Problem-Solving Therapy
Problem-Solving Therapy is a cognitive-behavioral treatment introduced by Thomas D'Zurilla and Marvin Goldfried in 1971 and later extended into its clinical form by Arthur Nezu. Its core mechanism: structured problem-solving skills (define, generate, evaluate, implement) counteract hopelessness and behavioral inaction in depression. This catalogue links it to depression and suicidality and self-harm, typically in individual format, short-term.
Related condition topics
These links support exploration. They do not establish that Problem-Solving Therapy is effective or recommended for each condition.
How Problem-Solving Therapy works
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
Epistemology
Evidence
2 condition assessments available
An overall effectiveness assessment has not been completed. Completed assessments for specific populations appear below.
Condition-specific assessments
Each conclusion applies to the population and use described. These source-based assessments do not certify the full entry or replace expert clinical review.
Suicidality & Self-Harm
Population and scope: Adults who self-harm receiving a tailored CBT-informed problem-solving intervention; suicide-focused problem-solving therapy for adults with a history of self-directed violence.
Guideline recommendation
NICE NG225 1.11.3 explicitly includes problem-solving therapy within its offered CBT-informed intervention tailored to adults who self-harm. VA/DoD 2024 recommendation 6 weakly suggests suicide-focused CBT, including problem-solving-based therapies, to reduce ideation after self-directed violence. The scope is a tailored or suicide-focused intervention, not every generic PST programme. The VA recommendation concerns ideation and does not establish fewer suicide attempts or deaths for generic PST.
Source assessment dated
Depression & Mood Disorders
Population and scope: Adults with uncomplicated MDD choosing psychotherapy.
Guideline recommendation
VA/DoD 2022 recommendation 7 weakly suggests PST among unranked options. This treatment recommendation does not establish superior efficacy or address depression prevention across other clinical populations.
Source assessment dated
Guidelines and official sources (10)
9 clinical guideline checks · 1 evidence registry check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Depression in adults: treatment and management (NG222)
Recommendation for the stated population
NICE includes problem-solving among treatment options. The format and choice depend on depression severity, clinical needs and patient preferences.
Scope: Adults with depression; guided self-help or individual problem-solving options.
- Problem-Solving Therapy for Depression
Discussed in the source
The archive records a 1998 strong rating and a 2015 status awaiting re-evaluation. These are evidence-registry classifications, separate from NICE’s recommendations.
Scope: Depression; historical Division 12 treatment ratings.
- Assessment and Management of Patients at Risk for Suicide
Recommendation for the stated population
VA/DoD includes problem-solving-based psychotherapies within its weak recommendation for suicide-focused CBT to reduce suicidal ideation. This recommendation concerns ideation and does not establish fewer suicide attempts or deaths for generic PST.
Scope: Suicide-focused, problem-solving-based CBT for adults aged 18 and over with a history of self-directed violence.
- Management of Major Depressive Disorder
Recommendation for the stated population
VA/DoD suggests problem-solving therapy among seven unranked psychotherapy options (weak for). Treatment strategy also depends on severity, chronicity, prior response and preference.
Scope: Adults with uncomplicated MDD choosing psychotherapy.
- Management of Major Depressive Disorder
Discussed in the source
VA/DoD strongly recommends first-line evidence-based psychotherapy, referring to the list that includes problem-solving therapy. This is a class-level recommendation, with no preferred individual approach.
Scope: Pregnant or breastfeeding adults with mild-to-moderate MDD.
- Clinical Practice Guideline for Management of Stroke Rehabilitation
Insufficient evidence for or against
VA/DoD finds insufficient evidence for or against solution-focused psychological interventions, explicitly including problem-solving therapy. The finding is specific to post-stroke depression prevention.
Scope: Preventing the onset of depression following stroke.
- Clinical Practice Guideline for the Treatment of Depression Across Three Age Cohorts
Recommendation for the stated population
APA conditionally suggests the specified individual problem-solving treatments for these populations.
Scope: Older adults with MDD and executive dysfunction, or minor/MDD depression with dementia.
- mhGAP: brief structured psychological treatment for depression
Recommendation for the stated population
WHO includes problem-solving therapy among the structured psychological interventions that should be offered. The recommendation is strong, with moderate-certainty evidence.
Scope: Adults with moderate-to-severe depression, within the mhGAP non-specialist-care context.
- Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders
Discussed in the source
WHO conditionally supports digital interventions based on approaches including problem-solving therapy, with low-certainty evidence. This is not a recommendation for every full problem-solving therapy program, and the reviewed trials did not establish benefit for attempts or deaths and were underpowered for those outcomes.
Scope: Digital support for people with suicidal thoughts.
- Self-harm: assessment, management and preventing recurrence (NG225)
Recommendation for the stated population
NICE says to offer a tailored intervention and explicitly names CBT and problem-solving therapy. This does not endorse every generic protocol or establish a reduction in suicide deaths.
Scope: Adults who have self-harmed; a structured, person-centred CBT-informed intervention tailored to their needs.
Recorded material under review
The existing notes below are retained separately from assessment records. These recorded claims await source checking, including study design, recommendations and numerical estimates.
15+ RCTs
Cuijpers et al. (2018)
Strong evidence for depression, especially older adults and primary care.
Training and certification
Graduate training + manual study. Straightforward and well-manualized
No formal certification
Graduate coursework + manual; optional 8 hrs
Minimal
Clinical cautions and blind spots
Assessment and precautions
For self-harm presentations: NICE NG225 calls for early psychosocial assessment, attention to immediate care needs and adaptations that support participation. NICE advises against using diagnosis, age, substance misuse or coexisting conditions as reasons to withhold psychological interventions for self-harm. Treatment suitability and the required level of care need individual assessment. Other uses, including depression, require their own assessment of suitability and precautions; these self-harm sources do not establish a universal PST contraindication list.
Sources for the corrected statements:
Blind spots
Structured skill focus can leave emotional and relational material untouched; later versions add emotion-focused coping for problems that cannot be solved, but the frame still fits situational difficulty better than grief or existential impasse
Philosophical roots
Dewey (reflective problem-solving); cognitive-behavioral tradition; D'Zurilla (social problem-solving model); pragmatism
Compared with other approaches
Test Yourself
Steps in problem-solving therapy?
Show answer
Define problem, generate solutions, evaluate, implement, verify.