care, other health care, and community settings. BA teaches patients experiencing depressive or anxiety symptoms a set of skills to re-engage in valued life activities that they once found rewarding and enjoyable.
Problem-Solving Therapy: How It Works & What to Expect
Problem-solving therapy (PST) is an intervention with cognitive and behavioral influences used to assist individuals in managing life problems. Therapists help clients learn effective skills to address their issues directly and make positive changes. PST is used in various settings to address mental health concerns such as depression, anxiety, and more.
Webinar Series
Problem-Solving Therapy (PST), recently revised and renamed Emotion-Centered PST, is an evidenced-based psychosocial intervention found to be effective for a wide range of client populations and psychological problems. The purpose of this webinar is to describe the relevance of EC-PST as a treatment and prevention approach to reduce suicidality.