Problem-solving therapy, which is also known as short term therapy or structured problem solving, arose out of the recognized need to teach patients psychosocial skills. This form of therapy involves providing patients with tools to identify and solve problems that arise from life stressors to improve overall quality of life and reduce the negative impact of psychological and physical illness.
History of Problem Solving Therapy
Problem-solving therapy was first developed in Great Britain in the primary care context. It was designed to be an evidence-based treatment that doctors could use in their practices with their patients.
Rather than directly addressing problems such as depression or anxiety, the aim of problem-solving therapy was to increase the self-efficacy of patients to solve specific life problems that contribute to psychological problems.
Types of Problems Treated
Problem-solving therapy is not advised for all types of psychological issues.
The primary use is problem-solving therapy is to address issues related to life stress and finding solutions to concrete issues. In this way, it can be applied to life problems that are typically associated with various psychological and physiological symptoms.
For this reason, most mental disorders would not be treated with problem-solving therapy. However, problem-solving therapy could be used alongside regular treatment to boost its effectiveness.
When Problem Solving Therapy Is Not Advised
Problem-solving therapy is not advised for the following diagnoses:
substance abuse disorders
post-traumatic stress disorder
panic disorder
bipolar disorder
psychosis
When Problem Solving Therapy Is Advised
Problem-solving therapy is advised for the following issues:
common mental health issues
managing stressful life events
dealing with the aftermath of a divorce
coping with the loss of a loved one
struggling after job loss
stress related to a cancer diagnosis
problems associated with heart disease
stress due to the accumulation of minor life issues (e.g., long commutes, stressful job)
struggles due to family problems
financial difficulties
problems with relationships
desire to find more personal meaning in your life
coping with everyday life stressors
basic psychological and emotional issues
problems that result from a medical illness
mental health issues resulting from life stressors
anxiety-related issues
problems with self-harm
feeling unhappy in your work or in your home
for managing specific symptoms of depression
to address concrete problems in your life
Your doctor or mental health professional will be able to advise whether problem-solving therapy could be helpful for your particular issue. In general, if you are struggling with real-life concrete problems that you feel you are having trouble finding solutions for, problem-solving therapy could be helpful for you.
Therapy Framework
In order to grasp how problem-solving therapy works, it’s helpful first to describe the framework or background to the therapy.
Problem-solving therapy is based on a model of stress and well-being that takes into account the importance of real-life problem-solving. In other words, the key to managing the impact of stressful life events in terms of later problems with mental health is to know how to solve problems as they arise.
There are two major components that make up the problem-solving therapy framework: Applying the problem-solving orientation to your life and using problem-solving skills.
Applying the Problem Solving Orientation
When you experience problem-solving therapy, you will learn how to apply the approach to all areas of your life.
This means that you will start to see problems as challenges to be solved instead of insurmountable obstacles. It also means that you will recognize the time and systematic action that is required to engage in effective problem-solving techniques.
For example, if you are living with depression or a medical illness, and struggling to eat healthy meals each day, you would see this as a problem that can be solved through a systematic plan that you take the time to implement.
Using Problem Solving Skills
The second component of problem-solving therapy is learning how to use problem-solving skills. This involves knowing how to identify the problem, defining it in a way that is helpful, trying to understand the problem in a deeper way, setting goals related to the problem, generating alternative creative solutions, choosing the best course of action, implementing the choice you have made, and evaluating the outcome to determine next steps.
To break it down more specifically, problem-solving therapy uses a four-pronged approach:
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 for the generation of potential solutions.
Generation of alternative solutions:
This stage involves generating various potential solutions to the problem at hand in order 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.
Format of Problem Solving Therapy
What is the format of problem-solving therapy? Let’s take a look at the different features that it involves.
Problem-solving therapy…
takes place over anywhere from 6 to 16 sessions
involves sessions that can be anywhere from 30 minutes to two hours long
takes place through a collaborative process between therapist and patient
is a type of cognitive behavioral therapy intervention
can take place one-on-one or in a group format
involves homework assignments
involves psychoeducation
can be combined with other treatment approaches
involves the development of personal empowerment of the patient
can be administered by a doctor or mental health professional
focuses on developing an action plan
helps you through the step-by-step details of how to solve life problems
focuses on real-life problems that you are experiencing at the moment
involves a series of stages of psychotherapy
Problem-solving therapy is all about training you to become adaptive in your life so that you can develop a problem-solving attitude and the specific skills required to execute strategies in your life right now.
Problem-solving therapy is also very practical in its approach and is only concerned with the present, rather than delving into your past.
Benefits of Problem Solving Therapy
What types of skills are developed during problem-solving therapy? Below are just some of the advantages that this type of therapy offers:
The ability to make effective decisions
Increased confidence to find creative solutions
Knowing how to identify which barriers will impede your progress
Being able to identify which stressors trigger your negative emotions (e.g., sadness, anger)
Knowing how to manage these emotions when they arise
Confidence that you can handle problems that you face
The ability to accept life problems that can’t be solved
Having a systematic approach on how to deal with life’s problems
Reduced avoidance and increased action-taking
The development of patience (realizing that not all problems have a “quick fix”)
Having a toolbox of strategies to solve the problems you face
As you can see, there are numerous benefits to engaging in problem-solving therapy that may extend into all areas of your life.
While other forms of psychotherapy such as cognitive-behavioral therapy may be helpful for dealing with negative thoughts, problem-solving therapy is ideal if you are struggling with life problems and stressors and you don’t feel well equipped with the necessary tools and strategies to solve your problems.
Research on Problem Solving Therapy
In order to understand whether problem-solving therapy might be effective for you, it’s helpful to consider the relevant research evidence.
In general, there is research evidence supporting the use of problem-solving therapy for issues related to major depressive disorder, generalized anxiety disorder, some personality disorders, poor quality of life due to illness such as cancer or diabetes, suicidal ideation, and emotional distress.
Meta-Analysis of 31 Studies
In a meta-analysis of 31 studies that examined the efficacy of problem-solving therapy among 2895 participants, it was shown that problem-solving therapy was more effective than no treatment at all, treatment as usual, and attention placebo. However, it was not found to be more effective than bona fide treatments that were offered as part of the original studies.
In addition, the researchers discovered that there were some factors that influence the effectiveness of problem-solving therapy. These included whether the therapy involved a component of problem orientation training and also whether there was homework assigned to participants.
This suggests that the best format for problem-solving therapy will involve teaching you how to view problems as challenges to be overcome so that when you face new problems outside of therapy, you feel equipped to face them rather than avoid them.
This also suggests that practical exercises, like the ones done during homework, are critical for allowing you to practice strategies so that they have a lasting impact.
Meta-Analysis of Problem Solving Therapy for Depression
In another meta-analysis of 21 studies using problem-solving therapy for depression, it was shown that problem-solving therapy was as effective as other psychosocial therapies and also as effective as antidepressant medication. It was also shown to be more effective than no treatment at all as well as an attention control.
Once again, it was determined that problem-solving therapy was more effective when it included training in having a positive problem orientation. In other words, it was very important that when therapy was complete, you had a mindset that you would be able to solve your problems in the future.
By Arlin Cuncic