Collaborative Problem Solving® (CPS)

About This Program

Target Population: Children and adolescents (ages 3-21) with a variety of behavioral challenges, including both externalizing (e.g., aggression, defiance, tantrums) and internalizing (e.g., implosions, shutdowns, withdrawal) who may carry a variety of related psychiatric diagnoses, and their parents/caregivers, unless not age appropriate (e.g. young adult or transition age youth)

For children/adolescents ages: 3 – 21

For parents/caregivers of children ages: 3 – 21

Program Overview

Collaborative Problem Solving® (CPS) is an approach to understanding and helping children with behavioral challenges who may carry a variety of psychiatric diagnoses, including oppositional defiant disorder, conduct disorder, attention-deficit/hyperactivity disorder, mood disorders, bipolar disorder, autism spectrum disorders, posttraumatic stress disorder, etc. CPS uses a structured problem solving process to help adults pursue their expectations while reducing challenging behavior and building helping relationships and thinking skills. Specifically, the CPS approach focuses on teaching the neurocognitive skills that challenging kids lack related to problem solving, flexibility, and frustration tolerance. Unlike traditional models of discipline, this approach avoids the use of power, control, and motivational procedures and instead focuses on teaching at-risk kids the skills they need to succeed. CPS provides a common philosophy, language and process with clear guideposts that can be used across settings. In addition, CPS operationalizes principles of trauma-informed care.

Program Goals

The goals of Collaborative Problem Solving® (CPS) are:

  • Reduction in externalizing and internalizing behaviors
  • Reduction in use of restrictive interventions (restraint, seclusion)
  • Reduction in caregiver/teacher stress
  • Increase in neurocognitive skills in youth and caregivers
  • Increase in family involvement
  • Increase in parent-child relationships
  • Increase in program cost savings

Logic Model

The program representative did not provide information about a Logic Model for Collaborative Problem Solving® (CPS).

Essential Components

The essential components of Collaborative Problem Solving® (CPS) include:

  • Three different types of intervention delivery to parents and/or children/adolescents depending on the personal situation:
    • Family therapy sessions (conducted both with and without the youth) which typically take place weekly for approximately 10-12 weeks
    • 4- and 8-week parent training curricula that teach the basics of the model to parents in a group format (maximum group size = 12 participants)
    • Direct delivery to youth in treatment or educational settings in planned sessions or in a milieu
  • In the family sessions or parent training sessions, parents receive:
    • An overarching philosophy to guide the practice of the approach ("kids do well if they can")
    • A specific assessment process and measures to identify challenging behaviors, predictable precipitants, and specific thinking skill deficits. Lagging thinking skills are identified in five primary domains:
      • Language and Communication Skills
      • Attention and Working Memory Skills
      • Emotion and Self-Regulation Skills
      • Cognitive Flexibility Skills
      • Social Thinking Skills
    • A specific planning process that helps adults prioritize behavioral goals and decide how to respond to predictable difficulties using 3 simple options based upon the goals they are trying to pursue:
      • Plan A – Imposition of adult will
      • Plan B – Solve the problem collaboratively
      • Plan C – Drop the expectation (for now, at least)
    • A specific problem solving process (operationalizing "Plan B") with three core ingredients that is used to collaborate with the youth to solve problems durably, pursue adult expectations, reduce challenging behaviors, teach skills, and create or restore a helping relationship.
  • When directly working with the youth in treatment or education settings, providers engage youth with:
    • An overarching philosophy to guide the practice of the approach ("kids do well if they can")
    • A specific problem solving process (operationalizing "Plan B") with three core ingredients that is used to collaborate with the youth to solve problems durably, pursue adult expectations, reduce challenging behaviors, teach skills, and create or restore a helping relationship.

Program Delivery

Child/Adolescent Services

Collaborative Problem Solving® (CPS) directly provides services to children/adolescents and addresses the following:

  • A range of internalizing and externalizing behaviors, including (but not limited to) physical and verbal aggression, destruction of property, self-harm, substance abuse, tantrums, meltdowns, explosions, implosive behaviors (shutting down), crying, pouting, whining, withdrawal, defiance, and oppositionality

Parent/Caregiver Services

Collaborative Problem Solving® (CPS) directly provides services to parents/caregivers and addresses the following:

  • Child with internalizing and/or externalizing behaviors, difficulty effectively problem solving with their child
Services Involve Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: Any caregivers, educators, and other supports are essential to the success of the approach. Caregivers, teachers and other adult supporters are taught to use the approach with the child outside the context of the clinical setting. School and clinical staff typically learn the model via single or multi-day workshops and through follow-up training and coaching.

Recommended Intensity:

Typically family therapy (in which the youth is the identified patient, but the parents are heavily involved in the sessions so that they can get better at using the approach with their child on their own) occurs once per week for approximately 1 hour. The approach can also be delivered in the home with greater frequency/intensity, such as twice a week for 90 minutes. Parent training group sessions occur once a week for 90 minutes over the course of 4 or 8 weeks. The approach can also be delivered by direct care staff in a treatment setting and/or educators in a school system, in which case delivery is not limited to scheduled sessions, but occurs in the context of regular contact in a residence or classroom.

Recommended Duration:

Family therapy: 8-12 weeks; In-home therapy: 8-12 weeks; Parent training groups: 4-8 weeks

Delivery Settings

This program is typically conducted in a(n):

  • Adoptive Home
  • Birth Family Home
  • Foster / Kinship Care
  • Hospital
  • Outpatient Clinic
  • Community-based Agency / Organization / Provider
  • Group or Residential Care
  • Justice Setting (Juvenile Detention, Jail, Prison, Courtroom, etc.)
  • School Setting (Including: Day Care, Day Treatment Programs, etc.)

Homework

Collaborative Problem Solving® (CPS) includes a homework component:

Identifying specific precipitants, prioritizing behavioral goals, and practicing the problem solving process are expected to be completed by the caregiver and youth between sessions.

Languages

Collaborative Problem Solving® (CPS) has materials available in languages other than English:

Chinese, French, Spanish

For information on which materials are available in these languages, please check on the program's website or contact the program representative (contact information is listed at the bottom of this page).

Resources Needed to Run Program

The typical resources for implementing the program are:

Trained personnel. If being delivered as parent group training, it requires a room big enough to hold the number of families (anywhere from a couple of parents up to 12 participants), as well as A/V equipment or printed materials for delivery of material in training curriculum.

Manuals and Training

Prerequisite/Minimum Provider Qualifications

Service providers and supervisors must be certified in CPS. There is no minimum educational level required before certification process can begin.

Manual Information

There is a manual that describes how to deliver this program.

Program Manual(s)

Treatment Manual: Greene, R. W., & Ablon, J. S. (2005). Treating explosive kids: The Collaborative Problem Solving approach. Guilford Press.

Training Information

There is training available for this program.

Training Contact:
Training Type/Location:

Training can be obtained onsite, at Massachusetts General Hospital in Boston, at trainings hosted in other locations, online (introductory training only), or via video/phone training and coaching.

Number of days/hours:

Ranges from a 2-hour exposure training to more intensive (2.5 day) advanced sessions as well as hourly coaching:

  • Exposure/Introductory training: These in-person and online trainings typically last from 2–6 hours and provide a general overview exposure of the model including the overarching philosophy, the assessment, planning and intervention process. Training can accommodate an unlimited number of participants.
  • Two-and-a-half day intensive trainings that provide participants in-depth exposure to all aspects of the model using didactic training, video demonstration, role play and breakout group practice. Tier 1 training is limited to 150 participants. Tier 2 training is limited to 75 participants.
  • Coaching sessions for up to 12 participants that provide ongoing support and troubleshooting in the model
Additional Resources:

There currently are additional qualified resources for training:

There are many certified trainers throughout North America who teach the model as well as well as systems that use the approach. The list is available at https://thinkkids.org/our-communities

Implementation Information

Pre-Implementation Materials

There are pre-implementation materials to measure organizational or provider readiness for Collaborative Problem Solving® (CPS) as listed below:

A CPS Organizational Readiness Assessment measure has been developed that is available for systems interested in implementing the model. It can be obtained by contacting the Director of Research and Evaluation, Dr. Alisha Pollastri, at apollastri@mgh.harvard.edu.

Formal Support for Implementation

There is formal support available for implementation of Collaborative Problem Solving® (CPS) as listed below:

Think:Kids provides implementation support in the form of ongoing coaching and fidelity and outcome monitoring. There is a Director of Implementation who oversees these activities.

Fidelity Measures

There are fidelity measures for Collaborative Problem Solving® (CPS) as listed below:

Self Study of CPS Sustainability, Updated 06/2019: A guide for systems to assess the degree to which they are have put the structures in place to implement CPS with fidelity. Can be obtained by contacting the Director of Research and Evaluation, Dr. Alisha Pollastri, at apollastri@mgh.harvard.edu.

CPS Manualized Expert-Rated Integrity Coding System (CPS-MEtRICS) and Treatment Integrity Rating Form-Short (CPS-TIRFS): Fidelity tools to help measure the degree to which CPS is being practiced with fidelity in a specific encounter. Can be obtained by contacting the Director of Research and Evaluation, Dr. Alisha Pollastri, at apollastri@mgh.harvard.edu.

Implementation Guides or Manuals

There are implementation guides or manuals for Collaborative Problem Solving® (CPS) as listed below:

Clinician Session Guide: Guides the clinician in all aspects of the treatment, from initial assessment to ongoing work. Can be obtained by contacting the Director of Research and Evaluation, Dr. Alisha Pollastri, at apollastri@mgh.harvard.edu.

CPS Coaching Guide: A guide specifically geared towards trainer individuals who are helping caregivers to implement the model over time. Available to certified trainers.

Research on How to Implement the Program

Research has been conducted on how to implement Collaborative Problem Solving® (CPS) as listed below:

Ercole-Fricke, E., Fritz, P., Hill, L. E., & Snelders, J. (2016). Effects of a Collaborative Problem Solving approach on an inpatient adolescent psychiatric unit. Journal of Child and Adolescent Psychiatric Nursing, 29(3), 127–134. https://doi.org/10.1111/jcap.12149

Pollastri, A. R., Boldt, S., Lieberman, R., & Ablon, J. S. (2016). Minimizing seclusion and restraint in youth residential and day treatment through site-wide implementation of Collaborative Problem Solving. Residential Treatment for Children & Youth, 33(3-4), 186–205. https://doi.org/10.1080/0886571X.2016.1188340

Pollastri, A. R., Ablon, J. S., & Hone, M. J. (Eds.). (2019). Collaborative Problem Solving: An evidence-based approach to implementation and practice. Springer.

Pollastri, A. R., Wang, L., Youn, S. J., Ablon, J. S., & Marques, L. (2020). The value of implementation frameworks: Using the active implementation frameworks to guide system-wide implementation of Collaborative Problem Solving. Journal of Community Psychology, 48(4), 1114–1131. https://doi.org/10.1002/jcop.22325

Relevant Published, Peer-Reviewed Research

Child Welfare Outcome: Child/Family Well-Being

Greene, R. W., Ablon J. S., Goring, J. C., Raezer-Blakely, L., Markey, J., Monuteaux, M. C., Henin, A, Edwards, G., & Rabbitt, S. (2004). Effectiveness of Collaborative Problem Solving in affectively dysregulated children with oppositional defiant disorder: Initial findings. Journal of Consulting and Clinical Psychology, 72(6), 1157–1164. https://doi.org/10.1037/0022-006X.72.6.1157

Type of Study: Randomized controlled trial
Number of Participants: 47

Population:

  • Age — 4–12 years
  • Race/Ethnicity — Not specified
  • Gender — 32 Male and 15 Female
  • Status — Participants were parents and their children with oppositional defiant disorder (ODD).

Location/Institution: Massachusetts

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to examine the efficacy of Collaborative Problem Solving (CPS) in affectively dysregulated children with oppositional defiant disorder (ODD). Participants were randomized to either the parent training version of CPS or parent training (PT). Measures utilized include the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children—Epidemiologic version (K-SADS–E), the Wechsler Intelligence Scale for Children—Revised, the Parent–Child Relationship Inventory (PCRI), the Parenting Stress Index (PSI), the Oppositional Defiant Disorder Rating Scale (ODDRS), and the Clinical Global Impression–Improvement (CGI-I). Results indicate that CPS produced significant improvements across multiple domains of functioning at posttreatment and at 4-month follow-up. Limitations include small sample size and length of follow-up.

Length of controlled postintervention follow-up: 4 months.

Pollastri, A. R., Boldt, S., Lieberman, R., & Ablon, J. S. (2016). Pollastri, A. R., Boldt, S., Lieberman, R., & Ablon, J. S. (2016). Minimizing seclusion and restraint in youth residential and day treatment through site-wide implementation of Collaborative Problem Solving. Residential Treatment for Children & Youth. 33(3–4), 186–205. https://doi.org/10.1080/0886571X.2016.1188340

Type of Study: Pretest–posttest study with a nonequivalent control group (Quasi-experimental)
Number of Participants: Not specified

Population:

  • Age — Not specified
  • Race/Ethnicity — Not specified
  • Gender — Not specified
  • Status — Participants were in residential and day treatment and included youth in foster care and child welfare.

Location/Institution: Oregon

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to describe the results of one agency’s experience implementing the Collaborative Problem Solving (CPS) approach organization-wide and its effect on reducing seclusion and restraint (S/R) rates. Participants were grouped into the CPS intervention at a residential or day treatment facility. Measures utilized include the Child and Adolescent Functional Assessment Scale (CAFAS) and the Child and Adolescent Needs Assessment (CANS). Results indicate that during the time studied, frequency of restrictive events in the residential facility decreased from an average of 25.5 per week to 2.5 per week, and restrictive events in the day treatment facility decreased from an average of 2.8 per week to 7 per year. Limitations include lack of randomization of participants, and lack of follow-up.

Length of controlled postintervention follow-up: None.

Additional References

Greene, R. W., & Ablon, J. S. (2005). Treating explosive kids: The Collaborative Problem Solving approach. Guilford Press.

Greene, R. W., Ablon, J. S., Goring, J. C., Fazio, V., & Morse, L. R. (2003). Treatment of oppositional defiant disorder in children and adolescents. In P. Barrett & T. H. Ollendick (Eds.), Handbook of Interventions that work with children and adolescents: Prevention and treatment. John Wiley & Sons.

Pollastri, A. R., Epstein, L. D., Heath, G. H., & Ablon, J. S. (2013). The Collaborative Problem Solving approach: Outcomes across settings. Harvard Review of Psychiatry, 21(4), 188–199. https://pubmed.ncbi.nlm.nih.gov/24651507/

Contact Information

J. Stuart Ablon
Title: Director
Agency/Affiliation: Think:Kids at Massachusetts General Hospital
Website: www.thinkkids.org
Email:
Phone: (617) 643-6024
Fax: (617) 643-9715

Date Research Evidence Last Reviewed by CEBC: July 2023

Date Program Content Last Reviewed by Program Staff: March 2020

Date Program Originally Loaded onto CEBC: May 2017