Modalities / Cognitive-Behavioral

Problem-Solving Therapy

D'Zurilla / Nezu · 1971
Key text: Problem-Solving Therapy (3rd ed, 2013)
Cognitive-Behavioral Focus: Skill-building Short-term Individual

Core Mechanism

Structured problem-solving skills (define, generate, evaluate, implement) counteract hopelessness and behavioral inaction in depression

Ontology

Depression maintained by poor problem orientation (negative appraisal of problems) and deficient problem-solving skills

Therapeutic Voice

"Let's list every possible solution, even the ones that seem impractical. We'll evaluate them after."

View of the Person

A problem-solving agent whose depression reflects poor problem orientation and deficient coping skills


Evidence

APA Div 12: listed. NICE: mentioned for depression

15+ RCTs

Cuijpers et al. (2018)

Strong evidence for depression, especially older adults and primary care.

Depression & Mood Disorders
Effect: d = 0.83
~50-60% response
Cuijpers et al., 2018 (2018)

Conditions

Epistemology

EmpiricistPragmatist

Blind Spots

Narrow skill focus may miss emotional depth; assumes problems are solvable — less suited for existential or grief concerns

Contraindications

Active psychosis with disorganized thinking, severe cognitive impairment beyond what adapted versions can accommodate, clients whose distress is primarily emotional and relational rather than situational, acute crisis


Training

Graduate training + manual study. Straightforward and well-manualized

No formal certification

Graduate coursework + manual; optional 8 hrs

Minimal


Philosophical Roots

Dewey (reflective problem-solving); cognitive-behavioral tradition; D'Zurilla (social problem-solving model); pragmatism

Related Modalities

Test Yourself

Steps in problem-solving therapy?

Show answer

Define problem, generate solutions, evaluate, implement, verify.


Sources