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9: Problem Solving Therapy
Risk Management and Treatment » Non-pharmacologic Treatments
9: Problem Solving Therapy
We suggest offering problem-solving based psychotherapies to: a) Patients with a history of more than one incident of self-directed violence to reduce repeat incidents of such behaviors; b) Patients with a history of recent self-directed violence to reduce suicidal ideation; and/or c) Patients with hopelessness and a history of moderate to severe traumatic brain injury
Strength:
Weak for
Category:
ReviewedNew-replaced
Grades and Definitions
- Strong for
- or "We recommend offering this option …"
- Weak for
- or "We suggest offering this option …"
- No recommendation
- or "There is insufficient evidence …"
- Weak against
- or "We suggest not offering this option …"
- Strong against
- or "We recommend against offering this option …"
Categories and Definitions |
||
|---|---|---|
| Evidence Reviewed* | Recommendation Category* | Definition* |
| Reviewed | New-added | New recommendation following review of the evidence |
| New-replaced | Recommendation from previous CPG that has been carried over to the updated CPG that has been changed following review of the evidence | |
| Not changed | Recommendation from previous CPG that has been carried forward to the updated CPG where the evidence has been reviewed but the recommendation is not changed | |
| Amended | Recommendation from the previous CPG that has been carried forward to the updated CPG where the evidence has been reviewed and a minor amendment has been made | |
| Deleted | Recommendation from the previous CPG that has been removed based on review of the evidence | |
| Not reviewed | Not changed | Recommendation from previous CPG that has been carried forward to the updated CPG, but for which the evidence has not been reviewed |
| Amended | Recommendation from the previous CPG that has been carried forward to the updated CPG where the evidence has not been reviewed and a minor amendment has been made | |
| Deleted | Recommendation from the previous CPG that has been removed because it was deemed out of scope for the updated CPG | |
| *Adapted from the NICE guideline manual (2012): The guidelines manual. London: National Institute for Health and Care Excellence;2012. and Martinez Garcia L, McFarlane E, Barnes S, Sanabria AJ, Alonso-Coello P, Alderson P. Updated recommendations: An assessment of NICE clinical guidelines. Implement Sci. 2014;9:72. | ||
Recommendation Resources
Problem-Solving Therapy (PST) for Suicide Prevention is a brief form of evidence-based treatment that teaches and empowers patients to solve the here-and-now problems contributing to suicidal ideation, self-directed violence and hopelessness. It has been shown to help increase self-efficacy and reduce risk of self-harm and suicide.
Training Resources
This section includes links to recommended trainings about PST.
- VA-provided PST resources
- Updated Moving Forward: Overcoming Life's Challenges Web Course
- PST resources from professional organizations
- Problem-Solving Therapy (PST) from the Suicide Prevention Resource Center
- Problem-Solving Therapy for Depression | Society of Clinical Psychology
- Problem Solving Therapy Canada
- PST Canada Workshop recommended pre-reading
Manuals
This section includes links to recommended manuals about PST.
Return to Resource OptionsWebinars
This section includes links to recommended manuals about PST.
-
Problem Solving Therapy for Suicide Prevention in VA Presented by Dr. Shannon Sisco - Emotion-Focused Problem Solving Therapy and Suicidality Presented by Dr. Art Nezu
- Suicide Prevention 2.0 Clinical Telehealth Program Presented by Dr. Jessica A Walker
Articles
This section includes links to recommended articles about CBT-SP.
- (2017). Problem-solving therapy for suicide prevention in veterans with moderate-to-severe traumatic brain injury. Rehabilitation psychology, 62(4). 600-608. https://doi.org/10.1017/S104161022000397X
- (2021). Problem-solving training for Veterans in home based primary care: an evaluation of intervention effectiveness. International psychogeriatrics, 1-12. Advance online publication. https://doi.org/10.1037/rep0000154
- (2018). Window to Hope: A Randomized Controlled Trial of a Psychological Intervention for the Treatment of Hopelessness Among Veterans With Moderate to Severe Traumatic Brain Injury. The Journal of head trauma rehabilitation, 33(2). E64-E73. https://doi.org/10.1097/HTR.0000000000000351
- (2011). Problem-solving therapy for people who present to hospital with self-harm: Zelen randomised controlled trial. The British journal of psychiatry : the journal of mental science, 199(4). 310-316. https://doi.org/10.1192/bjp.bp.110.090126
- (1994). Interpersonal problem-solving skills training in the treatment of self-poisoning patients. Suicide & life-threatening behavior, 24(4). 382-394. https://pubmed.ncbi.nlm.nih.gov/7740595/
- (2017). Social problem solving moderates emotional reactivity in predicting suicide ideation among U.S. Veterans. Military Behavioral Health, 5. 417-426. https://www.tandfonline.com/doi/abs/10.1080/21635781.2017.1337595
- (1990). Cognitive-behavioural problem solving in the treatment of patients who repeatedly attempt suicide. A controlled trial. The British journal of psychiatry: the journal of mental science, 157. 871-876. https://doi.org/10.1192/bjp.157.6.871
