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Problem Solving (:!?:Challenges/Solutions in PS
(Papworth et al, 2013…
Problem Solving
:!?:Challenges/Solutions in PS
(Papworth et al, 2013 & Westbrook et al, 2011)
- All talk and no action
Motivational techniques, explain rationale, manageable chunks
- There is no good solution
Just pick any one and try, practitioner picks one and if this leads to the client being disappointment will allow them to realize they have a preference
- Client can't identify problems
Challenge, give examples, frame as it making life "even" better
- Client can't think of solutions
Brainstorm ideas, offer suggestions if the client wants, ask to do for H/W
- Other people are the problem
Changing the clients own response may change others and improve clients coping
- Implementation does not resolve problem
Review learning as positive and closer to a solution, repeat the cycle
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Evidence base
:check:Westbrook et al, 2011
Depressed people have poorer/compromised problem solving skills
:check:Mynors et al, 2000
PS is an effective therapy for depression (equal to tricyclics and SSRI's) especially is poor coping/hopelessness is a maintenance factor
:green_cross:Bell & D'Zurilla, 2001
Meta-analysis showed that PS to be as effective as other therapies and medication in working age and older adults
:red_flag:Mynors et al, 2002
Reseach for PS is limited and focuses mainly on depression, benefits in anxiety is less established
Unclear as to why it work:
- is it fixing of the problem or empowerment
- maybe beneficial due to solving the problem therefore consequent de-stress from anticipatory concerns about unsolved problem
WHAT
It is an evidence based intervention that helps distance from problems and think about different practical solutions.
Aims to help individuals adopt a realistic optimistic view of coping, understand how to resolve problems and creatively develop an action plan geared to reducing psychological distress and enhance wellbeing
Interventions include: psychoeducation, problem solving exercises, motivational homework assignments.
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WHY
Depressed people will have impaired problem solving such as:
Depressive symptoms (low energy, indecision, self-critisicm)
Reduced activity from accumulation of problems, more energy is needed to solve problems (Papworth et al, 2013)
Use if problems cause symptoms or are not being addressed. If problems are causing symptoms, then addressing one problem will alleviate symptoms
Protocol :!:
- Give rationale and explain PS
- Identify the problem
- Identify solutions (as many as possible)
- Analyse strengths and weaknesses/pros and cons for all solutions
- Pick a solution based on the pros and cons that looks most likely to work
- Plan implementation, step by step what is needed to carry out solution (what, where, when, who, how)
- Implement
- Review, any progress? achievement? did it work? why
Richards & Whyte, 2011