Depression in Homebound Older Adults: Problem-Solving Therapy and Personal and Social Resourcefulness

The goal of problem-solving therapy is to teach patients systematic coping skills. For many homebound older adults, coping skills must also include both personal and social (help-seeking) resourcefulness. This study aimed to examine the relationship between perceived resourcefulness and depressive symptoms at postintervention and potential mediating effect of the resourcefulness among 121 low-income homebound older adults who participated in a pilot randomized controlled trial testing feasibility and preliminary efficacy of telehealth-PST. Resourcefulness Scale for Older Adults was used to measure personal and social resourcefulness. Only personal resourcefulness scores were significantly associated with depression outcomes at postintervention, and neither resourcefulness scores were significantly associated with group assignment. Analysis found no mediation effect of resourcefulness. The findings call for further research on potential mediators for the potentially effective depression treatment that could be sustained in the real world for low-income homebound older adults who have limited access to psychotherapy as a treatment modality.     

Behavioral Correlates of Self-Appraised Problem-Solving Ability: Problem-Solving Skills and Health-Compromising Behaviors

According to the revised social problem-solving model, problem solving skills should be associated with cognitive and behavioral attempts to solve or prevent personal problems. We reasoned that the Approach-Avoidance scale on the Problem-Solving Inventory (PSI; Heppner, 1988) measures problem-solving skills as defined in the model, and predicted that scores on this factor would be predictive of health-compromising behaviors among 96 undergraduate students. An aspect of the problem-orientation component would be predictive of global health perceptions. Ineffective problem-solving skills were associated with greater alcohol intake over a 2-week period, and with more sedentary leisure behavior on retrospective and prospective measures. Perceived control over emotions was predictive of health perceptions, as hypothesized. However, elements of problem solving were unrelated to tobacco use, illicit drug use, and exercise behaviors.     

A Task-Shifting Problem-Solving Therapy Intervention for Depression and Barriers to Antiretroviral Therapy Adherence for People Living With HIV in Zimbabwe: Case Series

HIV is prevalent in Sub-Saharan Africa, and depression frequently co-occurs. Depression is one of the most important predictors of poor adherence to antiretroviral therapy (ART). Little has been done to develop integrated interventions that are feasible and appropriate for task-shifting to nonspecialists that seek to address both depression and barriers to ART adherence in Sub-Saharan Africa.This case series describes an integrated intervention for depression and ART adherence delivered by a lay adherence counselor and supervised by a local psychologist. The 6-session intervention was based on problem-solving therapy for depression and for barriers to adherence (PST-AD), with stepped care for those whose depression did not recover with PST-AD. Primary outcomes were acceptability and depression. Acceptability was measured by participant attendance to the 6 sessions.Three case studies illustrate the structured intervention, solutions identified to adherence barriers and to problems underlying low mood, and changes seen in the participant's psychological symptoms. Acceptability of the intervention was high and common mental disorder symptoms scores measured using the SRQ-8 decreased overall.An integrated intervention for depression and adherence to ART appeared feasible in this low-income setting. An RCT of the intervention versus an appropriate comparison condition is needed to evaluate clinical and cost-effectiveness.     

The Effect of Problem-Solving Based Family Therapy on Emotional Intimacy and Marital Quality of Cultural Couples in Tabriz

Abstract

This study aimed to investigate the effect of problem-solving based family therapy on the emotional intimacy and marital quality of cultural couples in Tabriz. The research method was quasi-experimental by designing the pretest and post-test with the experimental group. The statistical population of this research consisted of all cultural couples with marital problems referring to counseling centers of Tabriz Education in 2019. The research sample based on The Cochran formula consisted of 32 couples that were selected by purposeful sampling and were randomly assigned into two experimental and control groups. The experimental group was exposed to 10 sessions of problem-solving based family therapy and the control group received no interventions. The research tool was the Marital Quality Index and the Intimacy Questionnaire, which was completed by both groups at the beginning and end of the intervention. The collected data were analyzed using SPSS software and inferential statistics of covariance analysis were also investigated. The results of covariance analysis showed that problem-solving based family therapy had a significant impact on the emotional intimacy and marital quality of cultural couples. Therefore, problem-solving based family therapy can be used as a treatment in couples with marital problems.     

Social Problem-Solving and Suicidal Ideation Among Homeless Youth Receiving a Cognitive Therapy Intervention: A Moderated Mediation Analysis

Despite the high prevalence of suicidal ideation and attempts among homeless youth, little research has examined how suicide prevention interventions influence suicide-related risk and protective factors, and ultimately produce positive outcome in suicidality in this population. Drawing on the Diathesis-Stress Model and the Interpersonal Theory of Suicide, the current study examined whether participation in Cognitive Therapy for Suicide Prevention (CTSP) moderated the mediation link between social problem-solving, perceived burdensomeness and thwarted belongingness, and suicidal ideation among a sample of homeless youth experiencing suicidal ideation. Social problem-solving refers to a set of cognitive, emotional, and behavioral coping responses in the face of stressful situations, and it is identified as a potent protective factor in alleviating perceived burdensomeness and thwarted belongingness, and reducing suicidal ideation. Participants included 150 homeless youth (M age = 20.99, range = 18-24; 41% female) who were randomly assigned to Cognitive Therapy for Suicide Prevention (CTSP) + Treatment as Usual (TAU) (n = 75) or Treatment as Usual alone (n = 75). Participants were assessed at baseline, 3, 6, and 9 months post-baseline. Findings showed that perceived burdensomeness mediated the association of social problem-solving with suicidal ideation only among youth participating in the CTSP condition. These findings provide evidence to support the promising effects of CTSP in enhancing the protective effects of social problem-solving on suicidal ideation through the mediating effects of perceived burdensomeness. Findings also have implications for improving intervention effectiveness with a community-based population at high risk of suicide.     

Adolescent-Parent Attachments Family Problem-Solving Styles

Variation in exploratory and collaborative behavior among family members define different problem-solving styles or “paradigms” in families. Similar characteristics distinguish patterns of attachment within dyads. This suggests an association between these phenomena. The hypothesis was tested in a laboratory study of families with young adolescents. Using the Reiss Card Sort Procedure (CSP) and a newly developed scheme for classifying adolescent attachments, it was demonstrated that particular problem-solving styles were linked to specific patterns of adolescent-parent attachments. An association of paradigms and attachment patterns may afford a new perspective on the dialectical interplay between individual and family development. The probabilities of paradigm-attachment association could prove useful when choosing an intervention model for family therapy.     

The Problem-Solving Aspect of Suicide

G. B. Gottsegen, and M. G. Gottsegen, Professional School Psychology, Vol. 3. New York: Grune &; Stratton, 1969, 407 pages, $17.75. Reviewed by Gilbert R. Gredler     

Improving Our Understanding of Impaired Social Problem-Solving in Children and Adolescents with Conduct Problems: Implications for Cognitive Behavioral Therapy

Clinical Child and Family Psychology Review - In cognitive behavioral therapy (CBT) children and adolescents with conduct problems learn social problem-solving skills that enable them to behave in...     

Difficulties in Family Therapy Evaluation I. A Comparison of Insight vs. Problem-Solving Approaches II. Design Critique and Recommendations

In Part 1, an outcome study comparing two methods of family treatment, is reported. Families were randomly assigned to one of two forms of conjoint therapy: an Insight-oriented treatment (N = 10 ) or a Problem-Solving intervention (N = 10 ). The results on self-report measures of family functioning indicate that the Problem-Solving intervention produced more favorable changes after three months. Experienced therapists did better than inexperienced therapists in the Insight-treatment condition but level of experience did not make a difference in the Problem-Solving therapy. A group of eight families who dropped out of the Insight-treatment group provided data on correlates of premature termination. In Part II, the study is critically reviewed. The practical obstacles to implementing an experimental design in a clinic setting are considered. Special attention is given to issues involving the selection of treatment and control conditions: sampling and the measurement of outcome. Alternatives to experimental designs are considered.     

Effects of Instructional Style on Problem-Solving Creativity

This study sought to determine the impact of 2 differing instructional approaches on creative problem-solving performance. Eighty-two college students completed a novel structure-building task after receiving algorithmic instruction (providing a rote, step-by-step algorithm for building a sample structure), heuristic instruction (demonstrating the same techniques in a more flexible form), or no instruction. All participants viewed the same sample structure before beginning the task. It was hypothesized that algorithmically instructed students would exhibit less exploratory behavior and lower levels of creativity than students receiving heuristic instruction. No specific hypotheses were made concerning the problem-solving creativity of students in the no-instruction condition. Results suggest that the type of instruction that students received influenced their perceptions of the task, their behaviors during the task, and their final solution to the structure problem. Students receiving algorithmic instruction exhibited greater confidence and speed when building their structures than did other students. However, they were significantly less likely to engage in exploratory behavior or to deviate from the sample structure than were students receiving heuristic instruction. Although there was no main effect of instruction condition on the judge-rated creativity of these structures, a significant interaction between instruction type and participants' attempts to replicate the sample structure was predictive of the structure's creativity. Theoretical and practical implications of these and other results are discussed.     

Rorschach Erlebnistypus and Problem-Solving Styles in Children

This study was designed to determine whether introversive versus extratensive children differed, on the basis of their Rorschach Erlebnistypus score, with respect to their approaches to three subtests (Block Design, Object Assembly, and Mazes) of the Wechsler intelligence Scale for Children-Revised. it was thought that the extratensives would manipulate the test materials more and make more mistakes than the introversives, owing to the notion that introversives would internalize more of their manipulations and attempted solutions. Analysis of the data revealed mixed results.