2015 EST Status: Treatment pending re-evaluation Very strong: High-quality evidence that treatment improves symptoms and functional outcomes at post-treatment and follow-up; little risk of harm; requires reasonable amount of resources; effective in non-research settings

Strong: Moderate- to high-quality evidence that treatment improves symptoms OR functional outcomes; not a high risk of harm; reasonable use of resources

Weak: Low or very low-quality evidence that treatment produces clinically meaningful effects on symptoms or functional outcomes; Gains from the treatment may not warrant resources involved

Insufficient Evidence: No meta-analytic study could be identified

Insufficient Evidence: Existing meta-analyses are not of sufficient quality

Treatment pending re-evaluation

1998 EST Status: Strong Research Support Strong: Support from two well-designed studies conducted by independent investigators.

Modest: Support from one well-designed study or several adequately designed studies.

Controversial: Conflicting results, or claims regarding mechanisms are unsupported.

Brief Summary

• Basic premise: the manner in which people historically and currently cope with extant stressful events via effective social problem solving may affect the degree to which they will experience psychological distress
• Essence of therapy: Contemporary Problem-Solving Therapy, or PST, is a transdiagnostic intervention, generally considered to be under a cognitive-behavioral umbrella, that increases adaptive adjustment to life problems and stress by training individuals in several affective, cognitive, and behavioral tools. The training is aimed at several barriers to effective problem solving. Through experiential practice, PST helps people to train their brains to overcome common barriers to the way they react to and attempt to solve real-life problems.
• Length: approx. 12 sessions; however, effective changes have been observed in PST programs with as few as 4 sessions and may extend to long-term intervention when individuals have long-term and inflexible problem-solving styles or a high degree of emotional dysregulation.

 

Treatment Resources

Editors: Alexandra Greenfield, MS

Note: The resources provided below are intended to supplement not replace foundational training in mental health treatment and evidence-based practice

Treatment Manuals / Outlines

Treatment Manuals

Treatment manuals available upon request for patients with depression and breast cancer, depression and heart failure, depression and hypertension, and veterans with housing instability (contact Dr. Arthur Nezu)

Books Available for Purchase Through External Sites

• Problem-Solving Therapy: A Treatment Manual (Nezu, Nezu, & D’Zurilla)

Measures, Handouts and Worksheets

• Problem-Solving Therapy Instructional Materials and Patient Handouts (Nezu, Nezu, & D’Zurilla)
• Social Problem-Solving Inventory-Revised (SPSI-R; D’Zurilla, Nezu, & Maydeu-Olivares)

Self-help Books

• Solving Life’s Problems: A 5-Step Guide to Enhanced Well-Being (Nezu, Nezu, & D’Zurilla)

Important Note: The books listed above are based on empirically-supported in-person treatments. They have not necessarily been evaluated empirically either by themselves or in conjunction with in-person treatment. We list them as a resource for clinicians who assign them as an adjunct to conducting in-person treatment.

Smartphone Apps

• Moving Forward (US Dept of Veterans Affairs & US Dept of Defense)

Video Demonstrations

Videos Available for Purchase Through External Sites

• Problem-Solving Therapy (APA/Nezu & Nezu)

Clinical Trials

• Efficacy of a social problem-solving therapy approach for unipolar depression (Nezu, 1986)
• Improving depression outcomes in older adults with comorbid medical illness (Harpole et al., 2005)
• Collaborative care management of late-life depression in the primary care setting: A randomized controlled trial (Unützer et al., 2002)
• Behavioral activation and problem-solving therapy for depressed breast cancer patients: Preliminary support for decreased suicidal ideation (Hopko et al., 2013)
• 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 (Garand et al., 2013)
• Problem-solving training for family caregivers of persons with traumatic brain injuries: A randomized controlled trial (Rivera et al., 2008)
• Problem-solving therapy and supportive therapy in older adults with major depression and executive dysfunction: Effect on disability (Alexopoulos et al., 2011)
• Six-month postintervention depression and disability outcomes of in-home telehealth problem-solving therapy for depressed, low-income, homebound older adults (Choi et al., 2014)
• Randomized controlled trial of collaborative care management of depression among low-income patients with cancer (Ell et al., 2008)
• The Pathways Study: A randomized trial of collaborative care in patients with diabetes and depression (Katon et al., 2004)
• Problem solving treatment and group psychoeducation for depression: Multicentre randomised controlled trial (Dowrick et al., 2000)
• Escitalopram and problem-solving therapy for prevention of poststroke depression: A randomized controlled trial (Robinson et al., 2000)
• Problem-solving therapy for relapse prevention in depression (Nezu & Nezu, 2010)
• Social problem-solving therapy for unipolar depression: An initial dismantling investigation (Nezu & Perri, 1989)
• Project Genesis: Assessing the efficacy of problem-solving therapy for distressed adult cancer patients (Nezu et al., 2003)

Meta-analyses and Systematic Reviews

• The efficacy of problem solving therapy in reducing mental and physical health problems: A meta-analysis (Malouff, Thorsteinsson, & Schutte, 2007)
• Problem solving therapies for depression: A meta-analysis (Cuijpers, van Straten, & Warmerdam, 2007)
• Problem-solving therapy for depression: A meta-analysis (Bell & D’Zurilla, 2009)
• Brief psychological therapies for anxiety and depression in primary care: Meta-analysis and meta-regression (Cape et al., 2010)
• Brief psychotherapy for depression: A systematic review and meta-analysis (Nieuwsma et al., 2012)
• Comparative efficacy of seven psychotherapeutic interventions for patients with depression: A network meta-analysis (Barth et al., 2013)
• Problem-solving therapy for depression in adults: A systematic review (Gellis & Kenaley, 2008)

Other Treatment Resources

• Moving Forward (free, interactive, 6-hour web program; US Dept of Veterans Affairs & US Dept of Defense)
• Social problem solving as a risk factor for depression (Nezu, Nezu, & Clark, 2008)
• Depression treatment for homebound medically ill older adults: Using evidence-based problem-solving therapy (Gellis & Nezu, 2011)