This document was printed from the website of the California Evidence-Based Clearinghouse for Child Welfare (CEBC), which you can access at http://www.cebc4cw.org/
This document was printed from the website of the California Evidence-Based Clearinghouse for Child Welfare (CEBC), which you can access at http://www.cebc4cw.org/
Note: Problem Solving Skills Training (PSST) was not responsive to the CEBC's request for information about their program. The following information was obtained from publicly available sources (websites, articles, etc.).
Scientific Rating:
1
Well-Supported by Research Evidence
See scale of 1-5
Relevance to Child Welfare Rating:
2
Medium
See scale of 1-3
Child Welfare Outcomes: Child/family well-being
Brief Description:
Problem Solving Skills Training (PSST) has been rated by the CEBC in the area of Disruptive Behavior Treatment (Child & Adolescent). PSST is aimed at decreasing inappropriate or disruptive behavior in children. The program teaches that problem behaviors arise because children lack constructive ways to deal with thoughts and feelings and instead resort to dysfunctional ones. The program uses a cognitive-behavior approach to teach techniques in managing thoughts and feelings, and interacting appropriately with others. Specific techniques include modeling, role-playing, positive reinforcement of appropriate behavior, and teaching alternative behaviors. Children are typically given homework to help them practice implementing these skills. Most sessions are individual, but parents may be brought in to observe and to learn how to assist in reinforcing new skills.
Manual and Training section:
The publicly available information indicates that there is a manual available for Problem Solving Skills Training (PSST), please contact Alan Kazdin at 203-432-9993.
Relevant Published, Peer-Reviewed Research:
Problem Solving Skills Training (PSST) is rated a "1 - Well-Supported by Research Evidence" on the Scientific Rating Scale based on the published, peer-reviewed research available. The practice must have at least two rigorous randomized controlled trials with one showing a sustained effect of at least 1 year. For more information on the rating of a "1 - Well-Supported by Research Evidence," please see the Scientific Rating Scale.
Kazdin, A., Esveldt-Dawson, K., French, N., & Unis, A. (1987). Problem-solving skills training and relationship therapy in the treatment of antisocial child behavior. Journal of Consulting and Clinical Psychology, 55(1), 76-85.
Type of Study: Randomized controlled trial
Number of participants: 56
Population:
Location/Institution: Not given
Summary: (To include comparison groups, outcomes, measures, notable limitations) To be included in the study, children had to be screened and found to be of normal intelligence, not on psychiatric medication, and not suffering from neurological impairment. Children were eligible for inclusion if their parents had scored them above the 98th percentile on the Aggression or Delinquency Scales of the Child Behavior Checklist (CBCL). They were independently diagnosed by clinical staff using the DSM-III. Participants were randomly assigned to receive Problem Solving Skills Training (PSST) or Relationship Therapy (RT), which focuses on the development of the therapist's relationship with the child. A third randomized control group had therapist contact with no directed focus on the elements of the two treatment conditions. This condition included therapist-child discussion of everyday events. Assessments included continuing use of the CBCL by parents and teachers. Therapists also evaluated program using the Therapist Evaluation Inventory. Children reported on their own progress using the Child Evaluation Inventory. Analysis found children in the PSST condition had greater decreases in aggression and externalizing behaviors and overall behavior problems and greater increases in pro-social behavior at follow-up than did the RT and control groups. However, the authors note that most children in the PSST group still fell outside of behavioral norms at the conclusion of the study. Limitations include use of a hospitalized sample and reliance on a small number and type of evaluations.
Length of post-intervention follow-up: Up to 1 year after treatment.
Kazdin, A. E., Bass, D., Siegel, T., & Thomas, C. (1989). Cognitive-behavioral therapy and relationship therapy in the treatment of children referred for antisocial behavior. Journal of Consulting and Clinical Psychology, 57(4), 522-535.
Type of Study: Randomized controlled trial
Number of participants: 112 children
Population:
Location/Institution: Not given
Summary: (To include comparison groups, outcomes, measures, notable limitations): Participants were randomized to receive one of two Problem Solving Skills Training (PSST) treatment conditions: standard PSST or PSST-P which included a set of planned activities and "homework" to be performed outside of therapeutic sessions. A third group was randomized to a relationship therapy (RT) condition which focused on interaction between the therapist and child. Parents completed the Child Behavior Checklist (CBCL) and teachers completed the School Behavior Checklist. Antisocial behavior was assessed using the Parent Daily Report and the Interview for Antisocial Behavior, also completed by parents. Children's self-reported outcomes were assessed with the Children's Action Tendency Scale and the Self-Esteem Inventory. Both PSST groups showed significantly higher improvement in behavior than the RT group. Improvement in PSST-P children's school-related behaviors were shown to be stronger in comparison with standard PSST. Improvements were maintained at 1-year follow-up. The authors note, however, that behavior for most children was not brought into normal range. A further consideration was the possibility that the conditions of well-implemented relationship therapy were not met, limiting its validity as a comparison group.
Length of post-intervention follow-up: 1 year.
Kazdin, A. E., Siegel, T. C., & Bass, D. (1992). Cognitive problem-solving skills training and parent management training in the treatment of antisocial behavior in children. Journal of Consulting and Clinical Psychology, 60(5), 733-747.
Type of Study: Randomized controlled trial
Number of participants: 97
Population:
Location/Institution: Not given
Summary: (To include comparison groups, outcomes, measures, notable limitations) This study examined two treatments: Problem Solving Skills Training (PSST) for children, and Parent Management Training (PMT), as a supporting treatment, for their parents. Participating families were randomly assigned to receive PSST, PMT, or a combination of PSST + PMT. Assessments included the Child Behavior Checklist (CBCL) and the Teacher Report Form (TRF). Teachers also completed an assessment of adaptive and competence behaviors, the Health Resources Inventory. Parents were interviewed concerning negative behavior using the Interview for Antisocial Behavior. Children completed the Children's Action Tendency Scale on aggressive behavior and the Self-Report Delinquency Checklist. A sampling of problem behaviors in the home was taken with the Parent Daily Report. Finally, parent and family functioning was measured with the Parenting Stress Index (PSI), the Beck Depression Inventory (BDI) (mothers), and the Family Environment Scale. Results indicated that children in all conditions showed significant improvement at home and school, which was maintained at follow-up. PSST + PMT had the greatest effects on children's aggressive, delinquent, and antisocial behavior; and was also associated with greater improvements in parental stress and depression. The study is limited by lack of an untreated comparison group and a large attrition rate, possibly due to the stresses of maintaining family treatment.
Length of post-intervention follow-up: 1 year.
References:
Kazdin, A. E., & Weisz, J. R. (2003). Evidence-based psychotherapies for children and adolescents. New York: Guildford Press.
Contact Information
Name: Alan E. Kazdin
Affiliation/Agency: Yale Parenting Center and Child Conduct Clinic
Phone: 203-432-9993
Fax: 203-432-5225
E-mail: childconductclinic@yale.edu
Date review compiled: April 2009