problem solving therapy nezu pdf

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Problem-solving therapy for depression : theory, research, and clinical guidelines

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Problem-Solving Therapy

A treatment manual.

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Arthur M. Nezu, PhD, ABPP

Christine Maguth Nezu, PhD, ABPP

Thomas D'Zurilla, PhD

Problem-Solving Therapy: A Treatment Manual is a laudable and distinctive resource that contributes to contemporary and exemplary psychotherapy in a big way."-- New England Psychologist

Through Problem-Solving Therapy: A Treatment Manual , Nezu and colleagues offer an excellent manual that has the potential to help a wide range of individuals cope with life's challenges. This book is an invaluable addition to any practicing psychologist's bookshelf."-- PsycCRITIQUES

Problem-solving therapy (PST) has been increasingly used to treat a variety of health and mental health problems due to its flexibility and proven effectiveness. This text, written by the co-developers of PST, is a comprehensive and detailed manual of how to apply PST to a wide variety of populations and situations. It reflects the significant conceptual and clinical revisions that supersede earlier versions of PST, and is based on the authors' clinical and research experience, the treatment outcome literature, and advances in related areas of psychology and neuroscience research.

The book offers specific treatment guidelines, sample client-therapist dialogues, clinical exercises and activities, homework assignments, client handouts, clinical case examples, and worksheets. These resources are based on a "stepped-care" model of PST that takes into account the nature of a client's problems, the intensity of these problems, the setting and treatment structure, and treatment goals. The manual offers clients four major "toolkits," which include a multitasking guide to overcoming "cognitive overload" when under stress, a guide to overcoming problems related to emotional dysregulation, a guide to overcoming barriers to effective problem-solving through use of healthy thinking and positive imagery, and a guide to fostering effective problem-solving by designing and employing a rational plan. Digital accompaniments include patient handouts, worksheets, and toolkits. Intended for use by a wide variety of mental health professionals in multiple settings, the manual can also serve as a text for both undergraduate and applied graduate courses.

SECTION I. CONCEPTUAL AND EMPIRICAL CONSIDERATIONS

One: Introduction, Brief History, and Social Problem-Solving Constructs

Two: A Problem-Solving Approach To Understanding Psychopathology: A Diathesis-Stress Model

Three: Problem-Solving Therapy: Empirical Support and Flexibility of Applications

SECTION II. ASSESSMENT, TREATMENT PLANNING, & GENERAL CLINICAL CONSIDERATIONS

Four: Assessment and Treatment Planning Issues

Five: General Clinical Considerations

SECTION III. PROBLEM-SOLVING THERAPY: SPECIFIC TREATMENT GUIDELINES

Six: Overview of the Problem-Solving Therapy Process; Introductory Sessions; & The Case of “Megan”

Seven: Toolkit #1. Problem-Solving Multi-Tasking: Overcoming Cognitive Overload

Eight: Toolkit #2. The S.S.T.A. Method: Overcoming Emotional Dysregulation and Maladaptive Problem Solving Under Stress

Nine: Toolkit #3. Healthy Thinking and Positive Imagery: Overcoming Negative Thinking and Low Motivation

Ten: Toolkit #4. Planful Problem Solving: Fostering Effective Problem Solving

Eleven Guided Practice, Future Forecasting, & Termination

Problem-Solving Test: Scoring Instructions

Patient Handouts

• Problem-Solving Worksheets
• Brief “Lesson” Plans

Arthur M. Nezu , PhD, ABPP, is Distinguished University Professor of Psychology, Professor of Medicine, and Professor of Public Health, Drexel University; and Special Professor of Forensic Mental Health & Psychiatry, The University of Nottingham, UK. He is the Editor of Journal of Consulting and Clinical Psychology; Past President/Head, Association for Advancement of Behavior Therapy, American Academy of Cognitive and Behavioral Psychology, World Congress of Behavioural and Cognitive Therapies, and Behavioral Psychology Specialty Council. He is the author of over 90 journal articles, 75 book chapters, and over 20 books.

Christine Maguth Nezu, PhD, ABPP , is professor of psychology and associate professor of medicine at Drexel University.

Thomas J. D’Zurilla , PhD, University of Illinois at Urbana-Champaign, is Professor Emeritus in the Department of Psychology at Stony Brook University.

• Release Date: December 11, 2012
• Paperback / softback
• Trim Size: 6in x 9in
• Number of Illustrations: 10
• Features: 10 illustrations
• ISBN: 9780826109408
• eBook ISBN: 9780826109408

Problem-Solving Therapy

Streaming options.

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In Problem-Solving Therapy , Drs. Arthur Nezu and Christine Maguth Nezu demonstrate their positive, goal-oriented approach to treatment. Problem-solving therapy is a cognitive–behavioral intervention geared to improve an individual's ability to cope with stressful life experiences. The underlying assumption of this approach is that symptoms of psychopathology can often be understood as the negative consequences of ineffective or maladaptive coping.

Problem-solving therapy aims to help individuals adopt a realistically optimistic view of coping, understand the role of emotions more effectively, and creatively develop an action plan geared to reduce psychological distress and enhance well-being. Interventions include psychoeducation, interactive problem-solving exercises, and motivational homework assignments.

In this session, Christine Maguth Nezu works with a woman in her 50s who is depressed and deeply concerned about her son's drug addiction. Dr. Nezu first assesses her strengths and weaknesses and then helps her to clarify the problem she is facing so she can begin to move toward a solution.

The overarching goal of problem-solving therapy (PST) is to enhance the individual's ability to cope with stressful life experiences and to foster general behavioral competence. The major assumption underlying this approach, which emanates from a cognitive–behavioral tradition, is that much of what is viewed as "psychopathology" can be understood as consequences of ineffective or maladaptive coping behaviors. In other words, failure to adequately resolve stressful problems in living can engender significant emotional and behavioral problems.

Such problems in living include major negative events (e.g., undergoing a divorce, dealing with the death of a spouse, getting fired from a job, experiencing a major medical illness), as well as recurrent daily problems (e.g., continued arguments with a coworker, limited financial resources, diminished social support). How people resolve or cope with such situations can, in part, determine the degree to which they will likely experience long-lasting psychopathology and behavioral problems (e.g., clinical depression, generalized anxiety, pain, anger, relationship difficulties).

For example, successfully dealing with stressful problems will likely lead to a reduction of immediate emotional distress and prevent long-term psychological problems from occurring. Alternatively, maladaptive or unsuccessful problem resolution, either due to the overwhelming nature of events (e.g., severe trauma) or as a function of ineffective coping attempts, will likely increase the probability that long-term negative affective states and behavioral difficulties will emerge.

Social Problem Solving and Psychopathology

According to this therapy approach, social problem solving (SPS) is considered a key set of coping abilities and skills. SPS is defined as the cognitive–behavioral process by which individuals attempt to identify or discover effective solutions for stressful problems in living. In doing so, they direct their problem-solving efforts at altering the stressful nature of a given situation, their reactions to such situations, or both. SPS refers more to the metaprocess of understanding, appraising, and adapting to stressful life events, rather than representing a single coping strategy or activity.

Problem-solving outcomes in the real world have been found to be determined by two general but partially independent processes—problem orientation and problem-solving style.

Problem orientation refers to the set of generalized thoughts and feelings a person has concerning problems in living, as well as his or her ability to successfully resolve them. It can either be positive (e.g., viewing problems as opportunities to benefit in some way, perceiving oneself as able to solve problems effectively), which serves to enhance subsequent problem-solving efforts, or negative (e.g.,viewing problems as a major threat to one's well-being, overreacting emotionally when problems occur), which functions to inhibit attempts to solve problems.

Problem-solving style refers to specific cognitive–behavioral activities aimed at coping with stressful problems. Such styles are either adaptive, leading to successful problem resolution, or dysfunctional, leading to ineffective coping, which then can generate myriad negative consequences, including emotional distress and behavioral problems. Rational problem solving is the constructive style geared to identify an effective solution to the problem and involves the systematic and planful application of specific problem-solving tasks. Dysfunctional problem-solving styles include (a) impulsivity/carelessness (i.e., impulsive, hurried, and incomplete attempts to solve a problem), and (b) avoidance (i.e.,avoiding problems, procrastinating, and depending on others to solve one's problems).

Important differences have been identified between individuals characterized as "effective" versus "ineffective" problem solvers. In general, when compared to effective problem solvers, persons characterized by ineffective problem solving report a greater number of life problems, more health and physical symptoms, more anxiety, more depression, and more psychological maladjustment. In addition, a negative problem orientation has been found to be associated with negative moods under both routine and stressful conditions, as well as pessimism, negative emotional experiences, and clinical depression. Further, persons with negative orientations tend to worry and complain more about their health.

Problem-Solving Therapy Goals

PST teaches individuals to apply adaptive coping skills to both prevent and cope with stressful life difficulties. Specific PST therapy objectives include

• enhancing a person's positive orientation
• fostering his or her application of specific rational problem-solving tasks (i.e., accurately identifying why a situation is a problem, generating solution alternatives, conducting a cost-benefit analysis in order to decide which ideas to choose to include as part of an overall solution plan, implementing the solution, monitoring its effects, and evaluating the outcome)
• reducing his or her negative orientation
• minimizing one's tendency to engage in dysfunctional problem-solving style activities (i.e., impulsively attempting to solve the problem or avoiding the problem)

PST interventions involve psychoeducation, interactive problem-solving training exercises, practice opportunities, and homework assignments intended to motivate patients to apply the problem-solving principles outside of the therapy sessions.

PST has been shown to be effective regarding a wide range of clinical populations, psychological problems, and the distress associated with chronic medical disorders. Scientific evaluations have focused on unipolar depression, geriatric depression, distressed primary-care patients, social phobia, agoraphobia, obesity, coronary heart disease, adult cancer patients, adults with schizophrenia, mentally retarded adults with concomitant psychiatric problems, HIV-risk behaviors, drug abuse, suicide, childhood aggression, and conduct disorder.

Moreover, PST is flexible with regard to treatment goals and methods of implementation. For example, it can be conducted in a group format, on an individual and couples basis, as part of a larger cognitive–behavioral treatment package, over the phone, as well as on the Internet. It can also be applied as a means of helping patients to overcome barriers associated with successful adherence to other medical or psychosocial treatment protocols (e.g., adhering to weight-loss programs, diabetes regulation).

Arthur M. Nezu, PhD, ABPP, is currently professor of psychology, medicine, and community health and prevention at Drexel University in Philadelphia. He is one of the codevelopers of a cognitive–behavioral approach to teaching social problem-solving skills and has conducted multiple RCTs testing its efficacy across a variety of populations. These populations include clinically depressed adults, depressed geriatric patients, adults with mental retardation and concomitant psychopathology, distressed cancer patients and their spousal caregivers, individuals in weight-loss programs, breast cancer patients, and adult sexual offenders.

Dr. Nezu has contributed to more than 175 professional and scientific publications, including the books Solving Life's Problems: A 5-Step Guide to Enhanced Well-Being , Helping Cancer Patients Cope: A Problem-Solving Approach , and Problem-Solving Therapy: A Positive Approach to Clinical Intervention . He also codeveloped the self-report measure Social Problem-Solving Inventory—Revised . Dr. Nezu is on numerous editorial boards of scientific and professional journals and a member of the Interventions Research Review Committee of the National Institute of Mental Health.

An award-winning psychologist, he was previously president of the Association for Advancement of Behavior Therapy, the Behavioral Psychology Specialty Council, the World Congress of Behavioral and Cognitive Therapies, and the American Board of Cognitive and Behavioral Psychology. He is a fellow of the American Psychological Association, the Association for Psychological Science, the Society for Behavior Medicine, the Academy of Cognitive Therapy, and the Academy of Cognitive and Behavioral Psychology. Dr. Nezu was awarded the diplomate in Cognitive and Behavioral Psychology from the American Board of Professional Psychology and currently serves as a trustee of that board.

He has been in private practice for over 25 years, and is currently conducting outcome studies to evaluate the efficacy of problem-solving therapy to treat depression among adults with heart disease.

Christine Maguth Nezu, PhD, ABPP, is currently professor of psychology, associate professor of medicine, and director of the masters programs in psychology at Drexel University in Philadelphia. She previously served as director of the APA-accredited Internship/Residency in Clinical Psychology, as well as the Cognitive–Behavioral Postdoctoral Fellowship Program, at the Medical College of Pennsylvania/Hahnemann University.

She is the coauthor or editor of more than 100 scholarly publications, including 15 books. Her publications cover a wide range of topics in mental health and behavioral medicine, many of which have been translated into a variety of foreign languages.

Dr. Maguth Nezu is currently the president-elect of the American Board of Professional Psychology, on the board of directors for the American Board of Cognitive and Behavioral Psychology, and on the board of directors for the American Academy of Cognitive and Behavioral Psychology. She is the recipient of numerous grant awards supporting her research and program development, particularly in the area of clinical interventions. She serves as an accreditation site visitor for APA for clinical training programs and is on the editorial boards of several leading psychology and health journals.

Dr. Maguth Nezu has conducted workshops on clinical interventions and case formulation both nationally and internationally. She is currently the North American representative to the World Congress of Cognitive and Behavioral Therapies. She holds a diplomate in Cognitive and Behavioral Psychology from the American Board of Professional Psychology and has been active in private practice for more than 20 years.

Her current areas of interest include the treatment of depression in medical patients, the integration of cognitive and behavioral therapies with patients' spiritual beliefs and practices, interventions directed toward stress, coping, and health, and cognitive behavior therapy and problem-solving therapy for individuals with personality disorders.

• D'Zurilla, T. J., & Nezu, A. M. (2007). Problem-solving therapy: A positive approach to clinical intervention (3rd ed.). New York: Springer Publishing Co.
• D'Zurilla, T. J., Nezu, A. M., & Maydeu-Olivares, A. (2002). Social Problem-Solving Inventory—Revised (SPSI-R): Technical manual . North Tonawanda, NY: Multi-Health Systems.
• Nezu, A. M. (2004). Problem solving and behavior therapy revisited. Behavior Therapy, 35 , 1–33.
• Nezu, A. M., & Nezu, C. M. (in press). Problem-solving therapy. In S. Richards & M. G. Perri (Eds.), Relapse prevention for depression . Washington, DC: American Psychological Association.
• Nezu, A. M., Nezu, C. M., & Clark, M. (in press). Problem solving as a risk factor for depression. In K. S. Dobson & D. Dozois (Eds.), Risk factors for depression . New York: Elsevier Science.
• Nezu, A. M., Nezu, C. M., & Perri, M. G. (2006). Problem solving to promote treatment adherence. In W. T. O'Donohue & E. Livens (Eds.), Promoting treatment adherence: A practical handbook for health care providers (pp. 135–148). New York: Sage Publications.
• Nezu, A. M., Nezu, C. M., & D'Zurilla, T. J. (2007). Solving life's problems: A 5-step guide to enhanced well-being . New York: Springer Publishing Co.
• Nezu, A. M., Nezu, C. M., Friedman, S. H., Faddis, S., & Houts, P. S. (1998). Helping cancer patients cope: A problem-solving approach . Washington, DC: American Psychological Association.
• Nezu, C. M., D'Zurilla, T. J., & Nezu, A. M. (2005). Problem-solving therapy: Theory, practice, and application to sex offenders. In M. McMurran & J. McGuire (Eds.), Social problem solving and offenders: Evidence, evaluation and evolution (pp. 103–123). Chichester, UK: Wiley.
• Nezu, C. M., Palmatier, A., & Nezu, A. M. (2004). Social problem-solving training for caregivers. In E. C. Chang, T. J. D'Zurilla, & L. J. Sanna (Eds.), Social problem solving: Theory, research, and training (pp. 223–238). Washington, DC: American Psychological Association.
• Cognitive–Behavioral Relapse Prevention for Addictions G. Alan Marlatt
• Cognitive–Behavioral Therapy With Donald Meichenbaum Donald Meichenbaum
• Depression With Older Adults Peter A. Lichtenberg
• Depression Michael D. Yapko
• Emotion-Focused Therapy for Depression Leslie S. Greenberg
• Relapse Prevention Over Time G. Alan Marlatt
• Behavioral Interventions in Cognitive Behavior Therapy: Practical Guidance for Putting Theory Into Action, Second Edition Richard F. Farmer and Alexander L. Chapman
• Experiences of Depression: Theoretical, Clinical, and Research Perspectives Sidney J. Blatt
• Preventing Youth Substance Abuse: Science-Based Programs for Children and Adolescents Edited by Patrick Tolan, José Szapocznik, and Soledad Sambrano

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Problem-Solving Therapy: A Positive Approach to Clinical Intervention, Third Edition 3rd Edition

MAXIMIZE POSITIVE PATIENT OUTCOMES

Enhance Function--Avert Relapses--Present New Problems

In this new updated edition, authors Thomas J. D'Zurilla and Arthur M. Nezu, present some of the most useful advances in problem-solving therapy (PST) today. An excellent resource for maximizing positive patient outcomes, this all-inclusive guide helps enhance your problem solving skills and apply successful clinical techniques to help your clients improve their lives. Known for its presentation of solid research results and effective PST training tools, this best-selling guide has been fully updated to include:

• NEW research data on social problem solving and adjustment
• NEW studies on the efficacy of PST
• NEW social problem solving models
• NEW updated and more user-friendly therapist's training manual

Written for a wide audience, from therapists and counselors to psychologists and social workers, this highly readable and practical reference is a must-have guide to helping your patients identify and resolve current life problems.

The book set is designed to be read alongside its informal "manual" accompaniment, Solving Life's Problems: A 5-Step Guide to Enhanced Well-Being by D'Zurilla, Nezu, and Christine Maguth Nezu.

Purchase of the two books as a set will get you these life-changing texts at an $7.00 savings over the two books bought individually.

• ISBN-10 0826114881
• ISBN-13 978-0826114884
• Edition 3rd
• Publisher Springer Publishing Company
• Publication date September 18, 2006
• Language English
• Dimensions 6 x 0.75 x 8.5 inches
• Print length 280 pages
• See all details

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From the back cover, about the author.

Thomas J. D’Zurilla , PhD, University of Illinois at Urbana-Champaign, is Professor Emeritus in the Department of Psychology at Stony Brook University.

Arthur M. Nezu , PhD, ABPP, is Distinguished University Professor of Psychology, Professor of Medicine, and Professor of Public Health, Drexel University; and Special Professor of Forensic Mental Health & Psychiatry, The University of Nottingham, UK. He is the Editor of Journal of Consulting and Clinical Psychology; Past President/Head, Association for Advancement of Behavior Therapy, American Academy of Cognitive and Behavioral Psychology, World Congress of Behavioural and Cognitive Therapies, and Behavioral Psychology Specialty Council. He is the author of over 90 journal articles, 75 book chapters, and over 20 books.

Product details

• Publisher ‏ : ‎ Springer Publishing Company; 3rd edition (September 18, 2006)
• Language ‏ : ‎ English
• Paperback ‏ : ‎ 280 pages
• ISBN-10 ‏ : ‎ 0826114881
• ISBN-13 ‏ : ‎ 978-0826114884
• Item Weight ‏ : ‎ 13.6 ounces
• Dimensions ‏ : ‎ 6 x 0.75 x 8.5 inches
• #1,753 in Psychiatry (Books)
• #2,856 in Psychotherapy
• #6,223 in Popular Psychology Psychotherapy

About the author

Thomas j. d'zurilla.

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• DOI: 10.1891/9780826143167
• Corpus ID: 149510486

Emotion-centered problem-solving therapy.

• A. Nezu , C. Nezu
• Published in Volume 1 1 December 2018

11 Citations

Effect of problem-solving treatment on self-reported disability among veterans with gulf war illness, examining the structural equation modeling between intrinsic-motivation, emotion regulation and ahdh: the mediating role of problem-solving, time-management, and behavioral-inhibition, facets of social problem-solving as moderators of the real-time relation between social rejection and negative affect in an at-risk sample., social problem solving moderates emotion reactivity in predicting suicide ideation among college students., running head: reducing mental health disparities 1 reducing mental health disparities by increasing the personal relevance of interventions, what cognitions best predict disturbed anger in adults a revision of the anger cognitions scale, reducing mental health disparities by increasing the personal relevance of interventions., social influence in malaysia and singapore: interrelationships between cultural orientation, social group identity, coping style, and social conformity, breaking bad news: awareness and practice among sudanese doctors, learning from accidents: nontechnical skills deficiency in the european process industry, 87 references, social problem-solving therapy for unipolar depression: an initial dismantling investigation., problem-solving therapy for depression: a meta-analysis., the efficacy of problem solving therapy in reducing mental and physical health problems: a meta-analysis., social problem-solving abilities and behavioral health, meta‐analysis of problem solving therapy for the treatment of major depressive disorder in older adults, problem solving and behavior therapy revisited, using problem-solving therapy to improve problem-solving orientation, problem-solving skills and quality of life in older hemodialysis patients, which social problem-solving components buffer depression in adolescent girls, problem-solving appraisal in suicide ideators and attempters., a problem‐solving intervention for hospice family caregivers: a randomized clinical trial, related papers.

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Problem-Solving Therapy

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• Christine E. Gould 2 , 3 ,
• Erin Sakai 2 &
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Behavioral intervention ; Skills-based therapy ; Treatment

Problem-solving therapy (PST), developed by Nezu and colleagues, is a non-pharmacological, empirically supported cognitive-behavioral treatment (D’Zurilla and Nezu 2006 ; Nezu et al. 1989 ). The problem-solving framework draws from a stress-diathesis model, namely, that life stress interacts with an individual’s predisposition toward developing a psychiatric disorder. The driving model behind PST posits that individuals who experience difficulty solving life’s problems or coping with stressors of everyday living struggle with psychiatric symptoms more often than individuals considered as good problem solvers. This psychological treatment teaches a step-by-step approach to the process of identifying and implementing adaptive solutions for daily problems. By teaching individuals to solve their problems more effectively and efficiently, this model assumes that their stress and related psychiatric symptoms will...

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D’Zurilla, T. J., & Nezu, A. M. (2006). Problem-solving therapy: A positive approach to clinical intervention (3rd ed.). New York: Springer.

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Nezu, A. M., Nezu, C. M., & Perri, M. G. (1989). Problem-solving therapy for depression: Therapy, research, and clinical guidelines . New York: Wiley.

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VA Palo Alto Health Care System, Palo Alto, CA, USA

Sherry A. Beaudreau, Christine E. Gould, Erin Sakai & J. W. Terri Huh

Stanford University School of Medicine, Stanford, CA, USA

Sherry A. Beaudreau, Christine E. Gould & J. W. Terri Huh

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Beaudreau, S.A., Gould, C.E., Sakai, E., Huh, J.W.T. (2015). Problem-Solving Therapy. In: Pachana, N. (eds) Encyclopedia of Geropsychology. Springer, Singapore. https://doi.org/10.1007/978-981-287-080-3_90-1

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DOI : https://doi.org/10.1007/978-981-287-080-3_90-1

Received : 15 October 2015

Accepted : 19 October 2015

Published : 18 November 2015

Publisher Name : Springer, Singapore

Online ISBN : 978-981-287-080-3

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