Group-based problem-solving therapy in self-poisoning females: A pilot study

Aims: The treatment of suicidal behaviour remains limited in efficacy. This pilot study assessed the effectiveness of a time-limited, group-based problem-solving therapy intervention compared with a treatment as usual control group, in females who self-poison. Method: A total of 18 clients were equally randomised to treatment or control groups. All clients were assessed using standardised questionnaires for depression, hopelessness, suicidal ideation and social problem-solving skills, at pre-treatment, post-treatment and two months follow-up. Results: The treatment group experienced significant reductions in levels of depression, hopelessness, suicidal ideation and improvements in self-assessed social problem-solving skills. Improvements in mental health and aspects of self-assessed problem-solving skills for the treatment group continued to be evident at two months follow-up. The control group did not change significantly over time on mental health measures or social problem solving abilities. Conclusion: Although limited by small sample size, the results suggest that group-based problem-solving therapy is effective in the management of deliberate self-poisoning. This paper is a unique contribution in that it examines the implementation of problem solving therapy with a homogenous population and in a group format. Methodological concerns and directions for future research are discussed.     

The Impact of Anger Management Treatment and Rational Emotive Behavior Therapy in a Public School Setting on Social Skills,Anger Management,and Depression

Public school students participated in a group to enhance and improve anger management. The study used a pre-post design with a comparison group. Students were assigned to either Anger Management Treatment or Anger Management plus Rational Emotive Behavior Therapy (REBT). Each child served as his or her own control and received an empirically validated intervention. Pretest–posttest data were evaluated using the Social Skills Rating System, the Children’s Depression Inventory and the Children’s Inventory of Anger. Results indicate that the addition of the REBT component to Anger Management reduced anger as well as depression, while improving social skills, suggesting the addition of a specialized cognitive behavioral component increased the effectiveness of the intervention.     

Social competence and conduct problems in young children: issues in assessment

Examined the differences in various facets of social competence in 2 groups of young children (ages 4-7 years)--a clinic-referred group of aggressive children (N = 60) diagnosed with oppositional defiant disorder or conduct problems and a matched comparison group of typically developing children (N = 60). Four aspects of social competence were assessed: social information processing, actual observations of conflict management skills and social play interactions during peer interactions, positive social interactions with mothers and fathers at home, and teacher reports of social competence. The social information processing assessed included problem-solving skills (hypothetical skills as demonstrated on a social problem-solving test), self-perceptions (child's awareness of his or her own social self and feelings of loneliness), perceptions of others (attributions), and perceptions of others' attitudes toward oneself. To determine the construct validity of various means of assessing child social competence, we correlated children's social information processing measures with parent and teacher reports of social adjustment and with actual observations of interactions during peer play and at home with parents. Results comparing the 2 groups suggest that young children with conduct problems have deficits in their social information processing awareness or interpretation of social cues--they overestimate their own social competence and misattribute hostile intent to others. Tests of cognitive problem solving and observations of peer play interactions indicated that the children with conduct problems had significantly fewer positive problem-solving strategies and positive social skills, more negative conflict management strategies, and delayed play skills with peers than the comparison children. Correlation analyses indicated significant correlations between children's negative attributions and the ratio of positive to negative problem-solving strategies with observations of peer play interactions.     

Social problem solving and mother-child interactions of educable mentally retarded children

Mothers of retarded children and nonretarded children were observed and videotaped as they interacted with their own child in a seminaturalistic situation, requiring teaching, cooperation, and free play. The child's social problem-solving abilities were assessed independently. The Vineland scale was employed to provide some convergent evidence of social problem-solving as a component of social competence. Twelve educable mentally retarded and 19 nonretarded 10-year-old children and their mothers comprised the sample. For the mentally retarded group, it was found that the higher maternal directiveness, the lower the child's social problem-solving skills. Mothers who often gave the child opportunity for decision-making and social influence had children with higher problem-solving skills. The retarded children produced significantly fewer different strategies for solving social problems, but gave a wider range of strategies than has been found in previous research. There was some support that social problem-solving skills are related to social maturity.     

Social problem solving: A moderator of the relation between negative life stress and depression symptoms in children

The social problem-solving skill of generating effective alternative solutions was tested as a moderator of the relation between negative life stress and depressed mood in children. Boys ( n= 25) and girls ( n= 25), ages 8 to 12 years, from inner-city, lower socioeconomic group families, completed measures of depression symptoms, negative impact of life events, and quantity and effectiveness of alternative solutions to social problems. Results indicated that the effectiveness of alternative solutions children generate in response to peer social problems moderates the relation between stress and depression. Children who experienced a high impact of negative life events, with less effective social problem-solving skills, reported higher levels of depression compared to children who experienced a high impact of negative life events but exhibited more effective social problem-solving skills. Results are discussed in terms of alternative theoretical models for the mechanisms whereby effective social problem-solving skills moderate stress-related depression.     

Social Problem-Solving Skills in Children with Traumatic Brain Injury: Long-Term Outcomes and Prediction of Social Competence

The effects of childhood traumatic brain injury (TBI) on social problem-solving were examined in 35 children with severe TBI, 40 children with moderate TBI, and 46 children with orthopedic injuries (OI). The children were recruited prospectively following injuries that occurred between 6 and 12 years of age. They were followed longitudinally, and ranged from 9 to 18 years of age at the time of the current study, which occurred on average 4 years post injury. They were administered a semi-structured interview used in previous research on social problem-solving to assess the developmental level of their responses to hypothetical dilemmas involving social conflict. Children in the severe TBI group defined the social dilemmas and generated alternative strategies to solve those dilemmas at the same developmental level as did children in the OI group. However, they articulated lower-level strategies as the best way to solve the dilemmas and used lower-level reasoning to evaluate the effectiveness of the strategies. After controlling for group membership, race, socioeconomic status, IQ, and age, children's social problem-solving, and particularly the developmental level of their preferred strategies for resolving conflicts, predicted parents ratings of children's social skills, peer relationships, aggressive behavior, and academic performance. The findings indicate that children with severe TBI demonstrate selective, long-term deficits in their social problem-solving skills that may help to account for their poor social and academic outcomes.     

Evaluation of a short-term group therapy program for children with behavior problems and their parents.

The current study investigated the effectiveness of a short-term, cognitive behavioral program for 106 primary school-aged children referred with externalizing behavior problems and their parents, compared with 39 children and their parents on a waiting-list to be treated. Exploring Together' comprised a children's group (anger management, problem-solving and social skills training), a parents' group (parenting skills training and dealing with parents' own issues), and a combined children's and parents' group (to target parent-child interactions). The program reduced children's behavior problems and improved their social skills at home. Changes in children's behaviors and social skills at home were generally maintained at 6- and 12-month follow-up. Implications of the findings for improving interventions for childhood externalizing behavior problems are discussed.     

The effects of behavior rehearsal and feedback on the acquisition of problem-solving skills in distressed and nondistressed couples

Couples who were paid to participate in an experimental marital enrichment program were randomly assigned to one of four treatment conditions or to a control group. All groups received training in solving marital problems, but the groups differed according to how they were trained; some received feedback (FB) on their previous taped performances, some had the opportunity to practice the skills suggested by the therapist (BR), some had both (complete treatment), and some simply were presented with instructions. Changes in problem-solving skills were assessed by behavioral observations of the frequency of positive problem-solving behavior before and after treatment, and global ratings of problem-solving effectiveness made by trained raters. In general, the complete treatment condition produced greater changes from pre- to post-test than any other condition. Couples in this condition showed significantly greater increases in positive behavior than any other group, and on global ratings of problem-solving skills they evidenced the greatest improvement, although on this measure they did not improve significantly more than BR couples.     

Spanish-Speaking Parent–Child Emotional Narratives and Children's Social Skills

We examined whether parents' content and style when discussing past positive and negative emotional experiences with their children were concurrently and predictively linked to prekindergarteners' social skills. Sixty-five low-income Spanish-speaking parent–child dyads discussed a past positive and negative emotional experience at the beginning of prekindergarten. Narratives were coded for parents' elaborative style and emotion resolution, cause, and attribution. Children's emotional and cognitive-processing words were also coded. Children's social problem-solving skills and prosocial behaviors were assessed at the beginning and at the end of prekindergarten. Concurrently, children's social problem-solving skills were related to parents' elaborative style when discussing positive emotional experiences and children's use of cognitive-processing words when discussing negative emotional experiences. Predictively, children whose parents offered resolutions when discussing negative emotional experiences at the beginning of prekindergarten had better social problem-solving skills at the end of prekindergarten. Parents who talked about causes or attributed emotions when discussing past emotional experiences did not necessarily have children with better social skills. Findings suggest that parents' scaffolding when discussing past positive and negative emotional experiences offers opportunities for prekindergarteners to develop social abilities crucial for school readiness.     

Social problem-solving skills in children with traumatic brain injury: long-term outcomes and prediction of social competence.

The effects of childhood traumatic brain injury (TBI) on social problem-solving were examined in 35 children with severe TBI, 40 children with moderate TBI, and 46 children with orthopedic injuries (OI). The children were recruited prospectively following injuries that occurred between 6 and 12 years of age. They were followed longitudinally, and ranged from 9 to 18 years of age at the time of the current study, which occurred on average 4 years post injury. They were administered a semi-structured interview used in previous research on social problem-solving to assess the developmental level of their responses to hypothetical dilemmas involving social conflict. Children in the severe TBI group defined the social dilemmas and generated alternative strategies to solve those dilemmas at the same developmental level as did children in the OI group. However, they articulated lower-level strategies as the best way to solve the dilemmas and used lower-level reasoning to evaluate the effectiveness of the strategies. After controlling for group membership, race, socioeconomic status, IQ, and age, children's social problem-solving, and particularly the developmental level of their preferred strategies for resolving conflicts, predicted parents ratings of children's social skills, peer relationships, aggressive behavior, and academic performance. The findings indicate that children with severe TBI demonstrate selective, long-term deficits in their social problem-solving skills that may help to account for their poor social and academic outcomes.     

The relationship between father absence and children's social problem solving competencies

Predictions of deficits in children's social problem-solving competencies due to early and continuing father absence were investigated. To test these predictions, equal numbers of father-present and father-absent third graders matched on a number of variables were assessed on measures of social problem-solving performance. In Phase 2 of the study, half of the children from the father-absent category received a 15 week intervention programme which was conducted by adult male trainers to provide structured practice in social problem solving. Results demonstrated that father-absent treatment subjects, compared to father-absent control subjects, improved their social problem-solving skills significantly. Despite improvement due to intervention, social problem-solving scores for father-absent treatment subjects were still below those for father-present control subjects. Educational and developmental implications of the findings were discussed.     

Parental Problem-Solving Abilities and the Association of Sickle Cell Disease Complications with Health-Related Quality of Life for School-Age Children

Children with sickle cell disease (SCD) are at risk for poor health-related quality of life (HRQOL). The current analysis sought to explore parent problem-solving abilities/skills as a moderator between SCD complications and HRQOL to evaluate applicability to pediatric SCD. At baseline, 83 children ages 6–12 years and their primary caregiver completed measures of child HRQOL. Primary caregivers also completed a measure of social problem-solving. A SCD complications score was computed from medical record review. Parent problem-solving abilities significantly moderated the association of SCD complications with child self-report psychosocial HRQOL (p = .006). SCD complications had a direct effect on parent proxy physical and psychosocial child HRQOL. Enhancing parent problem-solving abilities may be one approach to improve HRQOL for children with high SCD complications; however, modification of parent perceptions of HRQOL may require direct intervention to improve knowledge and skills involved in disease management.     

Relation between social problem-solving ability and subsequent level of psychological stress in college students.

A prospective design was used to examine the relation between social problem-solving ability and later psychological stress in college students during the first semester of the academic year. A new social problem-solving inventory measured not only general ability, but also more specific components of the problem-solving process (e.g., problem orientation, problem-solving skills; D'Zurilla & Nezu, 1990). The results of a hierarchical multiple regression analysis showed that general problem-solving ability was negatively related to later stress, even after prior stress level and number of life problems were controlled. More specific analyses indicated that subjects' problem orientation was a better predictor of stress than their problem-solving skills. Results are discussed in terms of the possible stress-reducing effects of perceived control and successful problem resolution.     

Treating boys with low school achievement and behavior problems: comparison of two kinds of intervention

Children with low school achievement frequently have behavior problems and interpersonal difficulties that pose a risk for psychosocial maladjustment. 39 boys were assessed and randomly assigned to one of two group treatment conditions: (a) interpersonal cognitive problem-solving for whom training was provided through oral and written language activities that met children's social and academic needs and (b) a language workshop, during which only academic difficulties were treated. Parents of children in both groups received group attention. Posttreatment assessments indicated that boys in both conditions showed significant improvements on school achievement and behavior problems, as they were measured by behavior scales reported by mothers and by an academic achievement test. Children in the problem-solving group improved significantly more than the other group on most measures. These results suggest that work with interpersonal cognitive problem-solving skills combined with reading and writing activities is a useful means to produce improvements in child behavior and school achievement.     

Diabetes-specific social learning variables and self-care behaviors among persons with type II diabetes

This study assessed the relationship between diabetes-specific social learning factors and diabetes self-care. Predictor variables were collected within the categories of knowledge (e.g., behavioral demonstrations, pencil-and-paper tests), beliefs/expectations (e.g., self-efficacy, self-motivation), skills (e.g., problem-solving and refusal skills), and environmental support (e.g., barriers to adherence, family support). Different results emerged across the three areas of the regimen assessed: diet, exercise, and glucose testing. Multiple-regression analyses revealed that the social learning variables consistently improved the prediction of self-care beyond that attributable to demographic variables but that the categories of social learning variables most closely related to self-care varied across regimen areas. These findings suggest that programs to enhance diabetes self-care could beneficially focus on life-style behaviors and employ strategies to increase regimen-related expectations and diabetes-specific social and problem-solving skills.     

Social problem-solving skills in boys with conduct and oppositional defiant disorders

The current study compared the social problem-solving skills of a clinic-based sample of 30 boys diagnosed with conduct disorder (CD) and 25 boys diagnosed with oppositional defiant disorder (ODD). Past research has indicated that contextual factors influence children's social problem-solving; thus, three hypothetical conflict situations (i.e., child-child, teacher-child, and parent-child) and situations which differed by degree of negative intent of the provocateur (i.e., hostile vs. Ambiguous intent) were examined. Problem-solving strategies were aggregated into three broad dimensions: 1) aggressive/antisocial solutions; 2) nonverbal-nonaggressive solutions; and 3) verbal-nonaggressive solutions. Compared to ODD boys, CD boys proposed more aggressive/antisocial solutions in parent-child conflicts when parental intent was ambiguous and in teacher-child conflicts regardless of intent. Compared to ODD boys, CD boys proposed fewer verbal-nonaggressive solutions in child-child conflicts. The implications of these findings for treatment intervention with CD and ODD boys were discussed. Aggr. Behav. 23:457–469, 1997. © 1997 Wiley-Liss, Inc.     

Evaluation of a conflict-resolution and problem-solving programme to enhance adolescents' self-concept

The effectiveness of an intervention programme, initially designed to enhance the self-concept and motivation of gifted underachieving girls, was evaluated for students identified as having a low self-concept and social relationship difficulties. Twenty male and female secondary-school students were randomly assigned to either a treatment or a control group. The programme, called ABLE (Attribution, Behaviour, Life skills Education), incorporates problem-solving, conflict resolution, and a multidimensional framework to investigate adolescents' self-concept formation. The adolescents in the study made significant improvements in the areas of general self-concept, physical appearance self-concept, and total self-concept. Teaching conflict-resolution and problem-solving skills had a beneficial influence on self-concept. The results are discussed in terms of the relevance of the programme and its application to school and counselling interventions.     

Social problem solving in adolescents with suicidal behavior: a systematic review

There is an increasing focus on deficiencies in problem solving as a vulnerability factor for suicidal behavior in general and hence a target for treatment in suicide attempters. In view of the uncertainty of evidence for this in adolescents we conducted a systematic review of the international research literature examining the possible relationship between deficiencies in social problem-solving skills and suicidal behavior in this population. This was based on searching two electronic databases: Medline 1966 to September 2003 and PsychInfo 1887 to September 2003. Twenty-two studies of social problem-solving skills in adolescents with suicidal behavior were found. Most of these studies, which compared adolescent patients with suicide attempts versus either nonsuicidal psychiatric or normal controls, found evidence for problem-solving deficits in the attempters; however, few of the differences remain after controlling for depression and/or hopelessness. Because most of the studies are cross-sectional, it is difficult to differentiate between the possibilities that deficiencies in problem-solving skills lead to depression when adolescents are faced by adversity and hence to suicidal behavior, or whether depression is the main factor which undermines problem-solving skills. Future research, preferably with longitudinal research designs, is required to determine the nature of the association between problem-solving skills and suicidal behavior in adolescents. This has important implications for therapeutic interventions.     

Effects of social problem-solving training on classroom behavior of urban disadvantaged students

Sixty-four urban disadvantaged fourth- and fifth-grade students were assigned to one of the following four treatment conditions: social problem-solving training, response cost, social problem-solving training plus response cost, and no treatment control. Those exposed to problem-solving training improved on measures of alternative thinking and consequential thinking skills. The training, however, did not affect teacher ratings of student behavior or observed classroom behavioral functioning. In addition, the response cost procedure did not enhance acquisition or utilization of problem-solving skills.