Article

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

ABSTRACT

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
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    • "On the one hand, employees are often faced with problems that theoretically can be solved. Problem solving[27]is an established therapeutic method in dealing with such problems and has been proven to be successful in reducing mental and physical health problems[28]. This method has also been effectively used in Web-based interventions to manage depression, anxiety, and stress[29], although mixed results have been observed in studies targeting employees with depressive symptoms[30,31]. "
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    ABSTRACT: Background: Work-related stress is highly prevalent among employees and is associated with adverse mental health consequences. Web-based interventions offer the opportunity to deliver effective solutions on a large scale; however, the evidence is limited and the results conflicting. Objective: This randomized controlled trial evaluated the efficacy of guided Web- and mobile-based stress management training for employees. Methods: A total of 264 employees with elevated symptoms of stress (Perceived Stress Scale-10, PSS-10 ≥22) were recruited from the general working population and randomly assigned to an Internet-based stress management intervention (iSMI) or waitlist control group. The intervention (GET.ON Stress) was based on Lazarus’s transactional model of stress, consisted of seven sessions, and applied both well-established problem solving and more recently developed emotion regulation strategies. Participants also had the opportunity to request automatic text messages on their mobile phone along with the iSMI. Participants received written feedback on every completed session from an e-coach. The primary outcome was perceived stress (PSS-10). Web-based self-report assessments for both groups were scheduled at baseline, 7 weeks, and 6 months. At 12 months, an extended follow-up was carried out for the iSMI group only. Results: An intention-to-treat analysis of covariance revealed significantly large effect differences between iSMI and waitlist control groups for perceived stress at posttest (F1,261=58.08, P<.001; Cohen’s d=0.83) and at the 6-month follow-up (F1,261=80.17, P<.001; Cohen’s d=1.02). The effects in the iSMI group were maintained at 12-month follow-up. Conclusions: This Web- and mobile-based intervention has proven effective in reducing stress in employees in the long term. Internet-based stress management interventions should be further pursued as a valuable alternative to face-to-face interventions. Trial Registration: German Clinical Trials Register (DRKS): 00004749; http://drks-neu.uniklinik-freiburg.de/drks_web/setLocale_EN.do (Archived by WebCite at http://www.webcitation.org/6e8rl98nl)
    Full-text · Article · Jan 2016 · Journal of Medical Internet Research
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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.
    Full-text · Article · Mar 2015 · Social Work in Health Care
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    • "PST has been extensively studied in adults and mixed age populations for a variety of mental health disorders, including MDD (Cuijpers et al., 2006; Nezu et al., 2013). Previous systematic reviews on PST for MDD in mixed-age populations have demonstrated that PST is effective for reducing depressive symptoms (Bell and D'Zurilla, 2009; Cuijpers et al., 2007; Malouff et al., 2007). Other reviews examining trials of psychotherapy for MDD in older adults did not examine PST separately from other types of psychotherapy (Cuijpers et al., 2006; Wilson et al., 2008) or included minor or subthreshold depression together with MDD (Cuijpers et al., 2014; Huang et al., 2015), making it difficult to evaluate the effects of PST in MDD specifically. "
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    ABSTRACT: Objective: Major depressive disorder (MDD) affects many older adults and is associated with poor medical and mental health outcomes. Problem Solving Therapy (PST) has emerged as a promising psychotherapy for MDD in older adults, although the efficacy of PST in this population has not been well described. We examined the effectiveness of PST for the treatment of MDD in older adults in a systematic review and meta-analysis. Methods: We searched electronic databases to identify randomized controlled trials comparing PST to a control condition or other treatment for MDD in adults with an average age of 60 years or older. We used meta-analysis to arrive at pooled summary measures of the efficacy of PST when compared to control conditions on the change in depressive symptoms and other outcomes. Results: Nine studies with a total of 569 participants (290 PST, 279 control) met inclusion criteria. Most studies administered PST in person and were between 6 and 12 weeks in duration. Meta-analysis of six studies evaluating the effect of PST on depression using the Hamilton Rating Scale for Depression identified a significant reduction in depression associated with PST (pooled mean difference = -6.94, 95%CI -10.91 to -2.97, d = 1.15, P = 0.0006). PST was also effective in reducing disability in studies reporting this outcome. Conclusions: Our review supports the existing research literature on PST suggesting that it is an effective treatment for older people with MDD. Further study is required to understand long-term outcomes associated with PST and its efficacy when compared to other treatments. Copyright © 2015 John Wiley & Sons, Ltd.
    Full-text · Article · Mar 2015 · American Journal of Geriatric Psychiatry
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