The efficacy of problem solving therapy in reducing mental and physical health problems: A meta-analysis

School of Psychology, University of New England, Armidale, NSW, 2351, Australia.
Clinical Psychology Review (Impact Factor: 7.18). 02/2007; 27(1):46-57. DOI: 10.1016/j.cpr.2005.12.005
Source: PubMed


This paper describes a meta-analysis of 31 studies that examined the efficacy of problem solving therapy (PST). The meta-analysis, encompassing 2895 participants, showed that PST is significantly more effective than no treatment (d=1.37), treatment as usual (d=0.54), and attention placebo (d=0.54), but not significantly more effective than other bona fide treatments offered as part of a study (d=0.22). Significant moderators included whether the PST included problem-orientation training, whether homework was assigned, and whether a developer of PST helped conduct the study.

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Available from: Einar B Thorsteinsson, Sep 30, 2015
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    • "The intervention also employed problem-solving therapy (PST) (Nezu, 2004) to assist the patient with prioritizing needs and identifying possible solutions. The aim of PST is not to solve problems for the patient; rather, to teach patients to address their problems and challenges by breaking them down into smaller goals and identifying actions that can be taken to solve them, with the ultimate goal of providing long-term and sustainable self-sufficiency (Enguidanos, Coulourides Kogan, Keefe, Geron, & Katz, 2011; Malouff, Thorsteinsson, & Schutte, 2007; Nezu, 2004). The social worker worked with the patient to identify problems or issues and to develop a plan to address them. "
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    ABSTRACT: High 30-day readmission rates are a major burden to the American medical system. Much attention is on transitional care to decrease financial costs and improve patient outcomes. Social workers may be uniquely qualified to improve care transitions and have not previously been used in this role. We present a case study of an older, dually eligible Latina woman who received a social work-driven transition intervention that included in-home and telephone contacts. The patient was not readmitted during the six-month study period, mitigated her high pain levels, and engaged in social outings once again. These findings suggest the value of a social worker in a transitional care role.
    Social Work in Health Care 03/2015; 54(3):177-92. DOI:10.1080/00981389.2015.1005273 · 0.62 Impact Factor
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    • "Next to this manual, a psychotherapy is offered in CC. Mostly, this is cognitive behavioral therapy or problem solving treatment (PST), both effective in the treatment of depression [47]. Next to psychotherapy, medication can be an element of a collaborative care approach, guided by a psychiatrist. "
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    ABSTRACT: The comorbidity of pain and depression is associated with high disease burden for patients in terms of disability, wellbeing, and use of medical care. Patients with major and minor depression often present themselves with pain to a general practitioner and recognition of depression in such cases is low, but evolving. Also, physical symptoms, including pain, in major depressive disorder, predict a poorer response to treatment. A multi-faceted, patient-tailored treatment programme, like collaborative care, is promising. However, treatment of chronic pain conditions in depressive patients has, so far, received limited attention in research. Cost effectiveness of an integrated approach of pain in depressed patients has not been studied. This article describes the aims and design of a study to evaluate effects and costs of collaborative care with the antidepressant duloxetine for patients with pain symptoms and a depressive disorder, compared to collaborative care with placebo and compared to duloxetine alone. This study is a placebo controlled double blind, three armed randomized multi centre trial. Patients with (sub)chronic pain and a depressive disorder are randomized to either a) collaborative care with duloxetine, b) collaborative care with placebo or c) duloxetine alone. 189 completers are needed to attain sufficient power to show a clinically significant effect of 0.6 SD on the primary outcome measures (PHQ-9 score). Data on depression, anxiety, mental and physical health, medication adherence, medication tolerability, quality of life, patient-doctor relationship, coping, health resource use and productivity will be collected at baseline and after three, six, nine and twelve months. In the collaborative care conditions a) and b), a care-manager provides Problem Solving Treatment and integrated symptom management guidance with a self-help manual, monitors depressive and pain symptoms, and refers patients to a physiotherapist for treatment according to a 'Graded Activity' protocol. A psychiatrist provides duloxetine or placebo and pain medication according to algorithms, and also monitors pain and depressive symptoms. In condition c), the psychiatrist prescribes duloxetine without collaborative care. After 12 weeks, the patient is referred back to the general practitioner with a consultation letter, with information for further treatment of the patient. This study enables us to show the value of a closely monitored integrated treatment model above usual pharmacological treatment. Furthermore, a comparison with a placebo arm enables us to evaluate effectiveness of duloxetine in this population in a real life setting. Also, this study will provide evidence-based treatments and tools for their implementation in practice. This will facilitate generalization and implementation of results of this study. Moreover, patients included in this study are screened for pain symptoms, differentiating between nociceptive and neuropathic pain. Therefore, pain relief can be thoroughly evaluated. Trial registration NTR1089
    BMC Psychiatry 05/2013; 13(1):147. DOI:10.1186/1471-244X-13-147 · 2.21 Impact Factor
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    • "Earlier research in controlled settings has demonstrated that, separately, MI and PST are more effective than attention alone [35,36], and there is evidence to support the efficacy of MI in a number of programs promoting change in lifestyle behavior [36]. Although it has been convincingly demonstrated that T2DM can be delayed or prevented in high risk individuals, it is still a considerable challenge to provide evidence-based lifestyle programs for high risk populations in ‘real life’ settings. "
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    ABSTRACT: BACKGROUND: Intensive lifestyle interventions in well-controlled settings are effective in lowering the risk of chronic diseases such as type 2 diabetes (T2DM) and cardiovascular diseases (CVD), but there are still no effective lifestyle interventions for everyday practice. In the Hoorn Prevention Study we aimed to assess the effectiveness of a primary care based lifestyle intervention to reduce the estimated risk of developing T2DM and for CVD mortality, and to motivate changes in lifestyle behaviors. METHODS: The Hoorn Prevention Study is a parallel group randomized controlled trial, implemented in the region of West-Friesland, the Netherlands. 622 adults with >=10% estimated risk of T2DM and/or CVD mortality were randomly assigned and monitored over a period of 12 months. The intervention group (n=314) received a theory-based lifestyle intervention based on an innovative combination of motivational interviewing and problem solving treatment, provided by trained practice nurses in 12 general practices. The control group (n=308) received existing health brochures. Primary outcomes was the estimated diabetes risk according to the formula of the Atherosclerosis Risk In Communities (ARIC) Study, and the estimated risk for CVD mortality according to the Systematic COronary Risk Evaluation (SCORE) formula. Secondary outcomes included lifestyle behavior (diet, physical activity and smoking). The research assistants, the principal investigator and the general practitioners were blinded to group assignment. Linear and logistic regression analysis was applied to examine the between-group differences in each outcome measure, adjusted for baseline values. RESULTS: 536 (86.2%) of the 622 participants (age 43.5 years) completed the 6-month follow-up, and 502 (81.2%) completed the 12-month follow-up. The mean baseline T2DM risk was 18.9% (SD 8.2) and the mean CVD mortality risk was 3.8% (SD 3.0). The intervention group participated in a median of 2 sessions. Intention-to-treat analyses showed no significant differences in outcomes between the two groups at 6 or 12-months follow-up. CONCLUSIONS: The lifestyle intervention was not more effective than health brochures in reducing risk scores for T2DM and CVD or improving lifestyle behavior in an at-risk population.Trial registration: Current Controlled Trials: ISRCTN59358434.
    International Journal of Behavioral Nutrition and Physical Activity 04/2013; 10(1):47. DOI:10.1186/1479-5868-10-47 · 4.11 Impact Factor
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