Problem Solving Skills Training (PSST)

Scientific Rating:
1
Well-Supported by Research Evidence
See scale of 1-5
Child Welfare System Relevance Level:
Medium
See descriptions of 3 levels

About This Program

The information in this program outline is provided by the program representative and edited by the CEBC staff. Problem Solving Skills Training (PSST) has been rated by the CEBC in the area of: Disruptive Behavior Treatment (Child & Adolescent).

Target Population: 7 to 14 year olds with behavioral problems, particularly children who struggle to handle disappointments, frustrations, or problems calmly

For children/adolescents ages: 7 – 14

Brief Description

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. It is designed to help children learn to slow down, stop and think, and generate multiple solutions to any given problem. The program uses a cognitive-behavioral 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.

Program Goals:

The goals of Problem Solving Skills Training (PSST) are:

  • Train the child to think differently about situations and behave differently in diverse situations
  • Help the child internalize the problem solving steps so that they are able to use them to evaluate potential solutions to problems occurring outside of therapy
  • Learn and generalize problem solving skills and how to apply problem solving skills using self-instruction
  • Learn how to generate positive solutions that would enable the child to avoid physical aggression, resolve the conflict, and keep themselves out of trouble

Essential Components

The essential components of Problem Solving Skills Training (PSST) include:

  • Sessions that are fun for children as they play various games and have the opportunity to earn prizes as they learn the following:
    • The 5 Problem Solving Steps used to handle any problem situation
    • How to use these problem solving steps for hypothetical problems
    • How to use these problem solving steps for simple problems outside of session
    • How to use these steps to solve challenging hypothetical situations
    • How to ultimately use these steps to solve problems that come up in their own life
  • Individual treatment with one of the staff of certified clinicians who will keep the child’s goals in mind throughout the therapy
  • A number of sessions with the parent before beginning with the child so that the parents will know how to encourage and maintain the child’s growth

Child/Adolescent Services

Problem Solving Skills Training (PSST) directly provides services to children/adolescents and addresses the following:

  • Oppositional behavior, aggressive behavior, antisocial behavior
Services Involve Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: Parents are involved sporadically during treatment to help support their child in implementing Problem Solving Skills Training.

Delivery Settings

This program is typically conducted in a(n):

  • Hospital
  • Outpatient Clinic

Homework

Problem Solving Skills Training (PSST) includes a homework component:

The child is given homework to help them learn to apply problem solving skills to everyday situations. Homework is a natural extension of treatment where learned problem solving skills are applied to real life situations.

Languages

Problem Solving Skills Training (PSST) does not have materials available in a language other than English.

Resources Needed to Run Program

The typical resources for implementing the program are:

PSST requires a standard clinical treatment room.

Minimum Provider Qualifications

PSST providers must be Master’s level mental health professionals.

Education and Training Resources

There is not a manual that describes how to implement this program; but there is training available for this program.

Training Contact:
Training is obtained:

Training is occasionally available either online or onsite.

Number of days/hours:

Total training time is about 8 hours.

Implementation Information

Since Problem Solving Skills Training (PSST) is rated on the Scientific Rating Scale, information was requested from the program representative on available pre-implementation assessments, implementation tools, and/or fidelity measures.

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Pre-Implementation Materials

There are no pre-implementation materials to measure organizational or provider readiness for Problem Solving Skills Training (PSST).

Formal Support for Implementation

There is no formal support available for implementation of Problem Solving Skills Training (PSST).

Fidelity Measures

There are no fidelity measures for Problem Solving Skills Training (PSST).

Implementation Guides or Manuals

There are implementation guides or manuals for Problem Solving Skills Training (PSST) as listed below:

A comprehensive overview of Problem Solving Skills Training is available for purchase at http://yaleparentingcenter.yale.edu/store.

Research on How to Implement the Program

Research has not been conducted on how to implement Problem Solving Skills Training (PSST).

Relevant Published, Peer-Reviewed Research

This program is rated a "1 - Well-Supported by Research Evidence" on the Scientific Rating Scale based on the published, peer-reviewed research available. The program must have at least two rigorous randomized controlled trials with one showing a sustained effect of at least 1 year. The article(s) below that reports outcomes from an RCT showing a sustained effect of at least 1 year has an asterisk (*) at the beginning of its entry. Please see the Scientific Rating Scale for more information.

Child Welfare Outcome: Child/Family Well-Being

Show relevant research...

*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:

  • Age — 7-13 years
  • Race/Ethnicity — 76.8% White and 23.2% Black
  • Gender — 45 Males and 11 Females
  • Status — Participants were inpatients at a psychiatric facility.

Location/Institution: Not specified

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 postintervention follow-up: 1 year.

*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

Population:

  • Age — 5-13 years
  • Race/Ethnicity — Not specified
  • Gender — 87 Males and 25 Females
  • Status — Participants were children receiving inpatient or outpatient treatment at a child conduct clinic.

Location/Institution: Not specified

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. Limitations include no direct assessment of cognitive processes that problem-solving skills training were designed to change and relationship therapy may not have been well or fairly tested.

Length of postintervention 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:

  • Age — 7-13 years
  • Race/Ethnicity — 69.1% White and 30.9% Black
  • Gender — 76 Males and 21 Females
  • Status — Participants were children referred for treatment to a psychiatric facility.

Location/Institution: Not specified

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. Limitations include lack of an untreated comparison group, large attrition rate, and small sample size.

Length of postintervention follow-up: 1 year.

Bushman, B. B., & Gimpel Peacock, G. (2010). Does teaching problem-solving skills matter? An evaluation of Problem-Solving Skills Training for the treatment of social and behavioral problems in children. Child & Family Behavior Therapy, 32, 103-124.

Type of Study: Randomized controlled trial using stratification by child age
Number of Participants: 26

Population:

  • Age — Mean=8.27 years
  • Race/Ethnicity — 23 Caucasians, 1 Asian, and 2 Biracial
  • Gender — 17 Males and 9 Females
  • Status — Participants were families with children with social and behavioral problems.

Location/Institution: Utah

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The study evaluated the effectiveness of Problem-Solving Skills Training (PSST) for the treatment of social and behavioral problems in a sample of children.  All parents received a parent training intervention, after which families were randomly assigned to either a PSST treatment group or a nondirective comparison group. Parents and children completed the Social Skills Rating System (SSRS) and parents completed the Parent Daily Report (PDR), Child Behavior Checklist for Ages 6-18 (CBCL/6-18), Parenting Stress Index-Short Form (PSI-SF), and a parent questionnaire at baseline, post-treatment, and at a 6-week follow-up. Results indicated that children in both the treatment and comparison group showed similar improvement, with PSST showing a minor advantage on several PDR and SSRS scales. Limitations included the small sample size and short-term follow-up.

Length of postintervention follow-up: 6 weeks.

References

Kazdin, A. E. (2010). Problem-solving skills training and parent management training for Oppositional Defiant Disorder and Conduct Disorder. In J. R. Weisz & A. E. Kazdin (Eds.). Evidence-based psychotherapies for children and adolescents (2nd ed., pp. 211-226). New York: Guilford Press.

Contact Information

Name: Alan E. Kazdin
Agency/Affiliation: Yale Parenting Center and Child Conduct Clinic
Website: yaleparentingcenter.yale.edu
Email:
Phone: (203) 432-9993
Fax: (203) 432-5225

Date Research Evidence Last Reviewed by CEBC: January 2017

Date Program Content Last Reviewed by Program Staff: June 2015

Date Program Originally Loaded onto CEBC: April 2009