Problem-Solving Therapy for Depression
Status: Strong Research Support
Problem-solving therapy (PST) teaches patients to more effectively generate solutions for problems, such as interpersonal conflicts or the pursuit of goals. Therapists help patients learn and effectively apply the steps of problem solving, including: 1) identifying problems, 2) generating multiple alternative solutions, 3) selecting the best solution from the alternatives, 4) developing a plan, 5) implementing the problem solving tactic, and 6) evaluating the efficacy of problem solving. According to Cuijpers, van Straten, and Warmerdam (2007) there are three general types of problem-solving therapy: social problem-solving therapy, problem-solving for primary care settings (which can be conducted by paraprofessionals), and self-examination problem-solving therapy, which helps patients determine their major goals, evaluate problems that are blocking those goals, and engage in problem-solving and acceptance of uncontrollable problems. PST is a short-term therapy (8-16 sessions) that can be provided in individual or group format. PST for primary care settings is briefer and consists of 4 to 6 sessions. PST has also been applied to geriatric and medical populations. PST has received empirical support as a treatment for depression, but some findings are mixed. Nezu (2004) notes that outcomes are best when the problem-solving orientation component of PST is included in addition to the skills training.
Key References (in reverse chronological order)
Cuijpers, P., van Straten, A., & Warmerdam, L. (2007). Problem-solving therapies for depression: A meta-analysis. European Psychiatry, 22, 9-15.
Gellis, Z. D. & Kenaley, B. (2007). Problem-solving therapy for depression in adults: A systematic review. Research on Social Work Practice, 1-15.
Malouff, J. M., Thorsteinsson, E. B., Schutte, N. S. (2007). The efficacy of problem solving therapy in reducing mental and physical health problems: A meta-analysis. Clinical Psychology Review, 27, 46-57.
Scogin, F, Welsh, D., Hanson, A. Stump, J. & Coates, A. (2005). Evidence-based psychotherapies for depression in older adults. Clinical Psychology: Science and Practice, 12, 222-237.
Nezu, A. M. (2004). Problem solving and behavior therapy revisited. Behavior Therapy, 35, 1-33.
Areán, P. A., Perri, M. G., Nezu, A. M., Schein, R. L., Christopher, F., & Joseph, T. X. (1993). Comparative effectiveness of social problem solving therapy and reminiscence therapy as treatments for depression in older adults. Journal of Consulting and Clinical Psychology, 61, 1003-1010.
Reynolds, C. F., Miller, M. D., Pasternak, R. D., Frank, E., Perel, J. M., & Cornes, C., (1999). Treatment of bereavement-related major depressive episodes in later life: A controlled study of acute and continuation treatment with nortriptyline and interpersonal psychotherapy. American Journal of Psychiatry, 156, 202-208.
D'Zurilla, T. J., & Nezu, A. M. (2007). Problem-solving therapy: A positive approach to clinical interventions (3rd ed.) NY: Springer Publishing Co.
D'Zurilla, T. J., & Nezu, A. M. (2001). Problem-solving therapies. In K. Dobson (Ed.), Handbook of cognitnve-behavioral therapies (2nd ed., pp 211-245). NY: Guilford.
Nezu, A. M., & Nezu, C. M. (2001). Problem-solving therapy. Journal of Psychotherapy Integration, 11, 187-205.
Nezu, A. M., Nezu C.M. & Perri, M.G. (1989). Problem-solving therapy for depression: Theory, research, and clinical guidelines. NY: Wiley