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What Is Problem-Solving Therapy?

Arlin Cuncic, MA, is the author of The Anxiety Workbook and founder of the website About Social Anxiety. She has a Master's degree in clinical psychology.

Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania.

Verywell / Madelyn Goodnight

Problem-Solving Therapy Techniques

How effective is problem-solving therapy, things to consider, how to get started.

Problem-solving therapy is a brief intervention that provides people with the tools they need to identify and solve problems that arise from big and small life stressors. It aims to improve your overall quality of life and reduce the negative impact of psychological and physical illness.

Problem-solving therapy can be used to treat depression , among other conditions. It can be administered by a doctor or mental health professional and may be combined with other treatment approaches.

At a Glance

Problem-solving therapy is a short-term treatment used to help people who are experiencing depression, stress, PTSD, self-harm, suicidal ideation, and other mental health problems develop the tools they need to deal with challenges. This approach teaches people to identify problems, generate solutions, and implement those solutions. Let's take a closer look at how problem-solving therapy can help people be more resilient and adaptive in the face of stress.

Problem-solving therapy is based on a model that takes into account the importance of real-life problem-solving. In other words, the key to managing the impact of stressful life events is to know how to address issues as they arise. Problem-solving therapy is very practical in its approach and is only concerned with the present, rather than delving into your past.

This form of therapy can take place one-on-one or in a group format and may be offered in person or online via telehealth . Sessions can be anywhere from 30 minutes to two hours long. 

Key Components

There are two major components that make up the problem-solving therapy framework:

• Applying a positive problem-solving orientation to your life
• Using problem-solving skills

A positive problem-solving orientation means viewing things in an optimistic light, embracing self-efficacy , and accepting the idea that problems are a normal part of life. Problem-solving skills are behaviors that you can rely on to help you navigate conflict, even during times of stress. This includes skills like:

• Knowing how to identify a problem
• Defining the problem in a helpful way
• Trying to understand the problem more deeply
• Setting goals related to the problem
• Generating alternative, creative solutions to the problem
• Choosing the best course of action
• Implementing the choice you have made
• Evaluating the outcome to determine next steps

Problem-solving therapy is all about training you to become adaptive in your life so that you will start to see problems as challenges to be solved instead of insurmountable obstacles. It also means that you will recognize the action that is required to engage in effective problem-solving techniques.

Planful Problem-Solving

One problem-solving technique, called planful problem-solving, involves following a series of steps to fix issues in a healthy, constructive way:

• Problem definition and formulation : This step involves identifying the real-life problem that needs to be solved and formulating it in a way that allows you to generate potential solutions.
• Generation of alternative solutions : This stage involves coming up with various potential solutions to the problem at hand. The goal in this step is to brainstorm options to creatively address the life stressor in ways that you may not have previously considered.
• Decision-making strategies : This stage involves discussing different strategies for making decisions as well as identifying obstacles that may get in the way of solving the problem at hand.
• Solution implementation and verification : This stage involves implementing a chosen solution and then verifying whether it was effective in addressing the problem.

Other Techniques

Other techniques your therapist may go over include:

• Problem-solving multitasking , which helps you learn to think clearly and solve problems effectively even during times of stress
• Stop, slow down, think, and act (SSTA) , which is meant to encourage you to become more emotionally mindful when faced with conflict
• Healthy thinking and imagery , which teaches you how to embrace more positive self-talk while problem-solving

What Problem-Solving Therapy Can Help With

Problem-solving therapy addresses life stress issues and focuses on helping you find solutions to concrete issues. This approach can be applied to problems associated with various psychological and physiological symptoms.

Mental Health Issues

Problem-solving therapy may help address mental health issues, like:

• Chronic stress due to accumulating minor issues
• Complications associated with traumatic brain injury (TBI)
• Emotional distress
• Post-traumatic stress disorder (PTSD)
• Problems associated with a chronic disease like cancer, heart disease, or diabetes
• Self-harm and feelings of hopelessness
• Substance use
• Suicidal ideation

Specific Life Challenges

This form of therapy is also helpful for dealing with specific life problems, such as:

• Death of a loved one
• Dissatisfaction at work
• Everyday life stressors
• Family problems
• Financial difficulties
• Relationship conflicts

Your doctor or mental healthcare professional will be able to advise whether problem-solving therapy could be helpful for your particular issue. In general, if you are struggling with specific, concrete problems that you are having trouble finding solutions for, problem-solving therapy could be helpful for you.

Benefits of Problem-Solving Therapy

The skills learned in problem-solving therapy can be helpful for managing all areas of your life. These can include:

• Being able to identify which stressors trigger your negative emotions (e.g., sadness, anger)
• Confidence that you can handle problems that you face
• Having a systematic approach on how to deal with life's problems
• Having a toolbox of strategies to solve the issues you face
• Increased confidence to find creative solutions
• Knowing how to identify which barriers will impede your progress
• Knowing how to manage emotions when they arise
• Reduced avoidance and increased action-taking
• The ability to accept life problems that can't be solved
• The ability to make effective decisions
• The development of patience (realizing that not all problems have a "quick fix")

Problem-solving therapy can help people feel more empowered to deal with the problems they face in their lives. Rather than feeling overwhelmed when stressors begin to take a toll, this therapy introduces new coping skills that can boost self-efficacy and resilience .

Other Types of Therapy

Other similar types of therapy include cognitive-behavioral therapy (CBT) and solution-focused brief therapy (SFBT) . While these therapies work to change thinking and behaviors, they work a bit differently. Both CBT and SFBT are less structured than problem-solving therapy and may focus on broader issues. CBT focuses on identifying and changing maladaptive thoughts, and SFBT works to help people look for solutions and build self-efficacy based on strengths.

This form of therapy was initially developed to help people combat stress through effective problem-solving, and it was later adapted to address clinical depression specifically. Today, much of the research on problem-solving therapy deals with its effectiveness in treating depression.

Problem-solving therapy has been shown to help depression in: 

• Older adults
• People coping with serious illnesses like cancer

Problem-solving therapy also appears to be effective as a brief treatment for depression, offering benefits in as little as six to eight sessions with a therapist or another healthcare professional. This may make it a good option for someone unable to commit to a lengthier treatment for depression.

Problem-solving therapy is not a good fit for everyone. It may not be effective at addressing issues that don't have clear solutions, like seeking meaning or purpose in life. Problem-solving therapy is also intended to treat specific problems, not general habits or thought patterns .

In general, it's also important to remember that problem-solving therapy is not a primary treatment for mental disorders. If you are living with the symptoms of a serious mental illness such as bipolar disorder or schizophrenia , you may need additional treatment with evidence-based approaches for your particular concern.

Problem-solving therapy is best aimed at someone who has a mental or physical issue that is being treated separately, but who also has life issues that go along with that problem that has yet to be addressed.

For example, it could help if you can't clean your house or pay your bills because of your depression, or if a cancer diagnosis is interfering with your quality of life.

Your doctor may be able to recommend therapists in your area who utilize this approach, or they may offer it themselves as part of their practice. You can also search for a problem-solving therapist with help from the American Psychological Association’s (APA) Society of Clinical Psychology .

If receiving problem-solving therapy from a doctor or mental healthcare professional is not an option for you, you could also consider implementing it as a self-help strategy using a workbook designed to help you learn problem-solving skills on your own.

During your first session, your therapist may spend some time explaining their process and approach. They may ask you to identify the problem you’re currently facing, and they’ll likely discuss your goals for therapy .

Keep In Mind

Problem-solving therapy may be a short-term intervention that's focused on solving a specific issue in your life. If you need further help with something more pervasive, it can also become a longer-term treatment option.

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Shang P, Cao X, You S, Feng X, Li N, Jia Y. Problem-solving therapy for major depressive disorders in older adults: an updated systematic review and meta-analysis of randomized controlled trials .  Aging Clin Exp Res . 2021;33(6):1465-1475. doi:10.1007/s40520-020-01672-3

Cuijpers P, Wit L de, Kleiboer A, Karyotaki E, Ebert DD. Problem-solving therapy for adult depression: An updated meta-analysis . Eur Psychiatry . 2018;48(1):27-37. doi:10.1016/j.eurpsy.2017.11.006

Nezu AM, Nezu CM, D'Zurilla TJ. Problem-Solving Therapy: A Treatment Manual . New York; 2013. doi:10.1891/9780826109415.0001

Owens D, Wright-Hughes A, Graham L, et al. Problem-solving therapy rather than treatment as usual for adults after self-harm: a pragmatic, feasibility, randomised controlled trial (the MIDSHIPS trial) .  Pilot Feasibility Stud . 2020;6:119. doi:10.1186/s40814-020-00668-0

Sorsdahl K, Stein DJ, Corrigall J, et al. The efficacy of a blended motivational interviewing and problem solving therapy intervention to reduce substance use among patients presenting for emergency services in South Africa: A randomized controlled trial . Subst Abuse Treat Prev Policy . 2015;10(1):46. doi:doi.org/10.1186/s13011-015-0042-1

Margolis SA, Osborne P, Gonzalez JS. Problem solving . In: Gellman MD, ed. Encyclopedia of Behavioral Medicine . Springer International Publishing; 2020:1745-1747. doi:10.1007/978-3-030-39903-0_208

Kirkham JG, Choi N, Seitz DP. Meta-analysis of problem solving therapy for the treatment of major depressive disorder in older adults . Int J Geriatr Psychiatry . 2016;31(5):526-535. doi:10.1002/gps.4358

Garand L, Rinaldo DE, Alberth MM, et al. 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 . Am J Geriatr Psychiatry . 2014;22(8):771-781. doi:10.1016/j.jagp.2013.07.007

Noyes K, Zapf AL, Depner RM, et al. Problem-solving skills training in adult cancer survivors: Bright IDEAS-AC pilot study .  Cancer Treat Res Commun . 2022;31:100552. doi:10.1016/j.ctarc.2022.100552

Albert SM, King J, Anderson S, et al. Depression agency-based collaborative: effect of problem-solving therapy on risk of common mental disorders in older adults with home care needs . The American Journal of Geriatric Psychiatry . 2019;27(6):619-624. doi:10.1016/j.jagp.2019.01.002

By Arlin Cuncic, MA Arlin Cuncic, MA, is the author of The Anxiety Workbook and founder of the website About Social Anxiety. She has a Master's degree in clinical psychology.

Cognitive Behavioral Therapy

Solving problems the cognitive-behavioral way, problem solving is another part of behavioral therapy..

Posted February 2, 2022 | Reviewed by Ekua Hagan

• What Is Cognitive Behavioral Therapy?
• Find a therapist who practices CBT
• Problem-solving is one technique used on the behavioral side of cognitive-behavioral therapy.
• The problem-solving technique is an iterative, five-step process that requires one to identify the problem and test different solutions.
• The technique differs from ad-hoc problem-solving in its suspension of judgment and evaluation of each solution.

As I have mentioned in previous posts, cognitive behavioral therapy is more than challenging negative, automatic thoughts. There is a whole behavioral piece of this therapy that focuses on what people do and how to change their actions to support their mental health. In this post, I’ll talk about the problem-solving technique from cognitive behavioral therapy and what makes it unique.

The problem-solving technique

While there are many different variations of this technique, I am going to describe the version I typically use, and which includes the main components of the technique:

The first step is to clearly define the problem. Sometimes, this includes answering a series of questions to make sure the problem is described in detail. Sometimes, the client is able to define the problem pretty clearly on their own. Sometimes, a discussion is needed to clearly outline the problem.

The next step is generating solutions without judgment. The "without judgment" part is crucial: Often when people are solving problems on their own, they will reject each potential solution as soon as they or someone else suggests it. This can lead to feeling helpless and also discarding solutions that would work.

The third step is evaluating the advantages and disadvantages of each solution. This is the step where judgment comes back.

Fourth, the client picks the most feasible solution that is most likely to work and they try it out.

The fifth step is evaluating whether the chosen solution worked, and if not, going back to step two or three to find another option. For step five, enough time has to pass for the solution to have made a difference.

This process is iterative, meaning the client and therapist always go back to the beginning to make sure the problem is resolved and if not, identify what needs to change.

Advantages of the problem-solving technique

The problem-solving technique might differ from ad hoc problem-solving in several ways. The most obvious is the suspension of judgment when coming up with solutions. We sometimes need to withhold judgment and see the solution (or problem) from a different perspective. Deliberately deciding not to judge solutions until later can help trigger that mindset change.

Another difference is the explicit evaluation of whether the solution worked. When people usually try to solve problems, they don’t go back and check whether the solution worked. It’s only if something goes very wrong that they try again. The problem-solving technique specifically includes evaluating the solution.

Lastly, the problem-solving technique starts with a specific definition of the problem instead of just jumping to solutions. To figure out where you are going, you have to know where you are.

One benefit of the cognitive behavioral therapy approach is the behavioral side. The behavioral part of therapy is a wide umbrella that includes problem-solving techniques among other techniques. Accessing multiple techniques means one is more likely to address the client’s main concern.

Salene M. W. Jones, Ph.D., is a clinical psychologist in Washington State.

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Open Access

Peer-reviewed

Research Article

Problem-solving interventions and depression among adolescents and young adults: A systematic review of the effectiveness of problem-solving interventions in preventing or treating depression

Roles Conceptualization, Data curation, Formal analysis, Writing – original draft, Writing – review & editing

* E-mail: [email protected]

Affiliation Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States of America

Roles Conceptualization, Writing – original draft

Affiliation Centre for Evidence and Implementation, London, United Kingdom

Roles Data curation

Roles Conceptualization, Writing – review & editing

Affiliation Department of Psychology, Virginia Commonwealth University, Richmond, VA, United States of America

Roles Conceptualization, Methodology

Roles Conceptualization, Project administration, Writing – review & editing

Affiliation Centre for Evidence and Implementation, Melbourne, Victoria, Australia

Roles Conceptualization, Formal analysis, Methodology, Writing – original draft, Writing – review & editing

Affiliation Department of Social Work, Monash University, Melbourne, Victoria, Australia

• Kristina Metz, 
• Jane Lewis, 
• Jade Mitchell, 
• Sangita Chakraborty, 
• Bryce D. McLeod, 
• Ludvig Bjørndal, 
• Robyn Mildon, 
• Aron Shlonsky

• Published: August 29, 2023
• https://doi.org/10.1371/journal.pone.0285949
• Peer Review
• Reader Comments

Problem-solving (PS) has been identified as a therapeutic technique found in multiple evidence-based treatments for depression. To further understand for whom and how this intervention works, we undertook a systematic review of the evidence for PS’s effectiveness in preventing and treating depression among adolescents and young adults. We searched electronic databases ( PsycINFO , Medline , and Cochrane Library ) for studies published between 2000 and 2022. Studies meeting the following criteria were included: (a) the intervention was described by authors as a PS intervention or including PS; (b) the intervention was used to treat or prevent depression; (c) mean or median age between 13–25 years; (d) at least one depression outcome was reported. Risk of bias of included studies was assessed using the Cochrane Risk of Bias 2.0 tool. A narrative synthesis was undertaken given the high level of heterogeneity in study variables. Twenty-five out of 874 studies met inclusion criteria. The interventions studied were heterogeneous in population, intervention, modality, comparison condition, study design, and outcome. Twelve studies focused purely on PS; 13 used PS as part of a more comprehensive intervention. Eleven studies found positive effects in reducing depressive symptoms and two in reducing suicidality. There was little evidence that the intervention impacted PS skills or that PS skills acted as a mediator or moderator of effects on depression. There is mixed evidence about the effectiveness of PS as a prevention and treatment of depression among AYA. Our findings indicate that pure PS interventions to treat clinical depression have the strongest evidence, while pure PS interventions used to prevent or treat sub-clinical depression and PS as part of a more comprehensive intervention show mixed results. Possible explanations for limited effectiveness are discussed, including missing outcome bias, variability in quality, dosage, and fidelity monitoring; small sample sizes and short follow-up periods.

Citation: Metz K, Lewis J, Mitchell J, Chakraborty S, McLeod BD, Bjørndal L, et al. (2023) Problem-solving interventions and depression among adolescents and young adults: A systematic review of the effectiveness of problem-solving interventions in preventing or treating depression. PLoS ONE 18(8): e0285949. https://doi.org/10.1371/journal.pone.0285949

Editor: Thiago P. Fernandes, Federal University of Paraiba, BRAZIL

Received: January 2, 2023; Accepted: May 4, 2023; Published: August 29, 2023

Copyright: © 2023 Metz et al. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant methods and data are within the paper and its Supporting Information files.

Funding: This work was commissioned by Wellcome Trust and was conducted independently by the evaluators (all named authors). No grant number is available. Wellcome Trust had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript. The authors declare no financial or other competing interests, including their relationship and ongoing work with Wellcome Trust. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Competing interests: The authors have declared that no competing interests exist.

Introduction

Depression among adolescents and young adults (AYA) is a serious, widespread problem. A striking increase in depressive symptoms is seen in early adolescence [ 1 ], with rates of depression being estimated to almost double between the age of 13 (8.4%) and 18 (15.4%) [ 2 ]. Research also suggests that the mean age of onset for depressive disorders is decreasing, and the prevalence is increasing for AYA. Psychosocial interventions, such as cognitive-behavioural therapy (CBT) and interpersonal therapy (IPT), have shown small to moderate effects in preventing and treating depression [ 3 – 6 ]. However, room for improvement remains. Up to half of youth with depression do not receive treatment [ 7 ]. When youth receive treatment, studies indicate that about half of youth will not show measurable symptom reduction across 30 weeks of routine clinical care for depression [ 8 ]. One strategy to improve the accessibility and effectiveness of mental health interventions is to move away from an emphasis on Evidence- Based Treatments (EBTs; e.g., CBT) to a focus on discrete treatment techniques that demonstrate positive effects across multiple studies that meet certain methodological standards (i.e., common elements; 9). Identifying common elements allows for the removal of redundant and less effective treatment content, reducing treatment costs, expanding available service provision and enhancing scability. Furthermore, introducing the most effective elements of treatment early may improve client retention and outcomes [ 9 – 13 ].

A potential common element for depression intervention is problem-solving (PS). PS refers to how an individual identifies and applies solutions to everyday problems. D’Zurilla and colleagues [ 14 – 17 ] conceptualize effective PS skills to include a constructive attitude towards problems (i.e., a positive problem-solving orientation) and the ability to approach problems systematically and rationally (i.e., a rational PS style). Whereas maladaptive patterns, such as negative problem orientation and passively or impulsively addressing problems, are ineffective PS skills that may lead to depressive symptoms [ 14 – 17 ]. Problem Solving Therapy (PST), designed by D’Zurilla and colleagues, is a therapeutic approach developed to decrease mental health problems by improving PS skills [ 18 ]. PST focuses on four core skills to promote adaptive problem solving, including: (1) defining the problem; (2) brainstorming possible solutions; (3) appraising solutions and selecting the best one; and (4) implementing the chosen solution and assessing the outcome [ 14 – 17 ]. PS is also a component in other manualized approaches, such as CBT and Dialectical Behavioural Therapy (DBT), as well as imbedded into other wider generalized mental health programming [ 19 , 20 ]. A meta-analysis of over 30 studies found PST, or PS skills alone, to be as effective as CBT and IPT and more effective than control conditions [ 21 – 23 ]. Thus, justifying its identification as a common element in multiple prevention [ 19 , 24 ] and treatment [ 21 , 25 ] programs for adult depression [ 9 , 26 – 28 ].

PS has been applied to youth and young adults; however, no manuals specific to the AYA population are available. Empirical studies suggest maladaptive PS skills are associated with depressive symptoms in AYA [ 5 , 17 – 23 ]. Furthermore, PS intervention can be brief [ 29 ], delivered by trained or lay counsellors [ 30 , 31 ], and provided in various contexts (e.g., primary care, schools [ 23 ]). Given PS’s versatility and effectiveness, PS could be an ideal common element in treating AYA depression; however, to our knowledge, no reviews or meta-analyses on PS’s effectiveness with AYA specific populations exist. This review aimed to examine the effectiveness of PS as a common element in the prevention and treatment of depression for AYA within real-world settings, as well as to ascertain the variables that may influence and impact PS intervention effects.

Identification and selection of studies

Searches were conducted using PsycInfo , Medline , and Cochrane Library with the following search terms: "problem-solving", “adolescent”, “youth”, and” depression, ” along with filters limiting results to controlled studies looking at effectiveness or exploring mechanisms of effectiveness. Synonyms and derivatives were employed to expand the search. We searched grey literature using Greylit . org and Opengrey . eu , contacted experts in the field and authors of protocols, and searched the reference lists of all included studies. The search was undertaken on 4 th June 2020 and updated on 11 th June 2022.

Studies meeting the following criteria were included: (a) the intervention was described by authors as a PS intervention or including PS; (b) the intervention was used to treat or prevent depression; (c) mean or median age between 13–25 years; and (d) at least one depression outcome was reported. Literature in electronic format published post 2000 was deemed eligible, given the greater relevance of more recent usage of PS in real-world settings. There was no exclusion for gender, ethnicity, or country setting; only English language texts were included. Randomized controlled trials (RCTs), quasi-experimental designs (QEDs), systematic reviews/meta-analyses, pilots, or other studies with clearly defined comparison conditions (no treatment, treatment as usual (TAU), or a comparator treatment) were included. We excluded studies of CBT, IPT, Acceptance and Commitment Therapy (ACT), Dialectical Behaviour Therapy (DBT), and modified forms of these treatments. These treatments include PS and have been shown to demonstrate small to medium effects on depression [ 13 , 14 , 32 ], but the unique contribution of PS cannot be disentangled. The protocol for this review was not registered; however, all data collection forms, extraction, coding and analyses used in the review are available upon inquiry from the first author.

Study selection

All citations were entered into Endnote and uploaded to Covidence for screening and review against the inclusion/exclusion criteria. Reviewers with high inter-rater reliability (98%) independently screened the titles and abstracts. Two reviewers then independently screened full text of articles that met criteria. Duplicates, irrelevant studies, and studies that did not meet the criteria were removed, and the reason for exclusion was recorded (see S1 File for a list of excluded studies). Discrepancies were resolved by discussion with the team leads.

Data extraction

Two reviewers independently extracted data that included: (i) study characteristics (author, publication year, location, design, study aim), (ii) population (age, gender, race/ethnicity, education, family income, depression status), (iii) setting, (iv) intervention description (therapeutic or preventative, whether PS was provided alone or as part of a more comprehensive intervention, duration, delivery mode), (v) treatment outcomes (measures used and reported outcomes for depression, suicidality, and PS), and (vi) fidelity/implementation outcomes. For treatment outcomes, we included the original statistical analyses and/or values needed to calculate an effect size, as reported by the authors. If a variable was not included in the study publication, we extracted the information available and made note of missing data and subsequent limitations to the analyses.

RCTs were assessed for quality (i.e., confidence in the study’s findings) using the Cochrane Risk of Bias 2.0 tool [ 33 ] which includes assessment of the potential risk of bias relating to the process of randomisation; deviations from the intended intervention(s); missing data; outcome measurement and reported results. Risk of bias pertaining to each domain is estimated using an algorithm, grouped as: Low risk; Some concerns; or High risk. Two reviewers independently assessed the quality of included studies, and discrepancies were resolved by consensus.

We planned to conduct one or more meta-analyses if the studies were sufficiently similar. Data were entered into a summary of findings table as a first step in determining the theoretical and practical similarity of the population, intervention, comparison condition, outcome, and study design. If there were sufficiently similar studies, a meta-analysis would be conducted according to guidelines contained in the Cochrane Collaboration Handbook of Systematic Reviews, including tests of heterogeneity and use of random effects models where necessary.

The two searches yielded a total number of 874 records (after the removal of duplicates). After title and abstract screening, 184 full-text papers were considered for inclusion, of which 25 studies met the eligibility criteria and were included in the systematic review ( Fig 1 ). Unfortunately, substantial differences (both theoretical and practical) precluded any relevant meta-analyses, and we were limited to a narrative synthesis.

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https://doi.org/10.1371/journal.pone.0285949.g001

Risk of bias assessment

Risk of bias assessments were conducted on the 23 RCTs ( Fig 2 ; assessments by study presented in S1 Table ). Risk of bias concerns were moderate, and a fair degree of confidence in the validity of study findings is warranted. Most studies (81%) were assessed as ‘some concerns’ (N = 18), four studies were ‘low risk’, and one ‘high risk’. The most frequent areas of concern were the selection of the reported result (n = 18, mostly due to inadequate reporting of a priori analytic plans); deviations from the intended intervention (N = 17, mostly related to insufficient information about intention-to-treat analyses); and randomisation process (N = 13).

https://doi.org/10.1371/journal.pone.0285949.g002

Study designs and characteristics

Study design..

Across the 25 studies, 23 were RCTs; two were QEDs. Nine had TAU or wait-list control (WLC) comparator groups, and 16 used active control groups (e.g., alternative treatment). Eleven studies described fidelity measures. The sample size ranged from 26 to 686 and was under 63 in nine studies.

Selected intervention.

Twenty interventions were described across the 25 studies ( Table 1 ). Ten interventions focused purely on PS. Of these 10 interventions: three were adaptations of models proposed by D’Zurilla and Nezu [ 20 , 34 ] and D’Zurilla and Goldfried [ 18 ], two were based on Mynors-Wallis’s [ 35 ] Problem-Solving Therapy (PST) guide, one was a problem-orientation video intervention adapted from D’Zurilla and Nezu [ 34 ], one was an online intervention adapted from Method of Levels therapy, and three did not specify a model. Ten interventions used PS as part of a larger, more comprehensive intervention (e.g., PS as a portion of cognitive therapy). The utilization and dose of PS steps included in these interventions were unclear. Ten interventions were primary prevention interventions–one of these was universal prevention, five were indicated prevention, and four were selective prevention. Ten interventions were secondary prevention interventions. Nine interventions were described as having been developed or adapted for young people.

https://doi.org/10.1371/journal.pone.0285949.t001

Intervention delivery.

Of the 20 interventions, eight were delivered individually, eight were group-based, two were family-based, one was mixed, and in one, the format of delivery was unclear. Seventeen were delivered face-to-face and three online. Dosage ranged from a single session to 21, 50-minute sessions (12 weekly sessions, then 6 biweekly sessions); the most common session formar was once weekly for six weeks (N = 5).

Intervention setting and participants.

Seventeen studies were conducted in high-income countries (UK, US, Australia, Netherlands, South Korea), four in upper-middle income (Brazil, South Africa, Turkey), and four in low- and middle-income countries (Zimbabwe, Nigeria, India). Four studies included participants younger than 13 and four older than 25. Nine studies were conducted on university or high school student populations and five on pregnant or post-partum mothers. The remaining 11 used populations from mental health clinics, the community, a diabetes clinic, juvenile detention, and a runaway shelter.

Sixteen studies included participants who met the criteria for a depressive, bipolar, or suicidal disorder (two of these excluded severe depression). Nine studies did not use depression symptoms in the inclusion criteria (one of these excluded depression). Several studies excluded other significant mental health conditions.

Outcome measures.

Eight interventions targeted depression, four post/perinatal depression, two suicidal ideation, two resilience, one ‘problem-related distress’, one ‘diabetes distress’, one common adolescent mental health problem, and one mood episode. Those targeting post/perinatal depression used the Edinburgh Postnatal Depression Scale as the outcome measure. Of the others, six used the Beck Depression Inventory (I or II), two the Children’s Depression Inventory, three the Depression Anxiety Stress Scale-21, three the Centre for Epidemiologic Studies Depression Scale, one the Short Mood and Feelings Questionnaire, one the Hamilton Depression Rating Scale, one the depression subscale on the Schedule for Affective Disorders and Schizophrenia for School-Age Children, one the Strengths and Difficulties Questionnaire, one the Youth Top Problems Score, one the Adolescent Longitudinal Interval Follow-up Evaluation and Psychiatric Status Ratings, one the Kiddie Schedule for Affective Disorders and Schizophrenia, and one the Mini International Neuropsychiatric Interview.

Only eight studies measured PS skills or orientation outcomes. Three used the Social Problem-Solving Inventory-Revised, one the Problem Solving Inventory, two measured the extent to which the nominated problem had been resolved, one observed PS in video-taped interactions, and one did not specify the measure.

The mixed findings regarding the effectiveness of PS for depression may depend on the type of intervention: primary (universal, selective, or indicated), secondary or tertiary prevention. Universal prevention interventions target the general public or a population not determined by any specific criteria [ 36 ]. Selective prevention interventions target specific populations with an increased risk of developing a disorder. Indicated prevention interventions target high-risk individuals with sub-clinical symptoms of a disorder. Secondary prevention interventions include those that target individuals diagnosed with a disorder. Finally, tertiary prevention interventions refer to follow-up interventions designed to retain treatment effects. Outcomes are therefore grouped by intervention prevention type and outcome. Within these groupings, studies with a lower risk of bias (RCTs) are presented first. According to the World Health Organisation guidelines, interventions were defined as primary, secondary or tertiary prevention [ 36 ].

Universal prevention interventions

One study reported on a universal prevention intervention targeting resilience and coping strategies in US university students. The Resilience and Coping Intervention, which includes PS as a primary component of the intervention, found a significant reduction in depression compared to TAU (RCT, N = 129, moderate risk of bias) [ 37 ].

Selective prevention interventions

Six studies, including five RCTs and one QED, tested PS as a selective prevention intervention. Two studies investigated the impact of the Manage Your Life Online program, which includes PS as a primary component of the intervention, compared with an online programme emulating Rogerian psychotherapy for UK university students (RCT, N = 213, moderate risk of bias [ 38 ]; RCT, N = 48, moderate risk of bias [ 39 ]). Both studies found no differences in depression or problem-related distress between groups.

Similarly, two studies explored the effect of adapting the Penn Resilience Program, which includes PS as a component of a more comprehensive intervention for young people with diabetes in the US (RCT, N = 264, moderate risk of bias) [ 40 , 41 ]. The initial study showed a moderate reduction in diabetes distress but not depression at 4-, 8-, 12- and 16-months follow-up compared to a diabetes education intervention [ 40 ]. The follow-up study found a significant reduction in depressive symptoms compared to the active control from 16- to 40-months; however, this did not reach significance at 40-months [ 41 ].

Another study that was part of wider PS and social skills intervention among juveniles in state-run detention centres in the US found no impacts (RCT, N = 296, high risk of bias) [ 42 ]. A QED ( N = 32) was used to test the effectiveness of a resilience enhancement and prevention intervention for runaway youth in South Korea [ 43 ]. There was a significant decrease in depression for the intervention group compared with the control group at post-test, but the difference was not sustained at one-month follow-up.

Indicated prevention interventions

Six studies, including five RCTs and one QED, tested PS as an indicated prevention intervention. Four of the five RCTs tested PS as a primary component of the intervention. A PS intervention for common adolescent mental health problems in Indian high school students (RCT, N = 251, low risk of bias) led to a significant reduction in psychosocial problems at 6- and 12 weeks; however, it did not have a significant impact on mental health symptoms or internalising symptoms compared to PS booklets without counsellor treatment at 6- and 12-weeks [ 31 ]. A follow-up study showed a significant reduction in overall psychosocial problems and mental health symptoms, including internalizing symptoms, over 12 months [ 44 ]. Still, these effects no longer reached significance in sensitivity analysis adjusting for missing data (RCT, N = 251, low risk of bias). Furthermore, a 2x2 factorial RCT ( N = 176, moderate risk of bias) testing PST among youth mental health service users with a mild mental disorder in Australia found that the intervention was not superior to supportive counselling at 2-weeks post-treatment [ 30 ]. Similarly, an online PS intervention delivered to young people in the Netherlands to prevent depression (RCT, N = 45, moderate risk of bias) found no significant difference between the intervention and WLC in depression level 4-months post-treatment [ 45 ].

One RCT tested PS approaches in a more comprehensive manualized programme for postnatal depression in the UK and found no significant differences in depression scores between intervention and TAU at 3-months post-partum (RCT, N = 292, moderate risk of bias) [ 46 ].

A study in Turkey used a non-equivalent control group design (QED, N = 62) to test a nursing intervention against a PS control intervention [ 47 ]. Both groups showed a reduction in depression, but the nursing care intervention demonstrated a larger decrease post-intervention than the PS control intervention.

Secondary prevention interventions

Twelve studies, all RCTs, tested PS as a secondary prevention intervention. Four of the 12 RCTs tested PS as a primary component of the intervention. An intervention among women in Zimbabwe (RCT, N = 58, moderate risk of bias) found a larger decrease in the Edinburgh Postnatal Depression Scale score for the intervention group compared to control (who received the antidepressant amitriptyline and peer education) at 6-weeks post-treatment [ 48 ]. A problem-orientation intervention covering four PST steps and involving a single session video for US university students (RCT, N = 110, moderate risk of bias), compared with a video covering other health issues, resulted in a moderate reduction in depression post-treatment; however, results were no longer significant at 2-weeks, and 1-month follow up [ 49 ].

Compared to WLC, a study of an intervention for depression and suicidal proneness among high school and university students in Turkey (RCT, N = 46, moderate risk of bias) found large effect sizes on post-treatment depression scores for intervention participants post-treatment compared with WLC. At 12-month follow-up, these improvements were maintained compared to pre-test but not compared to post-treatment scores. Significant post-treatment depression recovery was also found in the PST group [ 12 ]. Compared to TAU, a small but high-quality (low-risk of bias) study focused on preventing suicidal risk among school students in Brazil (RCT, N = 100, low risk of bias) found a significant, moderate reduction in depression symptoms for the treatment group post-intervention that was maintained at 1-, 3- and 6-month follow-up [ 50 ].

Seven of the 12 RCTs tested PS as a part of a more comprehensive intervention. Two interventions targeted mood episodes and were compared to active control. These US studies focused on Family-Focused Therapy as an intervention for mood episodes, which included sessions on PS [ 51 , 52 ]. One of these found that Family-Focused Therapy for AYA with Bipolar Disorder (RCT, N = 145, moderate risk of bias) had no significant impact on mood or depressive symptoms compared to pharmacotherapy. However, Family-Focused Therapy had a greater impact on the proportion of weeks without mania/hypomania and mania/hypomania symptoms than enhanced care [ 53 ]. Alternatively, while the other study (RCT, N = 127, low risk of bias) found no significant impact on time to recovery, Family-Focused Therapy led to significantly longer intervals of wellness before new mood episodes, longer intervals between recovery and the next mood episode, and longer intervals of randomisation to the next mood episode in AYA with either Bipolar Disorder (BD) or Major Depressive Disorder (MDD), compared to family and individual psychoeducation [ 52 ].

Two US studies used a three-arm trial to compare Systemic-behavioural Family Therapy (SBFT) with elements of PS, to CBT and individual Non-directive Supportive therapy (NST) (RCT, N = 107, moderate risk of bias) [ 53 , 54 ]. One study looked at whether the PS elements of CBT and SFBT mediated the effectiveness of these interventions for the remission of MDD. It found that PS mediated the association between CBT, but not SFBT, and remission from depression. There was no significant association between SBFT and remission status, though there was a significant association between CBT and remission status [ 53 ]. The other study found no significant reduction in depression post-treatment or at 24-month follow-up for SBFT [ 54 ].

A PS intervention tested in maternal and child clinics in Nigeria RCT ( N = 686, moderate risk of bias) compared with enhanced TAU involving psychosocial and social support found no significant difference in the proportion of women who recovered from depression at 6-months post-partum [ 55 ]. However, there was a small difference in depression scores in favour of PS averaged across the 3-, 6-, 9-, and 12-month follow-up points. Cognitive Reminiscence Therapy, which involved recollection of past PS experiences and drew on PS techniques used for 12-25-year-olds in community mental health services in Australia (RCT, N = 26, moderate risk of bias), did not reduce depression symptoms compared with a brief evidence-based treatment at 1- or 2-month follow-up [ 56 ]. Additionally, the High School Transition Program in the US (RCT, N = 497, moderate risk of bias) aimed to prevent depression, anxiety, and school problems in youth transitioning to high school [ 57 ]. There was no reduction in the percentage of intervention students with clinical depression compared to the control group. Similarly, a small study focused on reducing depression symptoms, and nonadherence to antiretroviral therapy in pregnant women with HIV in South Africa (RCT, N = 23, some concern) found a significant reduction in depression symptoms compared to TAU, with the results being maintained at the 3-month follow-up [ 58 ].

Reduction in suicidality

Three studies measured a reduction in suicidality. A preventive treatment found a large reduction in suicidal orientation in the PS group compared to control post-treatment. In contrast, suicidal ideation scores were inconsistent at 1-,3- and 6- month follow-up, they maintained an overall lower score [ 50 ]. Furthermore, at post-test, significantly more participants in the PS group were no longer at risk of suicide. No significant differences were found in suicide plans or attempts. In a PST intervention, post-treatment suicide risk scores were lower than pre-treatment for the PST group but unchanged for the control group [ 12 ]. An online treatment found a moderate decline in ideation for the intervention group post-treatment compared to the control but was not sustained at a one-month follow-up [ 49 ].

Mediators and moderators

Eight studies measured PS skills or effectiveness. In two studies, despite the interventions reducing depression, there was no improvement in PS abilities [ 12 , 52 ]. One found that change in global and functional PS skills mediated the relationship between the intervention group and change in suicidal orientation, but this was not assessed for depression [ 50 ]. Three other studies found no change in depression symptoms, PS skills, or problem resolution [ 38 – 40 ]. Finally, CBT and SBFT led to significant increases in PS behaviour, and PS was associated with higher rates of remission across treatments but did not moderate the relationship between SBFT and remission status [ 53 ]. Another study found no changes in confidence in the ability to solve problems or belief in personal control when solving problems. Furthermore, the intervention group was more likely to adopt an avoidant PS style [ 46 ].

A high-intensity intervention for perinatal depression in Nigeria had no treatment effect on depression remission rates for the whole sample. Still, it was significantly effective for participants with more severe depression at baseline [ 55 ]. A PS intervention among juvenile detainees in the US effectively reduced depression for participants with higher levels of fluid intelligence, but symptoms increased for those with lower levels [ 42 ].The authors suggest that individuals with lower levels of fluid intelligence may have been less able to cope with exploring negative emotions and apply the skills learned.

This review has examined the evidence on the effectiveness of PS in the prevention or treatment of depression among 13–25-year-olds. We sought to determine in what way, in which contexts, and for whom PS appears to work in addressing depression. We found 25 studies involving 20 interventions. Results are promising for secondary prevention interventions, or interventions targeting clinical level populations, that utilize PS as the primary intervention [ 12 , 47 – 49 ]. These studies not only found a significant reduction in depression symptoms compared to active [ 48 , 49 ] and non-active [ 12 , 47 ] controls but also found a significant reduction in suicidal orientation and ideation [ 12 , 47 , 49 ]. These findings are consistent with meta-analyses of adult PS interventions [ 21 , 22 , 23 ], highlighting that PS interventions for AYA can be effective in real-world settings.

For other types of interventions (i.e., universal, selective prevention, indicated prevention), results were mixed in reducing depression. The one universal program was found to have a small, significant effect in reducing depression symptoms compared to a non-active control [ 37 ]. Most selective prevention programs were not effective [ 39 , 40 , 56 ], and those that did show small, significant effects had mixed outcomes for follow-up maintenance [ 41 , 42 ]. Most indicated prevention programs were not effective [ 30 , 31 , 45 – 47 ], yet a follow-up study showed a significant reduction in internalizing symptoms at 12-month post-treatment compared to an active control [ 44 ]. Given that these studies targeted sub-clinical populations and many of them had small sample sizes, these mixed findings may be a result of not having sufficient power to detect a meaningful difference.

Our review found limited evidence about PS skills as mediator or moderator of depression. Few studies measured improvements in PS skills; fewer still found interventions to be effective. The absence of evidence for PS abilities as a pathway is puzzling. It may be that specific aspects of PS behaviours and processes, such as problem orientation [ 59 ], are relevant. Alternatively, there may be a mechanism other than PS skills through which PS interventions influence depression.

Studies with PS as part of a wider intervention also showed mixed results, even amongst clinical populations. Although there was no clear rationale for the discrepancies in effectiveness between the studies, it is possible that the wider program dilutes the focus and impact of efficacious therapeutic elements. However, this is difficult to discern given the heterogeneity in the studies and limited information on study treatments and implementation factors. A broad conclusion might be that PS can be delivered most effectively with clinical populations in its purest PS form and may be tailored to a range of different contexts and forms, a range of populations, and to address different types of problems; however, this tailoring may reduce effectiveness.

Although the scale of impact is broadly in line with the small to moderate effectiveness of other treatments for youth depression [ 6 ], our review highlights shortcomings in study design, methods, and reporting that would allow for a better understanding of PS effectiveness and pathways. Studies varied in how well PS was operationalised. Low dosage is consistent with usage described in informal conversations with practitioners but may be insufficient for effectiveness. Fidelity was monitored in only half the studies despite evidence that monitoring implementation improves effectiveness [ 60 ]. There were references to implementation difficulties, including attrition, challenges in operationalizing online interventions, and skills of those delivering. Furthermore, most of the studies had little information about comorbidity and no analysis of whether it influenced outcomes. Therefore, we were unable to fully examine and conceptualize the ways, how and for whom PS works. More information about study populations and intervention implementation is essential to understand the potential of PS for broader dissemination.

Our review had several limitations. We excluded studies that included four treatments known to be effective in treating depression among AYA (e.g., CBT) but where the unique contribution of PS to clinical outcome could not be disentangled. Furthermore, we relied on authors’ reporting to determine if PS was included: details about operationalization of PS were often scant. Little evidence addressing the fit, feasibility, or acceptability of PS interventions was found, reflecting a limited focus on implementation. We included only English-language texts: relevant studies in other languages may exist, though our post-2000 inclusion criteria may limit this potential bias due to improved translation of studies to English over the years. Finally, the heterogeneity of study populations, problem severity, comparison conditions, outcome measures, and study designs, along with a relatively small number of included studies, limits confidence in what we can say about implementation and treatment outcomes.

Overall, our review indicates that PS may have the best results when implemented its purest form as a stand-alone treatment with clinical level AYA populations; tailoring or imbedding PS into wider programming may dilute its effectiveness. Our review also points to a need for continued innovation in treatment to improve the operationalizing and testing of PS, especially when included as a part of a more comprehensive intervention. It also highlights the need for study methods that allow us to understand the specific effects of PS, and that measure the frequency, dosage, and timing of PS to understand what is effective for whom and in what contexts.

Supporting information

S1 file. list of excluded studies..

https://doi.org/10.1371/journal.pone.0285949.s001

S2 File. PRISMA checklist.

https://doi.org/10.1371/journal.pone.0285949.s002

S1 Table. Individual risk of bias assessments using cochrane RoB2 tool by domain (1–5) and overall (6).

https://doi.org/10.1371/journal.pone.0285949.s003

Acknowledgments

All individuals that contributed to this paper are included as authors.

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Problem-Solving Theory: The Task-Centred Model

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This chapter examines the task-centred model to illustrate the application of problem-solving theory for social work intervention. First, it provides a brief description of the problem-solving model. Its historical development and key principles and concepts are presented. Next, the chapter offers a general overview of the crisis intervention model. The task-centred model and crisis intervention share principles and methods drawn from problem-solving theory. The remainder of the chapter focuses on the task-centred model. It reviews its historical background, viability as a framework for social work generalist practice, as well as its applicability with diverse client populations and across cultural settings. The structured steps that guide task-centred implementation throughout the helping process are described. A brief critical review of the model’s strengths and limitations is provided. The chapter concludes with a brief summary and some closing thoughts.

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Ramos, B.M., Stetson, R.L. (2022). Problem-Solving Theory: The Task-Centred Model. In: Hölscher, D., Hugman, R., McAuliffe, D. (eds) Social Work Theory and Ethics. Social Work. Springer, Singapore. https://doi.org/10.1007/978-981-16-3059-0_9-1

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22 Best Counseling Interventions & Strategies for Therapists

Counseling is highly beneficial, with “far-reaching effects in life functioning” (Cochran & Cochran, 2015, p. 7).

While therapeutic relationships are vital to a positive outcome, so too are the selection and use of psychological interventions targeting the clients’ capability, opportunity, motivation, and behavior (Michie et al., 2014).

This article introduces some of the best interventions while identifying the situations where they are likely to create value for the client, helping their journey toward meaningful, value-driven goals.

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“Changing ingrained behavior patterns can be challenging” and must avoid or at least reduce the risk of reverting (Michie et al., 2014, p. 11).

The American Psychological Association (n.d., para. 1) describes an intervention as “any action intended to interfere with and stop or modify a process, as in treatment undertaken to halt, manage, or alter the course of the pathological process of a disease or disorder.”

Interventions are intentional behaviors or “change strategies” introduced by the counselor to help clients implement problem management and move toward goals (Nelson-Jones, 2014):

• Counselor-centered interventions are where the counselor does something to or for the client, such as providing advice.
• Client-centered interventions empower the client, helping them develop their capacity to intervene in their own problems (for example, monitoring and replacing unhelpful thinking).

Creating or choosing the most appropriate intervention requires a thorough assessment of the client’s behavioral targets, what is needed, and how best to achieve them (Michie et al., 2014).

The selection of the intervention is guided by the:

• Nature of the problem
• Therapeutic orientation of the counselor
• Willingness and ability of the client to proceed

During counseling, various interventions are likely to be needed at different times. For that reason, counselors will require a broad range of techniques that fit the client’s needs, values, and culture (Corey, 2013).

In recent years, an increased focus has been on the use of evidence-based practice, where the choice and use of interventions is based on the best available research to make a difference in the lives of clients (Corey, 2013).

“Clients are hypothesis makers and testers” who have the reflective capacity to think about how they think (Nelson-Jones, 2014, p. 261).

Helping clients attend to their thoughts and learn how to instruct themselves more effectively can help them break repetitive patterns of insufficiently strong mind skills while positively influencing their feelings.

The following list includes some of the most popular interventions used in a variety of therapeutic settings (modified from Magyar-Moe et al., 2015; Sommers-Flanagan & Sommers-Flanagan, 2015; Cochran & Cochran, 2015; Corey, 2013):

Detecting and disputing demanding rules

Rigid, demanding thinking is identified by ‘musts,’ ‘oughts,’ and ‘shoulds’ and is usually unhelpful to the client.

For example:

I must do well in this test, or I am useless. People must treat me in the way I want; otherwise, they are awful.

Clients can be helped to dispute such thinking using “reason, logic, and facts to support, negate or amend their rules” (Nelson-Jones, 2014, p. 265).

Such interventions include:

• Functional disputing Pointing out to clients that their thinking may stand in the way of achieving their goals
• Empirical disputing Encouraging clients to evaluate the facts behind their thoughts
• Logical disputing Highlighting the illogical jumps in their thinking from preferences to demands
• Philosophical disputing Exploring clients’ meaning and satisfaction outside of life issues

Identifying automatic perceptions

Our perceptions greatly influence how we think. Clients can benefit from recognizing they have choices in how they perceive things and avoiding jumping to conclusions.

• Creating self-talk Self-talk can be helpful for most clients and can target anger management, stress handling, and improving confidence. For example:

This is not the end of the world. I’ve done this before; I can do it well again.

• Creating visual perceptions Building on the client’s existing visual images can be helpful in understanding and working through problematic situations (and their solutions).

One simple exercise to help clients see the strong relationship between visualizing and feeling involves asking clients to think of someone they love. Almost always, they form a mental image along with a host of feelings.

Visual relaxation is a powerful self-helping skill involving clients taking time out of their busy life to find calm through vividly picturing a real or imagined relaxing scene.

Creating better expectations

Clients’ explanatory styles (such as expecting to fail) can create self-fulfilling prophecies. Interventions can help by:

• Assessing the likelihood of risks or rewards
• Increasing confidence in the potential for success
• Identifying coping skills and support factors
• Time projection Imagery can help by enabling the client to step into a possible future where they manage and overcome difficult times or worrying situations.

For example, the client can imagine rolling forward to a time when they are successful in a new role at work or a developing relationship.

Creating realistic goals

Goals can motivate clients to improve performance and transition from where they are now to where they would like to be. However, it is essential to make sure they are realistic, or they risk causing undue pressure and compromising wellbeing.

The following interventions can help (Nelson-Jones, 2014):

• Stating clear goals The following questions are helpful when clients are setting goals :

Does the goal reflect your values? Is the goal realistic and achievable? Is the goal specific? Is the goal measurable? Does the goal have a timeframe?

Helping clients to experience feelings

Counseling can influence clients’ emotions and their physical reactions to emotions by helping them (Nelson-Jones, 2014):

• Experience feelings
• Express feelings
• Manage feelings
• Empty chair dialogue This practical intervention involves the client engaging in an imaginary conversation with another person; it helps “clients experience feelings both of unresolved anger and also of weakness and victimization” (Nelson-Jones, 2014, p. 347).

The client may be asked to shift to the empty chair and play the other person’s part to explore conflict, interactions, and emotions more fully (Corey, 2013).

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“Counselors and counseling trainees make choices both concerning specific interventions and about interventions used in combination” (Nelson-Jones, 2014, p. 223).

Through early and continued engagement with the client throughout the counseling approach , the counselor and client set specific, measurable, and achievable goals and create a treatment plan with a defined intervention strategy (Dobson, 2010).

The treatment plan becomes a map, combining interventions to reach client goals and overcome problems – to get from where they are now to where they want to be. However, no plan should be too fixed or risk preventing the client’s progress in their ‘wished-for’ direction. Rather, it must be open for regular revisit and modification (Nelson-Jones, 2014).

Counseling and therapeutic treatment plans vary according to the approaches used and the client’s specific needs but should be strength-based and collaborative. Most treatment plans typically consider the following points (modified from GoodTherapy, 2019):

• History and assessment – E.g., psychosocial history, symptom onset, past and present diagnoses, and treatment history
• Present concerns – The current concerns and issues that led the client to counseling
• Counseling contract – A summary of goals and desired changes, responsibility, and the counseling approach adopted
• Summary of strengths – It can be helpful to summarize the client’s strengths, empowering them for goal achievement.
• Goals – Measurable treatment goals are vital to the treatment plan.
• Objectives – Goals are broken down into smaller, achievable outcomes that support achievement during counseling.
• Interventions – Interventions should be planned early to support objectives and overall goals.
• Tracking progress and outcomes – Regular treatment plan review should include updating progress toward goals.

While a vital aspect of the counseling process is to ensure that treatment takes an appropriate direction for the client, it is also valuable and helpful for clients and insurance companies to understand likely timescales.

“Depression is one of the most common mental health disorders with a high burden of disease and the leading cause of years of life lost due to disability” (Hu et al., 2020, p. 1).

• Exercise interventions Research has shown that even low-to-moderate levels of exercise can help manage and treat depression (Hu et al., 2020).
• Gratitude Practicing gratitude can profoundly affect how we see our lives and those around us. Completing gratitude journals and reviewing three positive things that have happened at the end of the day have been shown to decrease depression and promote wellbeing (Shapiro, 2020).
• Behavioral activation Scheduling activities that result in positive emotions can help manage and overcome depression (Behavioral Activation for Depression, n.d.).

Anxiety can stop clients from living their lives fully and experiencing positive emotions. Many interventions can help, including:

• Understanding your anxiety triggers Interoceptive exposure techniques focus on reproducing sensations associated with anxiety and other difficult emotions. Clients benefit from learning to identify anxiety triggers, behavioral changes, and associated bodily sensations (Boettcher et al., 2016).
• Using a building image Clients are asked to form a mental image of themselves as a building. Their description of its state of repair and quality of foundation provides helpful insight into the client’s wellbeing and degree of anxiety (Thomas, 2016).

Grief therapy

Grief therapy helps clients accept reality, process the pain, and adjust to a new world following the loss of a loved one. Several techniques can help, including (modified from (Worden, 2018):

• Creating memory books Compiling a memory book containing photographs, memorabilia, stories, and poems can help families come together, share their grief, and reminisce.
• Directed imagery Like the ‘empty chair’ technique, through imagining the missing loved one in front of them, the grieving person is given the opportunity to talk to them.

Substance abuse

“There has been significant progress and expansion in the development of evidence-based psychosocial treatments for substance abuse and dependence” (Jhanjee, 2014, p. 1). Psychological interventions play a growing role in disorder treatment programs; they include:

• Brief optimistic interventions Brief advice is delivered following screening and assessment to at-risk individuals to reduce drinking and other harmful activities.
• Motivational interviewing This technique involves using targeted questioning while expressing empathy through reflective listening to resolve client ambivalence about their substance abuse.

Marriage therapy

Interventions are a vital aspect of marriage therapy , often targeting communication skills, problem-solving, and taking responsibility (Williams, 2012).

They can include the following interventions:

• Taking responsibility It is vital that clients take responsibility for their actions within a relationship. The counselor will work with the couple, asking the following questions, as required (modified from Williams, 2012):

How have you contributed to the relationship’s problems? What changes are needed to improve the relationship? Are you willing to make the changes needed?

• Create an action plan Once the couple agrees, the changes will be combined into a plan, with specific actions to help them achieve their goal.

Helping cancer patients

“There is no evidence to suggest that having counseling will help treat or cure your cancer”; however, it may help with coping, relationship issues, and dealing with practical problems (Cancer Research UK, 2019, para. 16).

Several counseling interventions that have proven helpful with the psychological burden include (Guo et al., 2013):

• Psychoeducation Sharing the importance of mental wellbeing and coping with the client and involving them in their cancer treatment can reduce anxiety and improve confidence.
• Cognitive-Behavioral Therapy Replacing incorrect or unhelpful beliefs can help the client achieve a more positive outlook regarding the treatment.

Career counselors help individuals or groups cope more effectively with career concerns, including (Niles & Harris-Bowlsbey, 2017):

• Career choice
• Managing career changes and transitions
• Job-related stress
• Looking for a job

While there are many interventions and strategies, the following are insightful and effective:

• Creating narratives Working with clients to build personal career narratives can help them see their movement through life with more meaning and coherence and better understand their decisions. Such an intervention can be valuable in looking forward and choosing the next steps.
• Group counseling Multiple group sessions can be arranged to cover different aspects of career-related issues and related emotional issues. They may include role-play or open discussion around specific topics.

The ultimate goals are usually to “help group members respond to each other with a combination of therapeutic attending, and sharing their own reactions and related experiences” (Cochran & Cochran, 2015, p. 329).

Examples of group interventions include:

• Circle of friends This group intervention involves gathering a child’s peers into a circle of friendly support to encourage and help them with problem-solving. The intervention has led to increased social acceptance of children with special needs (Magyar-Moe et al., 2015).
• Group mindfulness Mindfulness in group settings has been shown to be physically and mentally beneficial (Shapiro, 2020). New members may start by performing a body-scan meditation where they bring awareness to each part of their body before turning their attention to their breathing.

World’s Largest Positive Psychology Resource

The Positive Psychology Toolkit© is a groundbreaking practitioner resource containing over 500 science-based exercises , activities, interventions, questionnaires, and assessments created by experts using the latest positive psychology research.

Updated monthly. 100% Science-based.

“The best positive psychology resource out there!” — Emiliya Zhivotovskaya , Flourishing Center CEO

We have many free interventions, using various approaches and mediums, that support the counseling process and client goal achievement.

• Nudge Interventions in Groups The group provides a valuable setting for exploring the potential of ‘nudges’ to alter behavior in a predictable way.
• Developing Interoceptive Exposure Therapy Interventions This worksheet explores the sensations behind panic attacks and phobias.
• Therapist Interoceptive Exposure Record Use this helpful log to track interoceptive exposure interventions.
• Motivational Interviewing This template uses the five stages of change to consider the client’s readiness for change and the appropriate interventions to use.
• Breaking Out of the Comfort Zone Making changes typically requires clients to step out of their comfort zone. This worksheet identifies opportunities to embrace new challenges.

More extensive versions of the following tools are available with a subscription to the Positive Psychology Toolkit© , but they are described briefly below:

• Benefit finding

Psychological research has identified long-term benefits to using benefit finding, with individuals reporting new appreciation for their strengths and building resilience (e.g., Affleck & Tennen, 1996; Davis et al., 1998; McMillen et al., 1997).

• Begin by talking about a traumatic event.
• Focus on the positive aspects of the experience.
• Consider what the experience has taught you.
• Identify how the experience has helped you grow
• Self-compassion box

Self-compassion is a crucial aspect of our psychological wellbeing, made up of showing ourselves kindness, accepting imperfection, and paying attention to personal suffering with clarity and objectivity.

• Step one – Begin by recognizing the uncompassionate self.
• Step two – Select self-compassion reminders.
• Step three – Redirect attention to self-compassion.
• Step four – Reflect on creating more self-compassion in life.

Over time, the client should see the gaps closing between where they are now and where they want to be.

If you’re looking for more science-based ways to help others reach their goals, check out this collection of 17 validated motivation & goal achievement tools for practitioners. Use them to help others turn their dreams into reality by applying the latest science-based behavioral change techniques.

Counseling uses interventions to create positive change in clients’ lives. They can be performed individually but typically form part of a treatment or intervention plan developed with the client.

Each intervention helps the client work toward their goals, strengthen their capabilities, identify opportunities, increase motivation, and modify behavior.

They aim to create sufficient momentum to support change and avoid the risk of the client reverting, transitioning the client (often one small step at a time) from where they are now to where they want to be.

While some interventions have value in multiple settings – individual, group, career, couples, family – others are specific and purposeful. Many interventions target unhelpful, repetitive thinking patterns and aim to replace harmful thoughts, unrealistic expectations, or biased thinking. Others create a possible future where the client can engage with what might be or could happen , coming to terms with change or their own negative emotions.

Use this article to explore the range of interventions available to counselors in sessions or as homework. Try them out in different settings, working with the client to identify their value or potential for modification.

We hope you enjoyed reading this article. Don’t forget to download our three Goal Achievement Exercises for free .

• Affleck, G., & Tennen, H. (1996). Construing benefits from adversity: Adaptational significance and dispositional underpinnings. Journal of Personality , 64 , 899–922.
• American Psychological Association. (n.d.). Intervention. In APA dictionary of psychology . Retrieved February 27, 2022, from https://dictionary.apa.org/intervention
• Behavioral Activation for Depression. (n.d.). Retrieved February 16, 2022, from https://medicine.umich.edu/sites/default/files/content/downloads/Behavioral-Activation-for-Depression.pdf
• Boettcher, H., Brake, C. A., & Barlow, D. H. (2016). Origins and outlook of interoceptive exposure. Journal of Behavior Therapy and Experimental Psychiatry , 53 , 41–51.
• Cancer Research UK. (2019). How counselling can help . Retrieved February 28, 2022, from https://www.cancerresearchuk.org/about-cancer/coping/emotionally/talking-about-cancer/counselling/how-counselling-can-help
• Cochran, J. L., & Cochran, N. H. (2015). The heart of counseling: Counseling skills through therapeutic relationships . Routledge, Taylor & Francis Group.
• Corey, G. (2013). Theory and practice of counseling and psychotherapy . Cengage.
• Davis, C. G., Nolen-Hoeksema, S., & Larson, J. (1998). Making sense of loss and benefiting from the experience: Two construals of meaning. Journal of Personality and Social Psychology , 75 , 561–574.
• Dobson, K. S. (Ed.) (2010). Handbook of cognitive-behavioral therapies (3rd ed.). Guilford Press.
• Guo, Z., Tang, H. Y., Li, H., Tan, S. K., Feng, K. H., Huang, Y. C., Bu, Q., & Jiang, W. (2013). The benefits of psychosocial interventions for cancer patients undergoing radiotherapy. Health and Quality of Life Outcomes , 11 (1), 1–12.
• GoodTherapy. (2019, September 25). Treatment plan . Retrieved February 27, 2022, from https://www.goodtherapy.org/blog/psychpedia/treatment-plan
• Hu, M. X., Turner, D., Generaal, E., Bos, D., Ikram, M. K., Ikram, M. A., Cuijpers, P., & Penninx, B. W. J. H. (2020). Exercise interventions for the prevention of depression: a systematic review of meta-analyses. BMC Public Health , 20 (1), 1255.
• Jhanjee, S. (2014). Evidence-based psychosocial interventions in substance use. Indian Journal of Psychological Medicine , 36 (2), 112–118.
• Magyar-Moe, J. L., Owens, R. L., & Conoley, C. W. (2015). Positive psychological interventions in counseling. The Counseling Psychologist , 43 (4), 508–557.
• McMillen, J. C., Smith, E. M., & Fisher, R. H. (1997). Perceived benefit and mental health after three types of disaster. Journal of Consulting and Clinical Psychology , 65 , 733–739.
• Michie, S., Atkins, L., & West, R. (2014). The behaviour change wheel: A guide to designing interventions . Silverback.
• Nelson-Jones, R. (2014). Practical counselling and helping skills . Sage.
• Niles, S. G., & Harris-Bowlsbey, J. (2017). Career development interventions . Pearson.
• Shapiro, S. L. (2020). Rewire your mind: Discover the science + practice of mindfulness . Aster.
• Sommers-Flanagan, J., & Sommers-Flanagan, R. (2015). Study guide for counseling and psychotherapy theories in context and practice: Skills, strategies, and techniques (2nd ed.). Wiley.
• Thomas, V. (2016). Using mental imagery in counselling and psychotherapy: A guide to more inclusive theory and practice . Routledge.
• Williams, M. (2012). Couples counseling: A step by step guide for therapists . Viale.
• Worden, J. W. (2018). Grief counseling and grief therapy: A handbook for the mental health practitioner . Springer.

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How to improve your problem solving skills and build effective problem solving strategies

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Effective problem solving is all about using the right process and following a plan tailored to the issue at hand. Recognizing your team or organization has an issue isn’t enough to come up with effective problem solving strategies. 

To truly understand a problem and develop appropriate solutions, you will want to follow a solid process, follow the necessary problem solving steps, and bring all of your problem solving skills to the table.  

We’ll first guide you through the seven step problem solving process you and your team can use to effectively solve complex business challenges. We’ll also look at what problem solving strategies you can employ with your team when looking for a way to approach the process. We’ll then discuss the problem solving skills you need to be more effective at solving problems, complete with an activity from the SessionLab library you can use to develop that skill in your team.

Let’s get to it! 

What is a problem solving process?

• What are the problem solving steps I need to follow?

Problem solving strategies

What skills do i need to be an effective problem solver, how can i improve my problem solving skills.

Solving problems is like baking a cake. You can go straight into the kitchen without a recipe or the right ingredients and do your best, but the end result is unlikely to be very tasty!

Using a process to bake a cake allows you to use the best ingredients without waste, collect the right tools, account for allergies, decide whether it is a birthday or wedding cake, and then bake efficiently and on time. The result is a better cake that is fit for purpose, tastes better and has created less mess in the kitchen. Also, it should have chocolate sprinkles. Having a step by step process to solve organizational problems allows you to go through each stage methodically and ensure you are trying to solve the right problems and select the most appropriate, effective solutions.

What are the problem solving steps I need to follow? 

All problem solving processes go through a number of steps in order to move from identifying a problem to resolving it.

Depending on your problem solving model and who you ask, there can be anything between four and nine problem solving steps you should follow in order to find the right solution. Whatever framework you and your group use, there are some key items that should be addressed in order to have an effective process.

We’ve looked at problem solving processes from sources such as the American Society for Quality and their four step approach , and Mediate ‘s six step process. By reflecting on those and our own problem solving processes, we’ve come up with a sequence of seven problem solving steps we feel best covers everything you need in order to effectively solve problems.

1. Problem identification 

The first stage of any problem solving process is to identify the problem or problems you might want to solve. Effective problem solving strategies always begin by allowing a group scope to articulate what they believe the problem to be and then coming to some consensus over which problem they approach first. Problem solving activities used at this stage often have a focus on creating frank, open discussion so that potential problems can be brought to the surface.

2. Problem analysis 

Though this step is not a million miles from problem identification, problem analysis deserves to be considered separately. It can often be an overlooked part of the process and is instrumental when it comes to developing effective solutions.

The process of problem analysis means ensuring that the problem you are seeking to solve is the right problem . As part of this stage, you may look deeper and try to find the root cause of a specific problem at a team or organizational level.

Remember that problem solving strategies should not only be focused on putting out fires in the short term but developing long term solutions that deal with the root cause of organizational challenges. 

Whatever your approach, analyzing a problem is crucial in being able to select an appropriate solution and the problem solving skills deployed in this stage are beneficial for the rest of the process and ensuring the solutions you create are fit for purpose.

3. Solution generation

Once your group has nailed down the particulars of the problem you wish to solve, you want to encourage a free flow of ideas connecting to solving that problem. This can take the form of problem solving games that encourage creative thinking or problem solving activities designed to produce working prototypes of possible solutions. 

The key to ensuring the success of this stage of the problem solving process is to encourage quick, creative thinking and create an open space where all ideas are considered. The best solutions can come from unlikely places and by using problem solving techniques that celebrate invention, you might come up with solution gold. 

4. Solution development

No solution is likely to be perfect right out of the gate. It’s important to discuss and develop the solutions your group has come up with over the course of following the previous problem solving steps in order to arrive at the best possible solution. Problem solving games used in this stage involve lots of critical thinking, measuring potential effort and impact, and looking at possible solutions analytically. 

During this stage, you will often ask your team to iterate and improve upon your frontrunning solutions and develop them further. Remember that problem solving strategies always benefit from a multitude of voices and opinions, and not to let ego get involved when it comes to choosing which solutions to develop and take further.

Finding the best solution is the goal of all problem solving workshops and here is the place to ensure that your solution is well thought out, sufficiently robust and fit for purpose. 

5. Decision making 

Nearly there! Once your group has reached consensus and selected a solution that applies to the problem at hand you have some decisions to make. You will want to work on allocating ownership of the project, figure out who will do what, how the success of the solution will be measured and decide the next course of action.

The decision making stage is a part of the problem solving process that can get missed or taken as for granted. Fail to properly allocate roles and plan out how a solution will actually be implemented and it less likely to be successful in solving the problem.

Have clear accountabilities, actions, timeframes, and follow-ups. Make these decisions and set clear next-steps in the problem solving workshop so that everyone is aligned and you can move forward effectively as a group. 

Ensuring that you plan for the roll-out of a solution is one of the most important problem solving steps. Without adequate planning or oversight, it can prove impossible to measure success or iterate further if the problem was not solved. 

6. Solution implementation 

This is what we were waiting for! All problem solving strategies have the end goal of implementing a solution and solving a problem in mind. 

Remember that in order for any solution to be successful, you need to help your group through all of the previous problem solving steps thoughtfully. Only then can you ensure that you are solving the right problem but also that you have developed the correct solution and can then successfully implement and measure the impact of that solution.

Project management and communication skills are key here – your solution may need to adjust when out in the wild or you might discover new challenges along the way.

7. Solution evaluation 

So you and your team developed a great solution to a problem and have a gut feeling its been solved. Work done, right? Wrong. All problem solving strategies benefit from evaluation, consideration, and feedback. You might find that the solution does not work for everyone, might create new problems, or is potentially so successful that you will want to roll it out to larger teams or as part of other initiatives. 

None of that is possible without taking the time to evaluate the success of the solution you developed in your problem solving model and adjust if necessary.

Remember that the problem solving process is often iterative and it can be common to not solve complex issues on the first try. Even when this is the case, you and your team will have generated learning that will be important for future problem solving workshops or in other parts of the organization. 

It’s worth underlining how important record keeping is throughout the problem solving process. If a solution didn’t work, you need to have the data and records to see why that was the case. If you go back to the drawing board, notes from the previous workshop can help save time. Data and insight is invaluable at every stage of the problem solving process and this one is no different.

Problem solving workshops made easy

Problem solving strategies are methods of approaching and facilitating the process of problem-solving with a set of techniques , actions, and processes. Different strategies are more effective if you are trying to solve broad problems such as achieving higher growth versus more focused problems like, how do we improve our customer onboarding process?

Broadly, the problem solving steps outlined above should be included in any problem solving strategy though choosing where to focus your time and what approaches should be taken is where they begin to differ. You might find that some strategies ask for the problem identification to be done prior to the session or that everything happens in the course of a one day workshop.

The key similarity is that all good problem solving strategies are structured and designed. Four hours of open discussion is never going to be as productive as a four-hour workshop designed to lead a group through a problem solving process.

Good problem solving strategies are tailored to the team, organization and problem you will be attempting to solve. Here are some example problem solving strategies you can learn from or use to get started.

Use a workshop to lead a team through a group process

Often, the first step to solving problems or organizational challenges is bringing a group together effectively. Most teams have the tools, knowledge, and expertise necessary to solve their challenges – they just need some guidance in how to use leverage those skills and a structure and format that allows people to focus their energies.

Facilitated workshops are one of the most effective ways of solving problems of any scale. By designing and planning your workshop carefully, you can tailor the approach and scope to best fit the needs of your team and organization. 

Problem solving workshop

• Creating a bespoke, tailored process
• Tackling problems of any size
• Building in-house workshop ability and encouraging their use

Workshops are an effective strategy for solving problems. By using tried and test facilitation techniques and methods, you can design and deliver a workshop that is perfectly suited to the unique variables of your organization. You may only have the capacity for a half-day workshop and so need a problem solving process to match. 

By using our session planner tool and importing methods from our library of 700+ facilitation techniques, you can create the right problem solving workshop for your team. It might be that you want to encourage creative thinking or look at things from a new angle to unblock your groups approach to problem solving. By tailoring your workshop design to the purpose, you can help ensure great results.

One of the main benefits of a workshop is the structured approach to problem solving. Not only does this mean that the workshop itself will be successful, but many of the methods and techniques will help your team improve their working processes outside of the workshop. 

We believe that workshops are one of the best tools you can use to improve the way your team works together. Start with a problem solving workshop and then see what team building, culture or design workshops can do for your organization!

Run a design sprint

Great for: 

• aligning large, multi-discipline teams
• quickly designing and testing solutions
• tackling large, complex organizational challenges and breaking them down into smaller tasks

By using design thinking principles and methods, a design sprint is a great way of identifying, prioritizing and prototyping solutions to long term challenges that can help solve major organizational problems with quick action and measurable results.

Some familiarity with design thinking is useful, though not integral, and this strategy can really help a team align if there is some discussion around which problems should be approached first. 

The stage-based structure of the design sprint is also very useful for teams new to design thinking.  The inspiration phase, where you look to competitors that have solved your problem, and the rapid prototyping and testing phases are great for introducing new concepts that will benefit a team in all their future work. 

It can be common for teams to look inward for solutions and so looking to the market for solutions you can iterate on can be very productive. Instilling an agile prototyping and testing mindset can also be great when helping teams move forwards – generating and testing solutions quickly can help save time in the long run and is also pretty exciting!

Break problems down into smaller issues

Organizational challenges and problems are often complicated and large scale in nature. Sometimes, trying to resolve such an issue in one swoop is simply unachievable or overwhelming. Try breaking down such problems into smaller issues that you can work on step by step. You may not be able to solve the problem of churning customers off the bat, but you can work with your team to identify smaller effort but high impact elements and work on those first.

This problem solving strategy can help a team generate momentum, prioritize and get some easy wins. It’s also a great strategy to employ with teams who are just beginning to learn how to approach the problem solving process. If you want some insight into a way to employ this strategy, we recommend looking at our design sprint template below!

Use guiding frameworks or try new methodologies

Some problems are best solved by introducing a major shift in perspective or by using new methodologies that encourage your team to think differently.

Props and tools such as Methodkit , which uses a card-based toolkit for facilitation, or Lego Serious Play can be great ways to engage your team and find an inclusive, democratic problem solving strategy. Remember that play and creativity are great tools for achieving change and whatever the challenge, engaging your participants can be very effective where other strategies may have failed.

LEGO Serious Play

• Improving core problem solving skills
• Thinking outside of the box
• Encouraging creative solutions

LEGO Serious Play is a problem solving methodology designed to get participants thinking differently by using 3D models and kinesthetic learning styles. By physically building LEGO models based on questions and exercises, participants are encouraged to think outside of the box and create their own responses. 

Collaborate LEGO Serious Play exercises are also used to encourage communication and build problem solving skills in a group. By using this problem solving process, you can often help different kinds of learners and personality types contribute and unblock organizational problems with creative thinking. 

Problem solving strategies like LEGO Serious Play are super effective at helping a team solve more skills-based problems such as communication between teams or a lack of creative thinking. Some problems are not suited to LEGO Serious Play and require a different problem solving strategy.

Card Decks and Method Kits

• New facilitators or non-facilitators 
• Approaching difficult subjects with a simple, creative framework
• Engaging those with varied learning styles

Card decks and method kids are great tools for those new to facilitation or for whom facilitation is not the primary role. Card decks such as the emotional culture deck can be used for complete workshops and in many cases, can be used right out of the box. Methodkit has a variety of kits designed for scenarios ranging from personal development through to personas and global challenges so you can find the right deck for your particular needs.

Having an easy to use framework that encourages creativity or a new approach can take some of the friction or planning difficulties out of the workshop process and energize a team in any setting. Simplicity is the key with these methods. By ensuring everyone on your team can get involved and engage with the process as quickly as possible can really contribute to the success of your problem solving strategy.

Source external advice

Looking to peers, experts and external facilitators can be a great way of approaching the problem solving process. Your team may not have the necessary expertise, insights of experience to tackle some issues, or you might simply benefit from a fresh perspective. Some problems may require bringing together an entire team, and coaching managers or team members individually might be the right approach. Remember that not all problems are best resolved in the same manner.

If you’re a solo entrepreneur, peer groups, coaches and mentors can also be invaluable at not only solving specific business problems, but in providing a support network for resolving future challenges. One great approach is to join a Mastermind Group and link up with like-minded individuals and all grow together. Remember that however you approach the sourcing of external advice, do so thoughtfully, respectfully and honestly. Reciprocate where you can and prepare to be surprised by just how kind and helpful your peers can be!

Mastermind Group

• Solo entrepreneurs or small teams with low capacity
• Peer learning and gaining outside expertise
• Getting multiple external points of view quickly

Problem solving in large organizations with lots of skilled team members is one thing, but how about if you work for yourself or in a very small team without the capacity to get the most from a design sprint or LEGO Serious Play session? 

A mastermind group – sometimes known as a peer advisory board – is where a group of people come together to support one another in their own goals, challenges, and businesses. Each participant comes to the group with their own purpose and the other members of the group will help them create solutions, brainstorm ideas, and support one another. 

Mastermind groups are very effective in creating an energized, supportive atmosphere that can deliver meaningful results. Learning from peers from outside of your organization or industry can really help unlock new ways of thinking and drive growth. Access to the experience and skills of your peers can be invaluable in helping fill the gaps in your own ability, particularly in young companies.

A mastermind group is a great solution for solo entrepreneurs, small teams, or for organizations that feel that external expertise or fresh perspectives will be beneficial for them. It is worth noting that Mastermind groups are often only as good as the participants and what they can bring to the group. Participants need to be committed, engaged and understand how to work in this context. 

Coaching and mentoring

• Focused learning and development
• Filling skills gaps
• Working on a range of challenges over time

Receiving advice from a business coach or building a mentor/mentee relationship can be an effective way of resolving certain challenges. The one-to-one format of most coaching and mentor relationships can really help solve the challenges those individuals are having and benefit the organization as a result.

A great mentor can be invaluable when it comes to spotting potential problems before they arise and coming to understand a mentee very well has a host of other business benefits. You might run an internal mentorship program to help develop your team’s problem solving skills and strategies or as part of a large learning and development program. External coaches can also be an important part of your problem solving strategy, filling skills gaps for your management team or helping with specific business issues. 

Now we’ve explored the problem solving process and the steps you will want to go through in order to have an effective session, let’s look at the skills you and your team need to be more effective problem solvers.

Problem solving skills are highly sought after, whatever industry or team you work in. Organizations are keen to employ people who are able to approach problems thoughtfully and find strong, realistic solutions. Whether you are a facilitator , a team leader or a developer, being an effective problem solver is a skill you’ll want to develop.

Problem solving skills form a whole suite of techniques and approaches that an individual uses to not only identify problems but to discuss them productively before then developing appropriate solutions.

Here are some of the most important problem solving skills everyone from executives to junior staff members should learn. We’ve also included an activity or exercise from the SessionLab library that can help you and your team develop that skill. 

If you’re running a workshop or training session to try and improve problem solving skills in your team, try using these methods to supercharge your process!

Active listening

Active listening is one of the most important skills anyone who works with people can possess. In short, active listening is a technique used to not only better understand what is being said by an individual, but also to be more aware of the underlying message the speaker is trying to convey. When it comes to problem solving, active listening is integral for understanding the position of every participant and to clarify the challenges, ideas and solutions they bring to the table.

Some active listening skills include:

• Paying complete attention to the speaker.
• Removing distractions.
• Avoid interruption.
• Taking the time to fully understand before preparing a rebuttal.
• Responding respectfully and appropriately.
• Demonstrate attentiveness and positivity with an open posture, making eye contact with the speaker, smiling and nodding if appropriate. Show that you are listening and encourage them to continue.
• Be aware of and respectful of feelings. Judge the situation and respond appropriately. You can disagree without being disrespectful.   
• Observe body language. 
• Paraphrase what was said in your own words, either mentally or verbally.
• Remain neutral. 
• Reflect and take a moment before responding.
• Ask deeper questions based on what is said and clarify points where necessary.   

Active Listening   #hyperisland   #skills   #active listening   #remote-friendly   This activity supports participants to reflect on a question and generate their own solutions using simple principles of active listening and peer coaching. It’s an excellent introduction to active listening but can also be used with groups that are already familiar with it. Participants work in groups of three and take turns being: “the subject”, the listener, and the observer.

Analytical skills

All problem solving models require strong analytical skills, particularly during the beginning of the process and when it comes to analyzing how solutions have performed.

Analytical skills are primarily focused on performing an effective analysis by collecting, studying and parsing data related to a problem or opportunity. 

It often involves spotting patterns, being able to see things from different perspectives and using observable facts and data to make suggestions or produce insight. 

Analytical skills are also important at every stage of the problem solving process and by having these skills, you can ensure that any ideas or solutions you create or backed up analytically and have been sufficiently thought out.

Nine Whys   #innovation   #issue analysis   #liberating structures   With breathtaking simplicity, you can rapidly clarify for individuals and a group what is essentially important in their work. You can quickly reveal when a compelling purpose is missing in a gathering and avoid moving forward without clarity. When a group discovers an unambiguous shared purpose, more freedom and more responsibility are unleashed. You have laid the foundation for spreading and scaling innovations with fidelity.

Collaboration

Trying to solve problems on your own is difficult. Being able to collaborate effectively, with a free exchange of ideas, to delegate and be a productive member of a team is hugely important to all problem solving strategies.

Remember that whatever your role, collaboration is integral, and in a problem solving process, you are all working together to find the best solution for everyone. 

Marshmallow challenge with debriefing   #teamwork   #team   #leadership   #collaboration   In eighteen minutes, teams must build the tallest free-standing structure out of 20 sticks of spaghetti, one yard of tape, one yard of string, and one marshmallow. The marshmallow needs to be on top. The Marshmallow Challenge was developed by Tom Wujec, who has done the activity with hundreds of groups around the world. Visit the Marshmallow Challenge website for more information. This version has an extra debriefing question added with sample questions focusing on roles within the team.

Communication  

Being an effective communicator means being empathetic, clear and succinct, asking the right questions, and demonstrating active listening skills throughout any discussion or meeting. 

In a problem solving setting, you need to communicate well in order to progress through each stage of the process effectively. As a team leader, it may also fall to you to facilitate communication between parties who may not see eye to eye. Effective communication also means helping others to express themselves and be heard in a group.

Bus Trip   #feedback   #communication   #appreciation   #closing   #thiagi   #team   This is one of my favourite feedback games. I use Bus Trip at the end of a training session or a meeting, and I use it all the time. The game creates a massive amount of energy with lots of smiles, laughs, and sometimes even a teardrop or two.

Creative problem solving skills can be some of the best tools in your arsenal. Thinking creatively, being able to generate lots of ideas and come up with out of the box solutions is useful at every step of the process. 

The kinds of problems you will likely discuss in a problem solving workshop are often difficult to solve, and by approaching things in a fresh, creative manner, you can often create more innovative solutions.

Having practical creative skills is also a boon when it comes to problem solving. If you can help create quality design sketches and prototypes in record time, it can help bring a team to alignment more quickly or provide a base for further iteration.

The paper clip method   #sharing   #creativity   #warm up   #idea generation   #brainstorming   The power of brainstorming. A training for project leaders, creativity training, and to catalyse getting new solutions.

Critical thinking

Critical thinking is one of the fundamental problem solving skills you’ll want to develop when working on developing solutions. Critical thinking is the ability to analyze, rationalize and evaluate while being aware of personal bias, outlying factors and remaining open-minded.

Defining and analyzing problems without deploying critical thinking skills can mean you and your team go down the wrong path. Developing solutions to complex issues requires critical thinking too – ensuring your team considers all possibilities and rationally evaluating them. 

Agreement-Certainty Matrix   #issue analysis   #liberating structures   #problem solving   You can help individuals or groups avoid the frequent mistake of trying to solve a problem with methods that are not adapted to the nature of their challenge. The combination of two questions makes it possible to easily sort challenges into four categories: simple, complicated, complex , and chaotic .  A problem is simple when it can be solved reliably with practices that are easy to duplicate.  It is complicated when experts are required to devise a sophisticated solution that will yield the desired results predictably.  A problem is complex when there are several valid ways to proceed but outcomes are not predictable in detail.  Chaotic is when the context is too turbulent to identify a path forward.  A loose analogy may be used to describe these differences: simple is like following a recipe, complicated like sending a rocket to the moon, complex like raising a child, and chaotic is like the game “Pin the Tail on the Donkey.”  The Liberating Structures Matching Matrix in Chapter 5 can be used as the first step to clarify the nature of a challenge and avoid the mismatches between problems and solutions that are frequently at the root of chronic, recurring problems.

Data analysis 

Though it shares lots of space with general analytical skills, data analysis skills are something you want to cultivate in their own right in order to be an effective problem solver.

Being good at data analysis doesn’t just mean being able to find insights from data, but also selecting the appropriate data for a given issue, interpreting it effectively and knowing how to model and present that data. Depending on the problem at hand, it might also include a working knowledge of specific data analysis tools and procedures. 

Having a solid grasp of data analysis techniques is useful if you’re leading a problem solving workshop but if you’re not an expert, don’t worry. Bring people into the group who has this skill set and help your team be more effective as a result.

Decision making

All problems need a solution and all solutions require that someone make the decision to implement them. Without strong decision making skills, teams can become bogged down in discussion and less effective as a result. 

Making decisions is a key part of the problem solving process. It’s important to remember that decision making is not restricted to the leadership team. Every staff member makes decisions every day and developing these skills ensures that your team is able to solve problems at any scale. Remember that making decisions does not mean leaping to the first solution but weighing up the options and coming to an informed, well thought out solution to any given problem that works for the whole team.

Lightning Decision Jam (LDJ)   #action   #decision making   #problem solving   #issue analysis   #innovation   #design   #remote-friendly   The problem with anything that requires creative thinking is that it’s easy to get lost—lose focus and fall into the trap of having useless, open-ended, unstructured discussions. Here’s the most effective solution I’ve found: Replace all open, unstructured discussion with a clear process. What to use this exercise for: Anything which requires a group of people to make decisions, solve problems or discuss challenges. It’s always good to frame an LDJ session with a broad topic, here are some examples: The conversion flow of our checkout Our internal design process How we organise events Keeping up with our competition Improving sales flow

Dependability

Most complex organizational problems require multiple people to be involved in delivering the solution. Ensuring that the team and organization can depend on you to take the necessary actions and communicate where necessary is key to ensuring problems are solved effectively.

Being dependable also means working to deadlines and to brief. It is often a matter of creating trust in a team so that everyone can depend on one another to complete the agreed actions in the agreed time frame so that the team can move forward together. Being undependable can create problems of friction and can limit the effectiveness of your solutions so be sure to bear this in mind throughout a project. 

Team Purpose & Culture   #team   #hyperisland   #culture   #remote-friendly   This is an essential process designed to help teams define their purpose (why they exist) and their culture (how they work together to achieve that purpose). Defining these two things will help any team to be more focused and aligned. With support of tangible examples from other companies, the team members work as individuals and a group to codify the way they work together. The goal is a visual manifestation of both the purpose and culture that can be put up in the team’s work space.

Emotional intelligence

Emotional intelligence is an important skill for any successful team member, whether communicating internally or with clients or users. In the problem solving process, emotional intelligence means being attuned to how people are feeling and thinking, communicating effectively and being self-aware of what you bring to a room. 

There are often differences of opinion when working through problem solving processes, and it can be easy to let things become impassioned or combative. Developing your emotional intelligence means being empathetic to your colleagues and managing your own emotions throughout the problem and solution process. Be kind, be thoughtful and put your points across care and attention. 

Being emotionally intelligent is a skill for life and by deploying it at work, you can not only work efficiently but empathetically. Check out the emotional culture workshop template for more!

Facilitation

As we’ve clarified in our facilitation skills post, facilitation is the art of leading people through processes towards agreed-upon objectives in a manner that encourages participation, ownership, and creativity by all those involved. While facilitation is a set of interrelated skills in itself, the broad definition of facilitation can be invaluable when it comes to problem solving. Leading a team through a problem solving process is made more effective if you improve and utilize facilitation skills – whether you’re a manager, team leader or external stakeholder.

The Six Thinking Hats   #creative thinking   #meeting facilitation   #problem solving   #issue resolution   #idea generation   #conflict resolution   The Six Thinking Hats are used by individuals and groups to separate out conflicting styles of thinking. They enable and encourage a group of people to think constructively together in exploring and implementing change, rather than using argument to fight over who is right and who is wrong.

Flexibility 

Being flexible is a vital skill when it comes to problem solving. This does not mean immediately bowing to pressure or changing your opinion quickly: instead, being flexible is all about seeing things from new perspectives, receiving new information and factoring it into your thought process.

Flexibility is also important when it comes to rolling out solutions. It might be that other organizational projects have greater priority or require the same resources as your chosen solution. Being flexible means understanding needs and challenges across the team and being open to shifting or arranging your own schedule as necessary. Again, this does not mean immediately making way for other projects. It’s about articulating your own needs, understanding the needs of others and being able to come to a meaningful compromise.

The Creativity Dice   #creativity   #problem solving   #thiagi   #issue analysis   Too much linear thinking is hazardous to creative problem solving. To be creative, you should approach the problem (or the opportunity) from different points of view. You should leave a thought hanging in mid-air and move to another. This skipping around prevents premature closure and lets your brain incubate one line of thought while you consciously pursue another.

Working in any group can lead to unconscious elements of groupthink or situations in which you may not wish to be entirely honest. Disagreeing with the opinions of the executive team or wishing to save the feelings of a coworker can be tricky to navigate, but being honest is absolutely vital when to comes to developing effective solutions and ensuring your voice is heard. 

Remember that being honest does not mean being brutally candid. You can deliver your honest feedback and opinions thoughtfully and without creating friction by using other skills such as emotional intelligence. 

Explore your Values   #hyperisland   #skills   #values   #remote-friendly   Your Values is an exercise for participants to explore what their most important values are. It’s done in an intuitive and rapid way to encourage participants to follow their intuitive feeling rather than over-thinking and finding the “correct” values. It is a good exercise to use to initiate reflection and dialogue around personal values.

Initiative 

The problem solving process is multi-faceted and requires different approaches at certain points of the process. Taking initiative to bring problems to the attention of the team, collect data or lead the solution creating process is always valuable. You might even roadtest your own small scale solutions or brainstorm before a session. Taking initiative is particularly effective if you have good deal of knowledge in that area or have ownership of a particular project and want to get things kickstarted.

That said, be sure to remember to honor the process and work in service of the team. If you are asked to own one part of the problem solving process and you don’t complete that task because your initiative leads you to work on something else, that’s not an effective method of solving business challenges.

15% Solutions   #action   #liberating structures   #remote-friendly   You can reveal the actions, however small, that everyone can do immediately. At a minimum, these will create momentum, and that may make a BIG difference.  15% Solutions show that there is no reason to wait around, feel powerless, or fearful. They help people pick it up a level. They get individuals and the group to focus on what is within their discretion instead of what they cannot change.  With a very simple question, you can flip the conversation to what can be done and find solutions to big problems that are often distributed widely in places not known in advance. Shifting a few grains of sand may trigger a landslide and change the whole landscape.

Impartiality

A particularly useful problem solving skill for product owners or managers is the ability to remain impartial throughout much of the process. In practice, this means treating all points of view and ideas brought forward in a meeting equally and ensuring that your own areas of interest or ownership are not favored over others. 

There may be a stage in the process where a decision maker has to weigh the cost and ROI of possible solutions against the company roadmap though even then, ensuring that the decision made is based on merit and not personal opinion. 

Empathy map   #frame insights   #create   #design   #issue analysis   An empathy map is a tool to help a design team to empathize with the people they are designing for. You can make an empathy map for a group of people or for a persona. To be used after doing personas when more insights are needed.

Being a good leader means getting a team aligned, energized and focused around a common goal. In the problem solving process, strong leadership helps ensure that the process is efficient, that any conflicts are resolved and that a team is managed in the direction of success.

It’s common for managers or executives to assume this role in a problem solving workshop, though it’s important that the leader maintains impartiality and does not bulldoze the group in a particular direction. Remember that good leadership means working in service of the purpose and team and ensuring the workshop is a safe space for employees of any level to contribute. Take a look at our leadership games and activities post for more exercises and methods to help improve leadership in your organization.

Leadership Pizza   #leadership   #team   #remote-friendly   This leadership development activity offers a self-assessment framework for people to first identify what skills, attributes and attitudes they find important for effective leadership, and then assess their own development and initiate goal setting.

In the context of problem solving, mediation is important in keeping a team engaged, happy and free of conflict. When leading or facilitating a problem solving workshop, you are likely to run into differences of opinion. Depending on the nature of the problem, certain issues may be brought up that are emotive in nature. 

Being an effective mediator means helping those people on either side of such a divide are heard, listen to one another and encouraged to find common ground and a resolution. Mediating skills are useful for leaders and managers in many situations and the problem solving process is no different.

Conflict Responses   #hyperisland   #team   #issue resolution   A workshop for a team to reflect on past conflicts, and use them to generate guidelines for effective conflict handling. The workshop uses the Thomas-Killman model of conflict responses to frame a reflective discussion. Use it to open up a discussion around conflict with a team.

Planning 

Solving organizational problems is much more effective when following a process or problem solving model. Planning skills are vital in order to structure, deliver and follow-through on a problem solving workshop and ensure your solutions are intelligently deployed.

Planning skills include the ability to organize tasks and a team, plan and design the process and take into account any potential challenges. Taking the time to plan carefully can save time and frustration later in the process and is valuable for ensuring a team is positioned for success.

3 Action Steps   #hyperisland   #action   #remote-friendly   This is a small-scale strategic planning session that helps groups and individuals to take action toward a desired change. It is often used at the end of a workshop or programme. The group discusses and agrees on a vision, then creates some action steps that will lead them towards that vision. The scope of the challenge is also defined, through discussion of the helpful and harmful factors influencing the group.

Prioritization

As organisations grow, the scale and variation of problems they face multiplies. Your team or is likely to face numerous challenges in different areas and so having the skills to analyze and prioritize becomes very important, particularly for those in leadership roles.

A thorough problem solving process is likely to deliver multiple solutions and you may have several different problems you wish to solve simultaneously. Prioritization is the ability to measure the importance, value, and effectiveness of those possible solutions and choose which to enact and in what order. The process of prioritization is integral in ensuring the biggest challenges are addressed with the most impactful solutions.

Impact and Effort Matrix   #gamestorming   #decision making   #action   #remote-friendly   In this decision-making exercise, possible actions are mapped based on two factors: effort required to implement and potential impact. Categorizing ideas along these lines is a useful technique in decision making, as it obliges contributors to balance and evaluate suggested actions before committing to them.

Project management

Some problem solving skills are utilized in a workshop or ideation phases, while others come in useful when it comes to decision making. Overseeing an entire problem solving process and ensuring its success requires strong project management skills. 

While project management incorporates many of the other skills listed here, it is important to note the distinction of considering all of the factors of a project and managing them successfully. Being able to negotiate with stakeholders, manage tasks, time and people, consider costs and ROI, and tie everything together is massively helpful when going through the problem solving process. 

Record keeping

Working out meaningful solutions to organizational challenges is only one part of the process.  Thoughtfully documenting and keeping records of each problem solving step for future consultation is important in ensuring efficiency and meaningful change. 

For example, some problems may be lower priority than others but can be revisited in the future. If the team has ideated on solutions and found some are not up to the task, record those so you can rule them out and avoiding repeating work. Keeping records of the process also helps you improve and refine your problem solving model next time around!

Personal Kanban   #gamestorming   #action   #agile   #project planning   Personal Kanban is a tool for organizing your work to be more efficient and productive. It is based on agile methods and principles.

Research skills

Conducting research to support both the identification of problems and the development of appropriate solutions is important for an effective process. Knowing where to go to collect research, how to conduct research efficiently, and identifying pieces of research are relevant are all things a good researcher can do well. 

In larger groups, not everyone has to demonstrate this ability in order for a problem solving workshop to be effective. That said, having people with research skills involved in the process, particularly if they have existing area knowledge, can help ensure the solutions that are developed with data that supports their intention. Remember that being able to deliver the results of research efficiently and in a way the team can easily understand is also important. The best data in the world is only as effective as how it is delivered and interpreted.

Customer experience map   #ideation   #concepts   #research   #design   #issue analysis   #remote-friendly   Customer experience mapping is a method of documenting and visualizing the experience a customer has as they use the product or service. It also maps out their responses to their experiences. To be used when there is a solution (even in a conceptual stage) that can be analyzed.

Risk management

Managing risk is an often overlooked part of the problem solving process. Solutions are often developed with the intention of reducing exposure to risk or solving issues that create risk but sometimes, great solutions are more experimental in nature and as such, deploying them needs to be carefully considered. 

Managing risk means acknowledging that there may be risks associated with more out of the box solutions or trying new things, but that this must be measured against the possible benefits and other organizational factors. 

Be informed, get the right data and stakeholders in the room and you can appropriately factor risk into your decision making process. 

Decisions, Decisions…   #communication   #decision making   #thiagi   #action   #issue analysis   When it comes to decision-making, why are some of us more prone to take risks while others are risk-averse? One explanation might be the way the decision and options were presented.  This exercise, based on Kahneman and Tversky’s classic study , illustrates how the framing effect influences our judgement and our ability to make decisions . The participants are divided into two groups. Both groups are presented with the same problem and two alternative programs for solving them. The two programs both have the same consequences but are presented differently. The debriefing discussion examines how the framing of the program impacted the participant’s decision.

Team-building 

No single person is as good at problem solving as a team. Building an effective team and helping them come together around a common purpose is one of the most important problem solving skills, doubly so for leaders. By bringing a team together and helping them work efficiently, you pave the way for team ownership of a problem and the development of effective solutions. 

In a problem solving workshop, it can be tempting to jump right into the deep end, though taking the time to break the ice, energize the team and align them with a game or exercise will pay off over the course of the day.

Remember that you will likely go through the problem solving process multiple times over an organization’s lifespan and building a strong team culture will make future problem solving more effective. It’s also great to work with people you know, trust and have fun with. Working on team building in and out of the problem solving process is a hallmark of successful teams that can work together to solve business problems.

9 Dimensions Team Building Activity   #ice breaker   #teambuilding   #team   #remote-friendly   9 Dimensions is a powerful activity designed to build relationships and trust among team members. There are 2 variations of this icebreaker. The first version is for teams who want to get to know each other better. The second version is for teams who want to explore how they are working together as a team.

Time management 

The problem solving process is designed to lead a team from identifying a problem through to delivering a solution and evaluating its effectiveness. Without effective time management skills or timeboxing of tasks, it can be easy for a team to get bogged down or be inefficient.

By using a problem solving model and carefully designing your workshop, you can allocate time efficiently and trust that the process will deliver the results you need in a good timeframe.

Time management also comes into play when it comes to rolling out solutions, particularly those that are experimental in nature. Having a clear timeframe for implementing and evaluating solutions is vital for ensuring their success and being able to pivot if necessary.

Improving your skills at problem solving is often a career-long pursuit though there are methods you can use to make the learning process more efficient and to supercharge your problem solving skillset.

Remember that the skills you need to be a great problem solver have a large overlap with those skills you need to be effective in any role. Investing time and effort to develop your active listening or critical thinking skills is valuable in any context. Here are 7 ways to improve your problem solving skills.

Share best practices

Remember that your team is an excellent source of skills, wisdom, and techniques and that you should all take advantage of one another where possible. Best practices that one team has for solving problems, conducting research or making decisions should be shared across the organization. If you have in-house staff that have done active listening training or are data analysis pros, have them lead a training session. 

Your team is one of your best resources. Create space and internal processes for the sharing of skills so that you can all grow together. 

Ask for help and attend training

Once you’ve figured out you have a skills gap, the next step is to take action to fill that skills gap. That might be by asking your superior for training or coaching, or liaising with team members with that skill set. You might even attend specialized training for certain skills – active listening or critical thinking, for example, are business-critical skills that are regularly offered as part of a training scheme.

Whatever method you choose, remember that taking action of some description is necessary for growth. Whether that means practicing, getting help, attending training or doing some background reading, taking active steps to improve your skills is the way to go.

Learn a process 

Problem solving can be complicated, particularly when attempting to solve large problems for the first time. Using a problem solving process helps give structure to your problem solving efforts and focus on creating outcomes, rather than worrying about the format. 

Tools such as the seven-step problem solving process above are effective because not only do they feature steps that will help a team solve problems, they also develop skills along the way. Each step asks for people to engage with the process using different skills and in doing so, helps the team learn and grow together. Group processes of varying complexity and purpose can also be found in the SessionLab library of facilitation techniques . Using a tried and tested process and really help ease the learning curve for both those leading such a process, as well as those undergoing the purpose.

Effective teams make decisions about where they should and shouldn’t expend additional effort. By using a problem solving process, you can focus on the things that matter, rather than stumbling towards a solution haphazardly. 

Create a feedback loop

Some skills gaps are more obvious than others. It’s possible that your perception of your active listening skills differs from those of your colleagues. 

It’s valuable to create a system where team members can provide feedback in an ordered and friendly manner so they can all learn from one another. Only by identifying areas of improvement can you then work to improve them. 

Remember that feedback systems require oversight and consideration so that they don’t turn into a place to complain about colleagues. Design the system intelligently so that you encourage the creation of learning opportunities, rather than encouraging people to list their pet peeves.

While practice might not make perfect, it does make the problem solving process easier. If you are having trouble with critical thinking, don’t shy away from doing it. Get involved where you can and stretch those muscles as regularly as possible. 

Problem solving skills come more naturally to some than to others and that’s okay. Take opportunities to get involved and see where you can practice your skills in situations outside of a workshop context. Try collaborating in other circumstances at work or conduct data analysis on your own projects. You can often develop those skills you need for problem solving simply by doing them. Get involved!

Use expert exercises and methods

Learn from the best. Our library of 700+ facilitation techniques is full of activities and methods that help develop the skills you need to be an effective problem solver. Check out our templates to see how to approach problem solving and other organizational challenges in a structured and intelligent manner.

There is no single approach to improving problem solving skills, but by using the techniques employed by others you can learn from their example and develop processes that have seen proven results. 

Try new ways of thinking and change your mindset

Using tried and tested exercises that you know well can help deliver results, but you do run the risk of missing out on the learning opportunities offered by new approaches. As with the problem solving process, changing your mindset can remove blockages and be used to develop your problem solving skills.

Most teams have members with mixed skill sets and specialties. Mix people from different teams and share skills and different points of view. Teach your customer support team how to use design thinking methods or help your developers with conflict resolution techniques. Try switching perspectives with facilitation techniques like Flip It! or by using new problem solving methodologies or models. Give design thinking, liberating structures or lego serious play a try if you want to try a new approach. You will find that framing problems in new ways and using existing skills in new contexts can be hugely useful for personal development and improving your skillset. It’s also a lot of fun to try new things. Give it a go!

Encountering business challenges and needing to find appropriate solutions is not unique to your organization. Lots of very smart people have developed methods, theories and approaches to help develop problem solving skills and create effective solutions. Learn from them!

Books like The Art of Thinking Clearly , Think Smarter, or Thinking Fast, Thinking Slow are great places to start, though it’s also worth looking at blogs related to organizations facing similar problems to yours, or browsing for success stories. Seeing how Dropbox massively increased growth and working backward can help you see the skills or approach you might be lacking to solve that same problem. Learning from others by reading their stories or approaches can be time-consuming but ultimately rewarding.

A tired, distracted mind is not in the best position to learn new skills. It can be tempted to burn the candle at both ends and develop problem solving skills outside of work. Absolutely use your time effectively and take opportunities for self-improvement, though remember that rest is hugely important and that without letting your brain rest, you cannot be at your most effective. 

Creating distance between yourself and the problem you might be facing can also be useful. By letting an idea sit, you can find that a better one presents itself or you can develop it further. Take regular breaks when working and create a space for downtime. Remember that working smarter is preferable to working harder and that self-care is important for any effective learning or improvement process.

Want to design better group processes?

Over to you

Now we’ve explored some of the key problem solving skills and the problem solving steps necessary for an effective process, you’re ready to begin developing more effective solutions and leading problem solving workshops.

Need more inspiration? Check out our post on problem solving activities you can use when guiding a group towards a great solution in your next workshop or meeting. Have questions? Did you have a great problem solving technique you use with your team? Get in touch in the comments below. We’d love to chat!

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Problem-solving interventions and depression among adolescents and young adults: A systematic review of the effectiveness of problem-solving interventions in preventing or treating depression

Kristina Metz

1 Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States of America

2 Centre for Evidence and Implementation, London, United Kingdom

Jade Mitchell

Sangita chakraborty, bryce d. mcleod.

3 Department of Psychology, Virginia Commonwealth University, Richmond, VA, United States of America

Ludvig Bjørndal

Robyn mildon.

4 Centre for Evidence and Implementation, Melbourne, Victoria, Australia

Aron Shlonsky

5 Department of Social Work, Monash University, Melbourne, Victoria, Australia

Associated Data

All relevant methods and data are within the paper and its Supporting Information files.

Problem-solving (PS) has been identified as a therapeutic technique found in multiple evidence-based treatments for depression. To further understand for whom and how this intervention works, we undertook a systematic review of the evidence for PS’s effectiveness in preventing and treating depression among adolescents and young adults. We searched electronic databases ( PsycINFO , Medline , and Cochrane Library ) for studies published between 2000 and 2022. Studies meeting the following criteria were included: (a) the intervention was described by authors as a PS intervention or including PS; (b) the intervention was used to treat or prevent depression; (c) mean or median age between 13–25 years; (d) at least one depression outcome was reported. Risk of bias of included studies was assessed using the Cochrane Risk of Bias 2.0 tool. A narrative synthesis was undertaken given the high level of heterogeneity in study variables. Twenty-five out of 874 studies met inclusion criteria. The interventions studied were heterogeneous in population, intervention, modality, comparison condition, study design, and outcome. Twelve studies focused purely on PS; 13 used PS as part of a more comprehensive intervention. Eleven studies found positive effects in reducing depressive symptoms and two in reducing suicidality. There was little evidence that the intervention impacted PS skills or that PS skills acted as a mediator or moderator of effects on depression. There is mixed evidence about the effectiveness of PS as a prevention and treatment of depression among AYA. Our findings indicate that pure PS interventions to treat clinical depression have the strongest evidence, while pure PS interventions used to prevent or treat sub-clinical depression and PS as part of a more comprehensive intervention show mixed results. Possible explanations for limited effectiveness are discussed, including missing outcome bias, variability in quality, dosage, and fidelity monitoring; small sample sizes and short follow-up periods.

Introduction

Depression among adolescents and young adults (AYA) is a serious, widespread problem. A striking increase in depressive symptoms is seen in early adolescence [ 1 ], with rates of depression being estimated to almost double between the age of 13 (8.4%) and 18 (15.4%) [ 2 ]. Research also suggests that the mean age of onset for depressive disorders is decreasing, and the prevalence is increasing for AYA. Psychosocial interventions, such as cognitive-behavioural therapy (CBT) and interpersonal therapy (IPT), have shown small to moderate effects in preventing and treating depression [ 3 – 6 ]. However, room for improvement remains. Up to half of youth with depression do not receive treatment [ 7 ]. When youth receive treatment, studies indicate that about half of youth will not show measurable symptom reduction across 30 weeks of routine clinical care for depression [ 8 ]. One strategy to improve the accessibility and effectiveness of mental health interventions is to move away from an emphasis on Evidence- Based Treatments (EBTs; e.g., CBT) to a focus on discrete treatment techniques that demonstrate positive effects across multiple studies that meet certain methodological standards (i.e., common elements; 9). Identifying common elements allows for the removal of redundant and less effective treatment content, reducing treatment costs, expanding available service provision and enhancing scability. Furthermore, introducing the most effective elements of treatment early may improve client retention and outcomes [ 9 – 13 ].

A potential common element for depression intervention is problem-solving (PS). PS refers to how an individual identifies and applies solutions to everyday problems. D’Zurilla and colleagues [ 14 – 17 ] conceptualize effective PS skills to include a constructive attitude towards problems (i.e., a positive problem-solving orientation) and the ability to approach problems systematically and rationally (i.e., a rational PS style). Whereas maladaptive patterns, such as negative problem orientation and passively or impulsively addressing problems, are ineffective PS skills that may lead to depressive symptoms [ 14 – 17 ]. Problem Solving Therapy (PST), designed by D’Zurilla and colleagues, is a therapeutic approach developed to decrease mental health problems by improving PS skills [ 18 ]. PST focuses on four core skills to promote adaptive problem solving, including: (1) defining the problem; (2) brainstorming possible solutions; (3) appraising solutions and selecting the best one; and (4) implementing the chosen solution and assessing the outcome [ 14 – 17 ]. PS is also a component in other manualized approaches, such as CBT and Dialectical Behavioural Therapy (DBT), as well as imbedded into other wider generalized mental health programming [ 19 , 20 ]. A meta-analysis of over 30 studies found PST, or PS skills alone, to be as effective as CBT and IPT and more effective than control conditions [ 21 – 23 ]. Thus, justifying its identification as a common element in multiple prevention [ 19 , 24 ] and treatment [ 21 , 25 ] programs for adult depression [ 9 , 26 – 28 ].

PS has been applied to youth and young adults; however, no manuals specific to the AYA population are available. Empirical studies suggest maladaptive PS skills are associated with depressive symptoms in AYA [ 5 , 17 – 23 ]. Furthermore, PS intervention can be brief [ 29 ], delivered by trained or lay counsellors [ 30 , 31 ], and provided in various contexts (e.g., primary care, schools [ 23 ]). Given PS’s versatility and effectiveness, PS could be an ideal common element in treating AYA depression; however, to our knowledge, no reviews or meta-analyses on PS’s effectiveness with AYA specific populations exist. This review aimed to examine the effectiveness of PS as a common element in the prevention and treatment of depression for AYA within real-world settings, as well as to ascertain the variables that may influence and impact PS intervention effects.

Identification and selection of studies

Searches were conducted using PsycInfo , Medline , and Cochrane Library with the following search terms: "problem-solving", “adolescent”, “youth”, and” depression, ” along with filters limiting results to controlled studies looking at effectiveness or exploring mechanisms of effectiveness. Synonyms and derivatives were employed to expand the search. We searched grey literature using Greylit . org and Opengrey . eu , contacted experts in the field and authors of protocols, and searched the reference lists of all included studies. The search was undertaken on 4 th June 2020 and updated on 11 th June 2022.

Studies meeting the following criteria were included: (a) the intervention was described by authors as a PS intervention or including PS; (b) the intervention was used to treat or prevent depression; (c) mean or median age between 13–25 years; and (d) at least one depression outcome was reported. Literature in electronic format published post 2000 was deemed eligible, given the greater relevance of more recent usage of PS in real-world settings. There was no exclusion for gender, ethnicity, or country setting; only English language texts were included. Randomized controlled trials (RCTs), quasi-experimental designs (QEDs), systematic reviews/meta-analyses, pilots, or other studies with clearly defined comparison conditions (no treatment, treatment as usual (TAU), or a comparator treatment) were included. We excluded studies of CBT, IPT, Acceptance and Commitment Therapy (ACT), Dialectical Behaviour Therapy (DBT), and modified forms of these treatments. These treatments include PS and have been shown to demonstrate small to medium effects on depression [ 13 , 14 , 32 ], but the unique contribution of PS cannot be disentangled. The protocol for this review was not registered; however, all data collection forms, extraction, coding and analyses used in the review are available upon inquiry from the first author.

Study selection

All citations were entered into Endnote and uploaded to Covidence for screening and review against the inclusion/exclusion criteria. Reviewers with high inter-rater reliability (98%) independently screened the titles and abstracts. Two reviewers then independently screened full text of articles that met criteria. Duplicates, irrelevant studies, and studies that did not meet the criteria were removed, and the reason for exclusion was recorded (see S1 File for a list of excluded studies). Discrepancies were resolved by discussion with the team leads.

Data extraction

Two reviewers independently extracted data that included: (i) study characteristics (author, publication year, location, design, study aim), (ii) population (age, gender, race/ethnicity, education, family income, depression status), (iii) setting, (iv) intervention description (therapeutic or preventative, whether PS was provided alone or as part of a more comprehensive intervention, duration, delivery mode), (v) treatment outcomes (measures used and reported outcomes for depression, suicidality, and PS), and (vi) fidelity/implementation outcomes. For treatment outcomes, we included the original statistical analyses and/or values needed to calculate an effect size, as reported by the authors. If a variable was not included in the study publication, we extracted the information available and made note of missing data and subsequent limitations to the analyses.

RCTs were assessed for quality (i.e., confidence in the study’s findings) using the Cochrane Risk of Bias 2.0 tool [ 33 ] which includes assessment of the potential risk of bias relating to the process of randomisation; deviations from the intended intervention(s); missing data; outcome measurement and reported results. Risk of bias pertaining to each domain is estimated using an algorithm, grouped as: Low risk; Some concerns; or High risk. Two reviewers independently assessed the quality of included studies, and discrepancies were resolved by consensus.

We planned to conduct one or more meta-analyses if the studies were sufficiently similar. Data were entered into a summary of findings table as a first step in determining the theoretical and practical similarity of the population, intervention, comparison condition, outcome, and study design. If there were sufficiently similar studies, a meta-analysis would be conducted according to guidelines contained in the Cochrane Collaboration Handbook of Systematic Reviews, including tests of heterogeneity and use of random effects models where necessary.

The two searches yielded a total number of 874 records (after the removal of duplicates). After title and abstract screening, 184 full-text papers were considered for inclusion, of which 25 studies met the eligibility criteria and were included in the systematic review ( Fig 1 ). Unfortunately, substantial differences (both theoretical and practical) precluded any relevant meta-analyses, and we were limited to a narrative synthesis.

Risk of bias assessment

Risk of bias assessments were conducted on the 23 RCTs ( Fig 2 ; assessments by study presented in S1 Table ). Risk of bias concerns were moderate, and a fair degree of confidence in the validity of study findings is warranted. Most studies (81%) were assessed as ‘some concerns’ (N = 18), four studies were ‘low risk’, and one ‘high risk’. The most frequent areas of concern were the selection of the reported result (n = 18, mostly due to inadequate reporting of a priori analytic plans); deviations from the intended intervention (N = 17, mostly related to insufficient information about intention-to-treat analyses); and randomisation process (N = 13).

Study designs and characteristics

Study design.

Across the 25 studies, 23 were RCTs; two were QEDs. Nine had TAU or wait-list control (WLC) comparator groups, and 16 used active control groups (e.g., alternative treatment). Eleven studies described fidelity measures. The sample size ranged from 26 to 686 and was under 63 in nine studies.

Selected intervention

Twenty interventions were described across the 25 studies ( Table 1 ). Ten interventions focused purely on PS. Of these 10 interventions: three were adaptations of models proposed by D’Zurilla and Nezu [ 20 , 34 ] and D’Zurilla and Goldfried [ 18 ], two were based on Mynors-Wallis’s [ 35 ] Problem-Solving Therapy (PST) guide, one was a problem-orientation video intervention adapted from D’Zurilla and Nezu [ 34 ], one was an online intervention adapted from Method of Levels therapy, and three did not specify a model. Ten interventions used PS as part of a larger, more comprehensive intervention (e.g., PS as a portion of cognitive therapy). The utilization and dose of PS steps included in these interventions were unclear. Ten interventions were primary prevention interventions–one of these was universal prevention, five were indicated prevention, and four were selective prevention. Ten interventions were secondary prevention interventions. Nine interventions were described as having been developed or adapted for young people.

Notes: Psychiatric measures: A-LIFE = Adolescent Longitudinal Interval Follow-up Evaluation; BDI = Beck Depression Inventory; BDI-II = Beck Depression Inventory-II; BSS = Beck Suicide Scale; CDI = Children’s Depression Inventory; CDRS-R = Children’s Depression Rating Scale, Revised; CES-D = Centre for Epidemiological Studies Depression Scale; DASS-21 = Depression Anxiety Stress Scale-21; DEP13 = 13 items from Schedule for Affective Disorders and Schizophrenia for School-Age Children; DSM-IV = Diagnostic and Statistical Manual of Mental Health Disorders, fourth edition; DSM-IV-TR = Diagnostic and Statistical Manual of Mental Health Disorders, fourth edition, text revision; DSM-5 = Diagnostic and Statistical Manual of Mental Health Disorders, fifth edition; EPDS = Edinburgh Postnatal Depression Scale; GHQ = General Health Questionnaire; GHQ-D = General Health Questionnaire Depression Scale; HDRS = Hamilton Depression Rating Scale; ICD-10 = International Classification of Diseases, 10 th revision

ISO-30 = Inventory of Suicide Orientation; K10 = Kessler Psychological Distress Scale; K-SADS = Kiddie Schedule for Affective Disorders and Schizophrenia; MADRS = Montgomery-Åsberg Depression Rating Scale; MFQ = Mood and Feelings Questionnaire; PSRs = Psychiatric Status Ratings; PSS-4 = Perceived Stress Scale-4; SCAN = Schedules for Clinical Assessment in Neuropsychiatry; SCIV = Structured Clinical Interview Clinical Version for DSM-IV Axis 1; SDQ = Strengths and Difficulties Questionnaire; SPS = Suicide Probability Scale; SWEMWBS = Short Warwick–Edinburgh Mental Well-Being Scale; YMRS = Young Mania Rating Scale; YTP = Youth Top Problems

Problem-solving measures: PSI = Problem Solving Inventory; SPSI = Social Problem-Solving Inventory; SPSI-R = Social Problem-Solving Inventory-Revised

Other terms: CAST = Coping and Support Training; CBT = Cognitive Behavioural Therapy; MYLO = Manage Your Life Online; NICE = National Institute of Health and Care Excellence; NST = Nondirective Supportive Therapy; PCT = Perceptual Control Therapy; PS = Problem Solving; PST = Problem-Solving Therapy; PST-PC = Problem-Solving Therapy for Pediatric Care; QED = Quasi-Experimental Design; RCT = Randomized Controlled Trial; SBFT = Systematic-Behavioural Family Therapy; TAU = Treatment As Usual; WLC = Waitlist Control; BP = Bipolar Disorder; MDD = major depressive disorder

Intervention delivery

Of the 20 interventions, eight were delivered individually, eight were group-based, two were family-based, one was mixed, and in one, the format of delivery was unclear. Seventeen were delivered face-to-face and three online. Dosage ranged from a single session to 21, 50-minute sessions (12 weekly sessions, then 6 biweekly sessions); the most common session formar was once weekly for six weeks (N = 5).

Intervention setting and participants

Seventeen studies were conducted in high-income countries (UK, US, Australia, Netherlands, South Korea), four in upper-middle income (Brazil, South Africa, Turkey), and four in low- and middle-income countries (Zimbabwe, Nigeria, India). Four studies included participants younger than 13 and four older than 25. Nine studies were conducted on university or high school student populations and five on pregnant or post-partum mothers. The remaining 11 used populations from mental health clinics, the community, a diabetes clinic, juvenile detention, and a runaway shelter.

Sixteen studies included participants who met the criteria for a depressive, bipolar, or suicidal disorder (two of these excluded severe depression). Nine studies did not use depression symptoms in the inclusion criteria (one of these excluded depression). Several studies excluded other significant mental health conditions.

Outcome measures

Eight interventions targeted depression, four post/perinatal depression, two suicidal ideation, two resilience, one ‘problem-related distress’, one ‘diabetes distress’, one common adolescent mental health problem, and one mood episode. Those targeting post/perinatal depression used the Edinburgh Postnatal Depression Scale as the outcome measure. Of the others, six used the Beck Depression Inventory (I or II), two the Children’s Depression Inventory, three the Depression Anxiety Stress Scale-21, three the Centre for Epidemiologic Studies Depression Scale, one the Short Mood and Feelings Questionnaire, one the Hamilton Depression Rating Scale, one the depression subscale on the Schedule for Affective Disorders and Schizophrenia for School-Age Children, one the Strengths and Difficulties Questionnaire, one the Youth Top Problems Score, one the Adolescent Longitudinal Interval Follow-up Evaluation and Psychiatric Status Ratings, one the Kiddie Schedule for Affective Disorders and Schizophrenia, and one the Mini International Neuropsychiatric Interview.

Only eight studies measured PS skills or orientation outcomes. Three used the Social Problem-Solving Inventory-Revised, one the Problem Solving Inventory, two measured the extent to which the nominated problem had been resolved, one observed PS in video-taped interactions, and one did not specify the measure.

The mixed findings regarding the effectiveness of PS for depression may depend on the type of intervention: primary (universal, selective, or indicated), secondary or tertiary prevention. Universal prevention interventions target the general public or a population not determined by any specific criteria [ 36 ]. Selective prevention interventions target specific populations with an increased risk of developing a disorder. Indicated prevention interventions target high-risk individuals with sub-clinical symptoms of a disorder. Secondary prevention interventions include those that target individuals diagnosed with a disorder. Finally, tertiary prevention interventions refer to follow-up interventions designed to retain treatment effects. Outcomes are therefore grouped by intervention prevention type and outcome. Within these groupings, studies with a lower risk of bias (RCTs) are presented first. According to the World Health Organisation guidelines, interventions were defined as primary, secondary or tertiary prevention [ 36 ].

Universal prevention interventions

One study reported on a universal prevention intervention targeting resilience and coping strategies in US university students. The Resilience and Coping Intervention, which includes PS as a primary component of the intervention, found a significant reduction in depression compared to TAU (RCT, N = 129, moderate risk of bias) [ 37 ].

Selective prevention interventions

Six studies, including five RCTs and one QED, tested PS as a selective prevention intervention. Two studies investigated the impact of the Manage Your Life Online program, which includes PS as a primary component of the intervention, compared with an online programme emulating Rogerian psychotherapy for UK university students (RCT, N = 213, moderate risk of bias [ 38 ]; RCT, N = 48, moderate risk of bias [ 39 ]). Both studies found no differences in depression or problem-related distress between groups.

Similarly, two studies explored the effect of adapting the Penn Resilience Program, which includes PS as a component of a more comprehensive intervention for young people with diabetes in the US (RCT, N = 264, moderate risk of bias) [ 40 , 41 ]. The initial study showed a moderate reduction in diabetes distress but not depression at 4-, 8-, 12- and 16-months follow-up compared to a diabetes education intervention [ 40 ]. The follow-up study found a significant reduction in depressive symptoms compared to the active control from 16- to 40-months; however, this did not reach significance at 40-months [ 41 ].

Another study that was part of wider PS and social skills intervention among juveniles in state-run detention centres in the US found no impacts (RCT, N = 296, high risk of bias) [ 42 ]. A QED ( N = 32) was used to test the effectiveness of a resilience enhancement and prevention intervention for runaway youth in South Korea [ 43 ]. There was a significant decrease in depression for the intervention group compared with the control group at post-test, but the difference was not sustained at one-month follow-up.

Indicated prevention interventions

Six studies, including five RCTs and one QED, tested PS as an indicated prevention intervention. Four of the five RCTs tested PS as a primary component of the intervention. A PS intervention for common adolescent mental health problems in Indian high school students (RCT, N = 251, low risk of bias) led to a significant reduction in psychosocial problems at 6- and 12 weeks; however, it did not have a significant impact on mental health symptoms or internalising symptoms compared to PS booklets without counsellor treatment at 6- and 12-weeks [ 31 ]. A follow-up study showed a significant reduction in overall psychosocial problems and mental health symptoms, including internalizing symptoms, over 12 months [ 44 ]. Still, these effects no longer reached significance in sensitivity analysis adjusting for missing data (RCT, N = 251, low risk of bias). Furthermore, a 2x2 factorial RCT ( N = 176, moderate risk of bias) testing PST among youth mental health service users with a mild mental disorder in Australia found that the intervention was not superior to supportive counselling at 2-weeks post-treatment [ 30 ]. Similarly, an online PS intervention delivered to young people in the Netherlands to prevent depression (RCT, N = 45, moderate risk of bias) found no significant difference between the intervention and WLC in depression level 4-months post-treatment [ 45 ].

One RCT tested PS approaches in a more comprehensive manualized programme for postnatal depression in the UK and found no significant differences in depression scores between intervention and TAU at 3-months post-partum (RCT, N = 292, moderate risk of bias) [ 46 ].

A study in Turkey used a non-equivalent control group design (QED, N = 62) to test a nursing intervention against a PS control intervention [ 47 ]. Both groups showed a reduction in depression, but the nursing care intervention demonstrated a larger decrease post-intervention than the PS control intervention.

Secondary prevention interventions

Twelve studies, all RCTs, tested PS as a secondary prevention intervention. Four of the 12 RCTs tested PS as a primary component of the intervention. An intervention among women in Zimbabwe (RCT, N = 58, moderate risk of bias) found a larger decrease in the Edinburgh Postnatal Depression Scale score for the intervention group compared to control (who received the antidepressant amitriptyline and peer education) at 6-weeks post-treatment [ 48 ]. A problem-orientation intervention covering four PST steps and involving a single session video for US university students (RCT, N = 110, moderate risk of bias), compared with a video covering other health issues, resulted in a moderate reduction in depression post-treatment; however, results were no longer significant at 2-weeks, and 1-month follow up [ 49 ].

Compared to WLC, a study of an intervention for depression and suicidal proneness among high school and university students in Turkey (RCT, N = 46, moderate risk of bias) found large effect sizes on post-treatment depression scores for intervention participants post-treatment compared with WLC. At 12-month follow-up, these improvements were maintained compared to pre-test but not compared to post-treatment scores. Significant post-treatment depression recovery was also found in the PST group [ 12 ]. Compared to TAU, a small but high-quality (low-risk of bias) study focused on preventing suicidal risk among school students in Brazil (RCT, N = 100, low risk of bias) found a significant, moderate reduction in depression symptoms for the treatment group post-intervention that was maintained at 1-, 3- and 6-month follow-up [ 50 ].

Seven of the 12 RCTs tested PS as a part of a more comprehensive intervention. Two interventions targeted mood episodes and were compared to active control. These US studies focused on Family-Focused Therapy as an intervention for mood episodes, which included sessions on PS [ 51 , 52 ]. One of these found that Family-Focused Therapy for AYA with Bipolar Disorder (RCT, N = 145, moderate risk of bias) had no significant impact on mood or depressive symptoms compared to pharmacotherapy. However, Family-Focused Therapy had a greater impact on the proportion of weeks without mania/hypomania and mania/hypomania symptoms than enhanced care [ 53 ]. Alternatively, while the other study (RCT, N = 127, low risk of bias) found no significant impact on time to recovery, Family-Focused Therapy led to significantly longer intervals of wellness before new mood episodes, longer intervals between recovery and the next mood episode, and longer intervals of randomisation to the next mood episode in AYA with either Bipolar Disorder (BD) or Major Depressive Disorder (MDD), compared to family and individual psychoeducation [ 52 ].

Two US studies used a three-arm trial to compare Systemic-behavioural Family Therapy (SBFT) with elements of PS, to CBT and individual Non-directive Supportive therapy (NST) (RCT, N = 107, moderate risk of bias) [ 53 , 54 ]. One study looked at whether the PS elements of CBT and SFBT mediated the effectiveness of these interventions for the remission of MDD. It found that PS mediated the association between CBT, but not SFBT, and remission from depression. There was no significant association between SBFT and remission status, though there was a significant association between CBT and remission status [ 53 ]. The other study found no significant reduction in depression post-treatment or at 24-month follow-up for SBFT [ 54 ].

A PS intervention tested in maternal and child clinics in Nigeria RCT ( N = 686, moderate risk of bias) compared with enhanced TAU involving psychosocial and social support found no significant difference in the proportion of women who recovered from depression at 6-months post-partum [ 55 ]. However, there was a small difference in depression scores in favour of PS averaged across the 3-, 6-, 9-, and 12-month follow-up points. Cognitive Reminiscence Therapy, which involved recollection of past PS experiences and drew on PS techniques used for 12-25-year-olds in community mental health services in Australia (RCT, N = 26, moderate risk of bias), did not reduce depression symptoms compared with a brief evidence-based treatment at 1- or 2-month follow-up [ 56 ]. Additionally, the High School Transition Program in the US (RCT, N = 497, moderate risk of bias) aimed to prevent depression, anxiety, and school problems in youth transitioning to high school [ 57 ]. There was no reduction in the percentage of intervention students with clinical depression compared to the control group. Similarly, a small study focused on reducing depression symptoms, and nonadherence to antiretroviral therapy in pregnant women with HIV in South Africa (RCT, N = 23, some concern) found a significant reduction in depression symptoms compared to TAU, with the results being maintained at the 3-month follow-up [ 58 ].

Reduction in suicidality

Three studies measured a reduction in suicidality. A preventive treatment found a large reduction in suicidal orientation in the PS group compared to control post-treatment. In contrast, suicidal ideation scores were inconsistent at 1-,3- and 6- month follow-up, they maintained an overall lower score [ 50 ]. Furthermore, at post-test, significantly more participants in the PS group were no longer at risk of suicide. No significant differences were found in suicide plans or attempts. In a PST intervention, post-treatment suicide risk scores were lower than pre-treatment for the PST group but unchanged for the control group [ 12 ]. An online treatment found a moderate decline in ideation for the intervention group post-treatment compared to the control but was not sustained at a one-month follow-up [ 49 ].

Mediators and moderators

Eight studies measured PS skills or effectiveness. In two studies, despite the interventions reducing depression, there was no improvement in PS abilities [ 12 , 52 ]. One found that change in global and functional PS skills mediated the relationship between the intervention group and change in suicidal orientation, but this was not assessed for depression [ 50 ]. Three other studies found no change in depression symptoms, PS skills, or problem resolution [ 38 – 40 ]. Finally, CBT and SBFT led to significant increases in PS behaviour, and PS was associated with higher rates of remission across treatments but did not moderate the relationship between SBFT and remission status [ 53 ]. Another study found no changes in confidence in the ability to solve problems or belief in personal control when solving problems. Furthermore, the intervention group was more likely to adopt an avoidant PS style [ 46 ].

A high-intensity intervention for perinatal depression in Nigeria had no treatment effect on depression remission rates for the whole sample. Still, it was significantly effective for participants with more severe depression at baseline [ 55 ]. A PS intervention among juvenile detainees in the US effectively reduced depression for participants with higher levels of fluid intelligence, but symptoms increased for those with lower levels [ 42 ].The authors suggest that individuals with lower levels of fluid intelligence may have been less able to cope with exploring negative emotions and apply the skills learned.

This review has examined the evidence on the effectiveness of PS in the prevention or treatment of depression among 13–25-year-olds. We sought to determine in what way, in which contexts, and for whom PS appears to work in addressing depression. We found 25 studies involving 20 interventions. Results are promising for secondary prevention interventions, or interventions targeting clinical level populations, that utilize PS as the primary intervention [ 12 , 47 – 49 ]. These studies not only found a significant reduction in depression symptoms compared to active [ 48 , 49 ] and non-active [ 12 , 47 ] controls but also found a significant reduction in suicidal orientation and ideation [ 12 , 47 , 49 ]. These findings are consistent with meta-analyses of adult PS interventions [ 21 , 22 , 23 ], highlighting that PS interventions for AYA can be effective in real-world settings.

For other types of interventions (i.e., universal, selective prevention, indicated prevention), results were mixed in reducing depression. The one universal program was found to have a small, significant effect in reducing depression symptoms compared to a non-active control [ 37 ]. Most selective prevention programs were not effective [ 39 , 40 , 56 ], and those that did show small, significant effects had mixed outcomes for follow-up maintenance [ 41 , 42 ]. Most indicated prevention programs were not effective [ 30 , 31 , 45 – 47 ], yet a follow-up study showed a significant reduction in internalizing symptoms at 12-month post-treatment compared to an active control [ 44 ]. Given that these studies targeted sub-clinical populations and many of them had small sample sizes, these mixed findings may be a result of not having sufficient power to detect a meaningful difference.

Our review found limited evidence about PS skills as mediator or moderator of depression. Few studies measured improvements in PS skills; fewer still found interventions to be effective. The absence of evidence for PS abilities as a pathway is puzzling. It may be that specific aspects of PS behaviours and processes, such as problem orientation [ 59 ], are relevant. Alternatively, there may be a mechanism other than PS skills through which PS interventions influence depression.

Studies with PS as part of a wider intervention also showed mixed results, even amongst clinical populations. Although there was no clear rationale for the discrepancies in effectiveness between the studies, it is possible that the wider program dilutes the focus and impact of efficacious therapeutic elements. However, this is difficult to discern given the heterogeneity in the studies and limited information on study treatments and implementation factors. A broad conclusion might be that PS can be delivered most effectively with clinical populations in its purest PS form and may be tailored to a range of different contexts and forms, a range of populations, and to address different types of problems; however, this tailoring may reduce effectiveness.

Although the scale of impact is broadly in line with the small to moderate effectiveness of other treatments for youth depression [ 6 ], our review highlights shortcomings in study design, methods, and reporting that would allow for a better understanding of PS effectiveness and pathways. Studies varied in how well PS was operationalised. Low dosage is consistent with usage described in informal conversations with practitioners but may be insufficient for effectiveness. Fidelity was monitored in only half the studies despite evidence that monitoring implementation improves effectiveness [ 60 ]. There were references to implementation difficulties, including attrition, challenges in operationalizing online interventions, and skills of those delivering. Furthermore, most of the studies had little information about comorbidity and no analysis of whether it influenced outcomes. Therefore, we were unable to fully examine and conceptualize the ways, how and for whom PS works. More information about study populations and intervention implementation is essential to understand the potential of PS for broader dissemination.

Our review had several limitations. We excluded studies that included four treatments known to be effective in treating depression among AYA (e.g., CBT) but where the unique contribution of PS to clinical outcome could not be disentangled. Furthermore, we relied on authors’ reporting to determine if PS was included: details about operationalization of PS were often scant. Little evidence addressing the fit, feasibility, or acceptability of PS interventions was found, reflecting a limited focus on implementation. We included only English-language texts: relevant studies in other languages may exist, though our post-2000 inclusion criteria may limit this potential bias due to improved translation of studies to English over the years. Finally, the heterogeneity of study populations, problem severity, comparison conditions, outcome measures, and study designs, along with a relatively small number of included studies, limits confidence in what we can say about implementation and treatment outcomes.

Overall, our review indicates that PS may have the best results when implemented its purest form as a stand-alone treatment with clinical level AYA populations; tailoring or imbedding PS into wider programming may dilute its effectiveness. Our review also points to a need for continued innovation in treatment to improve the operationalizing and testing of PS, especially when included as a part of a more comprehensive intervention. It also highlights the need for study methods that allow us to understand the specific effects of PS, and that measure the frequency, dosage, and timing of PS to understand what is effective for whom and in what contexts.

Supporting information

Acknowledgments.

All individuals that contributed to this paper are included as authors.

Funding Statement

This work was commissioned by Wellcome Trust and was conducted independently by the evaluators (all named authors). No grant number is available. Wellcome Trust had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript. The authors declare no financial or other competing interests, including their relationship and ongoing work with Wellcome Trust. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Data Availability

• PLoS One. 2023; 18(8): e0285949.

Decision Letter 0

PONE-D-23-00042Problem-solving interventions and depression among adolescents and young adults: A systematic review of the effectiveness of problem-solving interventions in preventing or treating depression among 13-25-year-oldsPLOS ONE

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Reviewer #1: Thank you for providing a very well-written, clear, and detailed manuscript of a very interesting and worthwhile study. It was a pleasure to read and I commend you on your work. I have only a few minor comments which are mostly just points of proofreading:

- Some abbreviations in Table 1 are either not detailed before usage here, or in fact aren't expanded upon at all. Please check and detail abbreviations in your notes section (namely PST, PCT, PST-PC, NST, DSM). I recognise that readers may be familiar with some of these or could hazard a well-educated guess, but for ease of readability and for clarity it would be beneficial to amend this.

- It would be beneficial, if possible from your data, to add more detail about the ages of participant in Table 1, or to provide more details in your results section. You explained that some studies included under 13s and/or over 25s, but it is unclear which studies did so. It would also help the reader to assess the included literature more effectively if the mean/median age of participants (as per your inclusion criteria) was noted in the table.

- Lines 200-202 are unclear and confusing to read

- While I recognise the need for your review, I'm not entirely sold on your research question by your introduction section. Particularly, why you have chosen this specific intervention for this population. It may be beneficial to expand on the final paragraph (lines 83-95).

- It may be beneficial to also add your thoughts on what your results mean for clinical practitioners in your discussion. You provide some good recommendations for research, but general expansion here would be helpful.

These are the only minor edits I see as being required as your paper is strong. The results and conclusion are well written and thorough. Thank you also for providing detailed supplementary materials.

Best of luck with your ongoing work

Reviewer #2: The systematic review summarizes 25 studies concerning the efficacy of problem-solving interventions for preventing or treating depression. The topic is thoroughly examined, and the results provide insight into the development of evidence-based interventions and the enhancement of mental health outcomes for adolescents and young adults.

I have some minor concerns which I will elaborate on below:

1. The use of "13-25 years olds" in the title can be misleading as it implies a full age range rather than the mean or median age.

Introduction:

2. While the introduction is logically structured, it would be beneficial to introduce problem-solving (PS) as a technique for depression treatment early on. PS intervention is a key concept, yet it is not mentioned until the last paragraph.

3. The rationale for focusing on the effect of PS interventions on depression needs further clarification. What makes PS a more relevant technique than other techniques? I agree that maladaptive PS is associated with depressive symptoms (line 84), while the construct of PS as a coping strategy may be different from PS as an intervention technique.

4. The relationship between PS technique and evidence-based treatments is slightly confusing. EBTs such as CBT have shown small to moderate effects in preventing and treating depression (line 66), so emphasis might move to discrete treatment techniques such as PS (line 75). However, PS is usually a component of CBT, a technique used in multiple sessions. What might account for a part of the therapy being more effective than the entire therapy?

5. Line 90 refers to the complex relationship between PS and depression. Although details can be found in the results section, it would be clearer to provide a specific explanation here for “complex.”

Discussion:

6. In line 381, the authors “sought to determine in what way, in which contexts, and for whom PS appears to work in addressing depression.” However, outcomes are not discussed by context or study population. Studies conducted among students could differ from those conducted among peripartum women. Did the comparisons between contexts/populations bring forth any conclusions?

7. Among studies that found a significant reduction in depression, some reported that the effect was not sustained (e.g., line 262, line 268, line 302) while others reported the opposite (e.g., line 311, line 350). Is there a possible explanation for this discrepancy?

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Reviewer #2:  Yes:  Tianyue Mi

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Author response to Decision Letter 0

24 Apr 2023

See below. Also replicated in the "Response to Reviewers" document.

Thank you to the two reviewers for their thoughtful and comprehensive review of our manuscript. We have carefully considered all the comments and made requested modifications. As a result, we believe that the manuscript is improved.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #1: N/A

Response to Reviewer 1 comments:

Reviewer #1: Thank you for providing a very well-written, clear, and detailed manuscript of a very interesting and worthwhile study. It was a pleasure to read and I commend you on your work. I have only a few minor comments which are mostly just points of proofreading:

Thank you for your keen eye and this suggestion. We have updated the manuscript to ensure that all acronyms in the table are in the notes section.

Thank you for this suggestion. We have added this information into the Table 1 under the “study population” information.

Thank you for this feedback. We have adjusted the sentence to hopefully increase comprehension. Please let us know if the sentence (now lines 198-199) is still unclear and/or confusing to read.

Thank you for this feedback. We have re-worked the introduction section to include more information on PS and its potential as an active ingredient for AYA depression treatment. Please see lines 71-94.

Thank you for this feedback. We have summarized the recommendations more clearly at the end of the paper. Please see lines 436-437 for clinical implications.

Thank you so much for the thorough and thoughtful review. We believe your comments aided to the creation of an improved manuscript.

Response to Reviewer 2 comments:

Reviewer #2: The systematic review summarizes 25 studies concerning the efficacy of problem-solving interventions for preventing or treating depression. The topic is thoroughly examined, and the results provide insight into the development of evidence-based interventions and the enhancement of mental health outcomes for adolescents and young adults.

Thank you for this suggestion. We have edited the title to only include the reference to adolescents and young adults to be more fitting.

Thank you for this feedback. We have re-worked the introduction section to have PS introduced earlier in the introduction.

Thank you for this feedback. We have re-worked the introduction section to include more information on background treatments using PS amongst adults and its potential as an active ingredient for AYA depression treatment. Please see lines 71-94.

Thank you for this feedback and question. We have added information to the manuscript that discusses a meta-analysis on PS within adult populations that found Problem Solving Therapy (PST) to be as effective as CBT and IPT, and more effective than WLC. We have additionally added information around the potential benefits of distilling common elements with this AYA population. Please see lines 71-94.

Thank you for this feedback and question. Due to all the additional PS information added to the introduction, we removed this statement and only addressed in the discussion section.

Thank you for this feedback and question. Unfortunately, due to the heterogeneity in the study samples and settings as well as limited implementation factors discussed in the publications, these factors were unable to be explored. I added this limitation to lines 412-423.

Thank you for this question. Unfortunately, the heterogeneity of study populations, problem severity, comparison conditions, outcome measures, and study designs, along with a relatively small number of included studies, limits confidence in what we can say about implementation and treatment outcomes. This includes an explanation for the discrepancies in sustained effects.

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Reviewer #1: No

Reviewer #2: Yes: Tianyue Mi

Submitted filename: Response to Reviewers.docx

Decision Letter 1

PONE-D-23-00042R1

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Thiago P. Fernandes, PhD

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Acceptance letter

11 May 2023

Dear Dr. Metz:

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Math Interventions

• Introduction
• Subitizing Interventions
• Counting Interventions: Whole Numbers Less Than 30
• Counting Interventions: Whole Numbers Greater Than 30 (Place Value)
• Counting Interventions: Fractions
• Counting Interventions: Decimals
• Composing and Decomposing Numbers Interventions
• Rounding Interventions
• Number Sense Lesson Plans
• Addition and Subtraction Facts
• Multiplication and Division Facts
• Computational Fluency Lesson Plans
• Understanding the Problem Interventions

Understanding the Problem

Response to error: understanding the problem, feedback during the lesson, strategies to try after the lesson.

• Planning and Executing a Solution Interventions
• Monitoring Progress & Reflecting on a Solution Interventions
• Problem-Solving Process Interventions
• Problem-Solving Lesson Plans
• Identifying Essential Variables Interventions
• Direct Models Interventions
• Counting On/Back Interventions
• Deriving Interventions
• Interpreting the Results Interventions
• Mathematical Modeling Lesson Plans
• Math Rules and Concepts Interventions
• Math Rules and Concepts Lesson Plans

Understanding the problem is the first step in problem-solving. During this step, the student must be able to describe the problem and check his own understanding by talking it through and asking questions as he goes. This page includes intervention strategies that you can use to support your students in this area. As you read, consider which of these interventions best aligns with your student's strengths and needs in the whole-learner domains.

Explicit Instruction

If you are intervening to support your students' ability to understand the problem, you should start by explicitly teaching the skill. This sounds like:

• Explain the Skill/Concept.  Define understanding the problem, and explain the activity. ( "The first step to problem-solving is to make sure we understand what the problem is asking us. We do this by talking through it to make sure we understand all of the pieces. We can also ask ourselves questions about what is happening or what we're trying to figure out." "Today we are going to learn how to think through a problem to help us understand it."  )
• Model Skill with Examples.  Think aloud about talking through a problem to check for understanding.  ( "Listen as I read this probl em and make sure that I'm understanding what's happening . I'm going to read each sentence and make sure I understand what it is about. The problem is: The boy had one apple... okay, so the boy had an apple.  The girl had two apples: T his sentence tells me that the girl had two apples, which is more than the boy had. How many apples did they have together? The problem wants to know how many apples they had total, or together. I think that means I need to add up the amount that the boy has and the amount that the girl has . Now I understand what the problem is asking me." )
• Model Skill with Non-Examples.  Think aloud about using this strategy ineffectively. ( "Now, I'm going to show you how I make a mistake and read a problem without making sure that I understand all of the parts. The boy had one apple. The girl had two apples. How many apples did they have together? The problem tells me that there is a boy and a girl in the story. They were eating apples together. But wait a second! I don't know what I'm trying to figure out! I only paid attention to certain parts of the story, and now I'm not set up to solve the problem. That's why we need to make sure to think through all of the parts of a story." )
• Practice the Skill.  Engage in one or more of the activities below to practice the skill with your student, providing feedback as necessary. ( "Now you try. I'm going to give you a problem ..." )

Activity A: Teach Comprehension, Not Key Words

If the student is in the habit of underlining key words in a story or appears to be  misunderstanding what a problem is asking because she is over attending to certain words in the story without trying to read and understand the problem holistically, teach this strategy. Teaching students to search for key words is not a recommended intervention strategy; therefore, it's important to intervene if you are working with a student who has been taught to attack word problems in this way . Burns (2007) writes, "Instruction of this type does little more than offer children tricks to find answers. Even worse, the implication is that getting the answer is most important and that relying on tricks is an effective strategy for finding those answers. This often results in children looking for tricks, rather than trying to make sense out of problems."  Teach Comprehension, Not Key Words, helps students understand that, in order to solve a real-world problem, you need to understand the whole story.

Teach Comprehension, Not Key Words in Action Tell the student who pulls out key words from the story that he'll be learning a better way to understand the story. Then, model thinking through the story, and ask how that type of understanding is different from just picking out key words. The below example refers to the following problem: There were some birds on the telephone wire; 3 flew away, and now there are 9 on the wire and 3 on the tree. How many birds were on the wire before any flew away?

Teacher: Watch as I think through this story to make sure I understand: There were some birds on the telephone wire  Okay, I get that. There were birds sitting on a wire. 3 flew away, now there are 9 on the wire and 3 on the tree —  Three of the birds flew away, which means that there were probably more than three to begin with. There are now nine left on the wire. Okay, so three flew away, and nine are still on the wire. The three that flew away are now on the tree. Okay, so there are still nine on the wire. 

How many birds were on the wire before any flew away?  So, the problem wants to me to figure out how many were there in the first place, before the 3 flew away. I understand what I have to do.

Teacher: Now, you try it!

Activity B: Unpack the Problem

If your student struggles to understand the context of the story problem, teach Unpack the Problem (Carpenter et al., 2015). This strategy helps a student to think through the story elements in the problem, and to consider the problem as a whole, rather than merely its component parts. 

Unpack the Problem in Action As you read the scenario below, sourced from Carpenter et al. (2005), consider: What guiding questions does the teacher use to help the student unpack the problem?

UnpacktheProblem.pdf

Carpenter, T. P., Fennema, E., Franke, M.L., Levi, L., & Empson, S. B. (2015). Children's mathematics: Cognitively guided instruction. Portsmouth, NH: Heinemann.

Activity C: Reread and Retell

If your student is struggling to understand the story, teach him to Reread and Retell. In this strategy, the student rereads the story multiple times and then tries to tell the story in his own words, without looking back. Another variation of this strategy is for the teacher to reread the story (or teacher/student choral read the story multiple times) and then the student tells the story in his own words, without looking back.

Reread and Retell in Action The below example refers to the following problem.

There were some birds on the telephone wire; 3 flew away, and now there are 9 on the wire and 3 on the tree. How many birds were on the wire before any flew away? Teacher: Reread this story, and tell me what it is says in your own words.

Student reads story three times: Well, it tells me that there were some birds that were just hanging out on those wire things that are above the street. Then a couple of them, actually 3 of them, left the wire. But, there were still 9 there. The problem is asking me how many were there before the first 3 left. 

Burns, M. (2007). About Teaching Mathematics: A K-8 Resource. Sausalito, CA: Math Solutions Publications. 

Think about the following scenario, which takes place after a teacher has explicitly taught a student to check his understanding of the problem below. 

There were some birds on the telephone wire; 3 flew away, and now there are 9 on the wire and 3 on the tree. How many birds were on the wire before any flew away?

     Teacher: "Talk through the problem, and ask yourself questions as you go. This will help      you make sure you understand the problem before you plan a strategy for solving it."      Student: "It's ok. I get it. It's about birds on a telephone wire, and then some flew away."      Teacher: "It sounds like you understand the characters in the problem, but do you      understand the quantities or what the problem is asking you to figure out ? You need to      make sure you understand all parts of the problem in order to solve it."            Student: "Sure, it says right here, "How many birds were on the wire before any flew      away?"     In such a case, what might you do? 

When you are planning your lessons, you should anticipate that your student will make errors throughout. Here are a series of prompts that you can use to respond to errors. Keep in mind that all students are different, and that students might respond better to some types of feedback than others.

If your student struggles to meet your objective, there are various techniques that you might try to adjust the activity to your student's needs. 

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Discover and empower student innovators - desi in public schools.

Nurture problem-solving capacity in the next generation of students in India’s underserved schools

Future-readiness (i.e creativity, innovation & problem solving) is currently not prioritized but is essential for students’ success as thriving individuals and meaningful contributors to their surroundings. Over the course of our intervention, we build these skills that are core to inculcating problem solving capacity. We work with government institutions for foundational and advanced programs.

HundrED shortlisted this innovation

HundrED has shortlisted this innovation to one of its innovation collections. The information on this page has been checked by HundrED.

About the innovation

Problem-solving, creativity and innovation are crucial skills and abilities which our students need to develop to thrive in this volatile, uncertain, complex and ambiguous world. The OECD Report, the pandemic and India’s own National Education Policy recognize that while these skills are important, they are not prioritized by our schools. We developed a scalable model to address this crucial need.

Through our foundational programs based on Human Centred Design (Design Thinking), we enable the students to work on ideas of their choice, by practising important Problem Solving skills and mindsets. Over the course of our intervention (25 hours spread across the year), we build these skills that are core to inculcating problem solving capacity. Through bootcamps and mentorship, they turn these solutions into prototypes that are showcased to their peers and members from their community. To realise this, we run programs that are developed for in-person and online deployment. Since our inception 6 years ago, we have reached more than 400,000 students, generating over 100,000 ideas

The advanced programs encourage select students to further develop their prototypes into products that can bring about a change in the lives of people around them. We focus on advanced skills and mindsets and connect the students with experts from the field to mentor them further.

Our model has an in person and a hybrid model of intervention. The in-person model started with a pilot in 2 schools in 2017 and is presently active in 74 schools in Telangana, India. This has been in partnership with the Dept of Social and Tribal Welfare, Government of Telangana. The hybrid model was piloted in 4000 schools in 2020 and has currently been implemented in over 41,000 schools, reaching more than 500,000 students in three countries. This program is in partnership with YuWaah, state governments and the Central Government’s Atal Innovation Mission in India and with UNICEF and the Ministries of Education in Maldives and Bhutan.

Our innovation is a curriculum that works with schools and has a system level model. We can make it available on request to explore.

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10.1.1: Interventions and Problem Solving

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Social issues impair social functioning and negatively impact the lives of individuals, groups, and organizations (Bruhn and Rebach 2007). People effected by a particular social issue may face a variety of obstacles and challenges associated with the problem including labeling, stigma, discrimination, and isolation. Sociological practitioners work to address the problem by changing the social setting, arrangement, norms, and behaviors surrounding the issue and the people involved. A sociological practitioner may serve as the facilitator of this social change, a broker by acting on the behalf of others for change, or a clinician by providing direct services or help to change the situation of individuals and families.

There are six approaches most commonly used by sociological and other professional practitioners, communities, and clients to address social problems and create change. To resolve or improve situations, different problems require different approaches based on the client needs and social resources available to them. Each sociological approach incorporates a different level of analysis to assess the problem with a specific focal area of intervention. When social change requires different levels of analysis, sociological approaches must identify and explore multiple solutions across continuums. Not all approaches result in an expeditious solution. Sociological approaches and interventions take planning and time to implement and can take years to gain permanent change or improve people’s lives.

Process of Intervention

Regardless of approach, sociologists follow an incremental process of intervention to remedy a social problem. Each sociological approach includes a process of intervention that includes an assessment, planning, implementation, and evaluation phase. There are no timelines of completion defined within each phase. Rather the sociological practitioner, clients, and other impacted individuals or groups set deadlines and completion parameters based on context and need.

The first phase examines the social problem and needs of those it impairs. This is an investigative stage to gather information and understand the situation to define the problem (Bruhn and Rebach 2007). A sociological practitioner must first identify the presenting problem and client(s). The presenting problem refers to the client’s perspective of the problem as they see it in their own words (Bruhn and Rebach 2007). The assessment is a discovery phase of the history and evolution of the problem within the geographic region to find out who is seeking help and why. The assessment also helps determine the role or involvement of the sociological practitioner in the intervention.

An assessment is a case study guided by the nature of the problem and clients (Bruhn and Rebach 2007). Data collection may include interviews, focus groups, surveys, and secondary analysis (e.g., analytic data, educational records, criminal records, medical files, etc.). Findings and results are presented and discussed with clients and other involved parties to formulate solutions and objectives of intervention.

The next stage in the process is to plan the steps for achieving intervention objectives. The plan is a formal (written) agreement among interventionists (including the sociological practitioner) and client(s) outlining the objectives and roles and responsibilities of each person involved. The plan will include observable, measurable objectives that include: 1) subject and verb stating the condition to achieve, 2) amount or percentage of reduction or improvement of the condition, and 3) timeframe or deadline for completion (Bruhn and Rebach 2007). Both process and outcome objectives must be delineated in the plan. Process objectives will focus on program operations or services, and outcome objectives concentrate on the results of the intervention against baseline data (i.e., data collected prior to intervention). Interventionists and clients work together to develop a plan so everyone has an equal voice and understanding of their duties, obligations, and work to complete in the implementation phase.

Consider a social problem you would like to address in your community. Conduct secondary analysis of the issue to identify the presenting problem, clientele, and existing community services. Explore nonprofit and public agencies in your community working on the problem you chose to help you gather information.

After completing your analysis, draft four observable, measurable objectives of intervention for the problem and population you wish to address. Two objectives must focus on process and two on outcomes. All outcomes must include a verb and subject stating the condition to achieve, amount or percentage of reduction or improvement of the condition, and timeframe or deadline for completion.

The third phase in the process centers on implementation. In this stage, the plan commences according to the steps outlined in the formal agreement. Implementation puts the plan into action by following the proposed sequence and schedule. This phase engages strategies in order to accomplish objectives. For example, solving chronic poverty in your community might require employing several strategies such as improving K-12 education, increasing higher education enrollments and job skills training, providing access to health care, and developing employment opportunities. During the implementation phase, interventionists and collaborators will initiate and work on each strategy for change.

The final phase in the process of intervention is evaluation. Sociologists use evaluation to find out if a program, service, or intervention works (Steele and Price 2008). There are two types of evaluation. A process or formative evaluation gathers information to help improve or change a program, service, or intervention. Did everything occur and work according to plan? Sociological practitioners work with clients to determine program strengths, weaknesses, and areas of improvement to strengthen or adapt the program (Steele and Price 2008). An outcome or summative evaluation measures the impact of the program, service, or intervention on clients or participants. Were benchmarks achieved or changes made? Practitioners measure changes in clients over the duration of their participation from start to completion. The impact evaluation determines if change occurred, any unintended outcomes, and the long-term effects.

Evaluation is an ongoing task tracking program progress from beginning to end (Bruhn and Rebach 2007). Interventionists and practitioners must monitor the program continuously to ensure the service or intervention is advancing toward change, and adjustments or alternatives are deployed to increase effectiveness in a timely manner. The goal of evaluation is to know why a program, service, or intervention succeeded or failed to reform or adapt present and future support and solutions. Evaluation is a mechanism of continual improvement by regularly providing information and identifying unintended consequences.

Evaluation requires both quantitative and qualitative data (see page 5) using a variety of data collection methods and tools to gather information (e.g., tests, questionnaires, archival data, etc.). Data collection tools vary from program to program, sometimes tools exist to conduct an evaluation, and other times practitioners must develop them (Viola and McMahon 2010). Practitioners lead in the development of data collection protocols, tools, and instruments for review by participants (e.g., clients and community members) before they are ready to use.

As a contributing member of an evaluation team, sociological practitioners (see page 3) must be aware of role-conflict . It is imperative to avoid role-conflict in a participatory evaluation model. In other words, practitioners must be aware of their role within the evaluative context or situation as to whether one is serving as a researcher, practitioner, or interventionist (i.e., clinical sociologist). It is difficult to implement the scientific method (process and procedures) in the field within the standards of academic research when serving as a practitioner (Bruhn and Rebach 2007). Sociological practitioners or interventionists do not always have control over the evaluation research, study environment, or time to complete an evaluative study as prescribed by the scientific method.

The Workforce Internship Networking (WIN) Center at West Hill College Lemoore in California connects and supports students and alumni by providing employment, occupational readiness, and job placement information and resources to advance personal career goals. The WIN Center provides a space for employers and students to connect. At the WIN Center, students and alumni receive skills training, employment and internship application assistance, and support in creating a professional profile.

• Describe why it might be important to evaluate the WIN Center.
• Considering the importance of evaluating college campus programs, how often would you recommend evaluating the WIN Center’s programs and services? What should the evaluation examine?
• What role could program monitoring play in the overall evaluation of the WIN Center?
• If you were responsible for overseeing program monitoring and the evaluation of the WIN Center, what data would you collect to assess its impact?

In addition, evaluations may cause tension between practitioners (interventionists) and evaluation associates. Interventionists are responsible for providing data and keeping records while implementing program activities. Conflicting demands for an interventionists’ time and energy during the program implementation process may lead to a delay in gathering and sharing data with evaluators. Evaluation is not always equally valued, and some interventionists may consider evaluation unimportant or a threat to their work or process resulting in uncooperative behavior or interest.

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Ny IMM-avhandling om problemlösningsintervention vid sjukskrivning

Välkommen till Ida Karlssons disputation på avhandlingen ”A problem-solving intervention for employees on sickness absence due to common mental disorders : effects, ethics and process ” den 14 juni.

Tid: 14 juni kl. 9.00 Plats: Rockefeller (Nobels väg 11, entréplan). Karolinska Institutet, Solna Handledare: Elisabeth Björk Brämberg, senior forskare, Institutet för miljömedicin (IMM) Opponent: Professor Evelien Brouwers, Dept. of Tranzo/Scientific Center for Care and Wellbeing, Div. of Tilburg School for Social and Behavioural Sciences, Tilburg University

Tre frågor till Ida

Vad handlar avhandlingen om?

Avhandlingen utvärderar en problemlösningsintervention i kombination med arbetsgivarinvolvering. Interventionen gavs av rehabiliteringskoordinatorer vid primärvården i Sverige till anställda som var sjukskrivna på grund av depression, ångest eller stress. Interventionen jämfördes med vanlig vård i en randomiserad kontrollerad studie. Fyra studier rapporteras i denna avhandling. Den första studien var en effektutvärdering som undersökte antal sjukfrånvarodagar för interventions- och kontrollgruppen under en 18-månaders uppföljningsperiod. Den andra studien undersökte möjliggörande och hindrande faktorer för att delta i interventionen. Den tredje studien undersökte etiska utmaningar som potentiellt kan uppstå vid deltagande i interventionen. Den fjärde studien utvärderade processutfall.

Kan du berätta om några intressanta resultat?

Anställda i interventionsgruppen deltog i fler sessioner med koordinatorn och fler möten med sin chef, trots detta hade kontrollgruppen en liknande minskning av sjukfrånvarodagar över tid. Vi behöver förstå mer om varför vi inte såg någon skillnad mellan interventions- och kontrollgruppen. Den liknande minskningen i sjukfrånvarodagar kan bero på bristande kontrast mellan interventions- och kontrollgruppen och det svenska sjukförsäkringssystemet som utvärderar de anställdas rätt till sjukfrånvaro vid specifika tidpunkter. 

I intervjuerna med koordinatorer, anställda och chefer rapporterades att interventionens struktur underlättade rehabiliteringsprocessen. Vidare rapporterade de anställda att det var möjliggörande att lära sig identifiera problem och lösningar för att återgå till arbetet, men interventionen var mer tidskrävande än vanlig vård och beroende av goda relationer. Etiska utmaningar identifierades på organisatorisk nivå, i form av skillnader mellan sjukvårdens och arbetsplatsens mål och värderingar, och på individnivå, vad gäller osäkerhet kring hur mycket information man vill dela med sin chef samt oklara roller för koordinatorn och chefen. Vi rekommenderar att koordinatorerna blir medvetna om dessa utmaningar för att kunna stödja anställda och chefer under rehabiliteringsprocessen. 

Vilken ytterligare forskning behövs inom området?

• Vi behöver förstå mer om vilken kombination av insatser som stödjer anställda att återgå till arbete.
• Vi behöver utforska implementeringsstrategier som kan stärka följsamheten till de olika stegen i interventionen.
• Vi behöver också en bättre förståelse för vilken grupp av anställda som behöver stöd med att återgå till arbetet. Denna kunskap skulle kunna stödja primärvården i att fördela sina resurser.

Läs avhandlingen här