The Basics of Problem-Solving Therapy (PST)


Problem-solving therapy (PST) is an evidence-based practice to help people work through problems. It involves seven steps. These steps include:

  1. Identifying the problem
  2. Setting the goal
  3. Brainstorming options
  4. Weighing the pros and cons
  5. Selection of the best option(s)
  6. Creating an action plan
  7. Evaluating the outcome

What to Expect in a Session

You will meet with a therapist to accomplish your goals. During the first session, your therapist will likely go over what is outlined in this article. By the end of that session, you will have created an action plan associated with your goal to overcome your first problem. You will have homework to complete before your next session. When you return to the therapist’s office, you will evaluate the outcome and judge whether or not it’s appropriate to set a new goal for the same problem or address a different problem altogether.

Weight Gain Example

Here’s an example of a potential problem and how you would go through the steps:

  1. Identifying the problem: substantial weight gain during the pandemic
  2. Setting the goal: eat healthier
  3. Brainstorming options:
    1.  changing what you buy at the grocery to exclude sweets,
    2. making meals for yourself instead of eating out,
    3. acquiring a taste for salads

Weighing the pros and cons:

Pros Cons
Option 1 Healthier diet Will miss sweets
Option 2 Healthier diet More work
Option 3 Healthier diet You don’t like salads
  1. Selecting the best option: changing what you buy at the grocery store to exclude sweets
  2. Creating an action plan: do not buy sweets at the grocery store

In this example, your homework would be not to buy sweets at the grocery store. In the next session, your therapist will check in about Step 7: Evaluating the outcome and seeing whether you purchased the sweets. The key to this practice is a non-judgmental response from the therapist. If you didn’t buy the sweets, good work! If you did, you are your therapist will have to keep brainstorming and troubleshooting. That is part of the process.

Now that you have an overview and an example of PST, let’s take a deeper dive into some of the core components.

Brief Symptom Assessment

As a way to track progress, many practitioners of PST will use a Brief Symptom Assessment. A popular one is the “SIGECAM” model. You will be asked to rank how you are doing in a variety of different areas on a 1-10 scale:

  • Sleep: no difficulty vs. significant trouble falling asleep or staying asleep
  • Interest: very high interest vs. very low interest
  • Guilt: not guilty vs. feeling very guilty
  • Energy: lots of energy vs. no energy
  • Concentration: easy to concentrate vs. difficult to concentrate
  • Appetite: eating a normal diet vs. eating way too much or too little
  • Mood: feeling good all the time vs. feeling depressed or anxious all the time

At the end of this assessment, you will have a number corresponding to the number you gave on the scale for each subcategory. If PST is working effectively, your number should improve over time.

The Action Plan

Step 6 is an essential part of PST as this is where your homework between sessions will originate. To make an effective action plan, you will have to determine who’s involved, any support you need to accomplish the goal, and when you plan on executing the action. Also, if your action plan is particularly distressing to you, it can be helpful to include pleasurable activities.

Potential Paperwork

Implementing problem-solving therapy requires that the client takes control and that the therapist serves as more of a secretary. In some versions of PST, there can be a lot of paperwork involved. You can fill out charts like the pro-con one, make lists when brainstorming, and make a chart for your action plan. It is important to express how much recordkeeping you want him or her to do for you early on to your therapist.

Ambivalence vs. Ambition

The remarkable aspect of PST is that it has all the tools incorporated to hold you accountable. However, you have to be willing and ready to make the change. If you are still in a state of ambivalence and unsure whether you want to change, this intervention will not work. You have to be ambitious and ready to collaborate with your therapist.

How Problem-Solving Therapy Helps

PST is a hands-on technique to help you make changes in your life where you see fit. It is a seven-step process and can work in various circumstances as long as the client has transitioned from a place of ambivalence to a place of ambition. There can be a lot of paperwork involved, depending on the style of their therapist who is delivering PST. At the beginning of each session, you will start with a Brief Symptom Assessment and Step 7: Evaluating the outcome of your homework. You will end each session with an action plan. Hopefully, if implemented effectively over time, you will have more favorable scores on the Brief Symptom Inventory. PST is an evidence-based practice worth asking your therapist about if it feels relevant.

Many therapists use the evidence-based practice of problem-solving therapy (PST) to get results in their therapy sessions. This type of therapy can help you identify problems and develop solutions to them. Problem-solving therapy is a hands-on technique involving seven steps. It is done in conjunction with a therapist with a lot of paperwork such as behavioral assessments but can help you find the answers you are looking for. At Valiant Living, we incorporate elements of this to help our clients struggling with addiction and co-occurring mental illness. While the example listed in this blog post is one of aiming to eat healthier, PST can apply to a wide range of other issues, no matter how seemingly big or small. At our men’s only treatment facility in Denver, Colorado, we can help you solve problems. To learn more about the services we offer, reach out to us today at (303) 952-5035.