Problem-solving therapy (PST) is a form of psychotherapy that is centered on developing and improving a patient’s coping skills and enhancing his or her ability to handle stressful or upsetting life experiences. “It’s the notion of focusing on the problem in the moment as opposed to psychodynamic therapy, which focuses on both the problem and the underpinnings,” explains Jaine L. Darwin, Psy.D., a psychologist and psychoanalyst in Cambridge, Mass.
PST — also known as short-term therapy, problem-solving treatment, and structured problem solving — operates from the belief that the patient’s symptoms stem from his or her everyday problems. By resolving these problems, the patient’s symptoms will improve.
How PST Works
With PST, the therapist teaches the patient how to use a step-by-step process to solve life problems. The aim is for the therapist to assist the patient in identifying problems, coming up with several realistic solutions, selecting the best solution possible, developing and implementing an action plan, and assessing how effective the problem-solving attempt was.
Interventions during PST sessions include psychoeducation (to teach the patient skills to better deal with depression), interactive problem-solving exercises, and motivational homework assignments, according to the American Psychological Association.
PST is a short-term therapy (between eight and 16 sessions) that can be conducted in an individual or group format. The therapy can also be provided in primary care settings with a general practitioner though the course tends to be briefer, consisting of four to six sessions. Insurance may cover some of the treatments.
Types of Problem-Solving Therapy
There are three general types of problem-solving therapy:
• Social problem-solving therapy: This is a cognitive–behavioral process through which patients identify effective solutions for coping with stressful, everyday problems in social settings and learn how to adapt, rather than employing a single coping strategy.
• Problem-solving for primary care settings: The therapy is provided by a primary care physician rather than in an analyst’s office. Research shows that PST is a brief, effective treatment for mild to moderate psychological disorders, including depression.
• Self-examination problem-solving therapy: This helps patients determine their major goals, asses the problems that are getting in the way of those goals, and apply problem-solving techniques as well as accept uncontrollable situations.
Disorders PST Treats
In addition to depression, PST can help with the following conditions or situations:
• deliberate self-harm
• interpersonal relationship problems
• unhappiness in work, home, or love life
What the Expert Says
Although research shows that problem-solving therapy is an effective treatment for depression, not every expert agrees that it’s the best therapy for the condition. “With problem-solving therapy, you identify a circumscribed problem and together figure out behavioral or actionable strategies,” says Jeffrey L. Binder, Ph.D., a professor of psychology at Argosy University in Atlanta. “Depression — in general — would be too broad a problem. You’d have to identify a particularly negative symptom or set of symptoms of depression or a particular environmental circumstance that is contributing to or causing the problem. The therapy is focused on very concrete problems.”