What is problem-solving therapy?

Problem-solving therapy (PST) is a structured and evidence-based psychological treatment that aims to help people learn how to manage the problems that are adding to their emotional upset.

It teaches practical skills to solve problems in life, rather than just trying to “feel better,” which in turn reduces depressive symptoms.

What’s the goal of problem-solving therapy?

The goal is straightforward:

To assist in managing the everyday problems that contribute to emotional distress by teaching practical, structured problem-solving skills.

In a bit more detail:

• Empowerment
  
  

PST aims to make people feel capable and in control again.

Depression often makes you feel powerless. PST counters that by building confidence in handling life’s challenges.

• Skill-building

It’s about teaching a method, not just offering temporary support.

Clients learn how to define problems clearly, generate solutions, and make decisions systematically, skills they can use long after therapy ends.

• Reducing emotional distress

Depressive symptoms are usually lessened by solving or improving the problems that cause stress (like relationship conflicts, financial issues, work difficulties).

• Breaking the negative cycle
  
  

Depression can create a loop: problems feel overwhelming → avoidance increases → problems worsen → depression worsens.

PST interrupts this loop by promoting action instead of avoidance.

• Encouraging resilience

It’s not about eliminating every life issue, which is impossible.

Instead, PST helps people cope more effectively with new challenges that arise in the future, thereby building long-term psychological resilience.

Why is problem-solving therapy effective in treating depression?

It’s helpful to treat depression because it directly targets several critical factors that maintain or worsen depressive symptoms, such as:

1. Depression often impairs problem-solving ability
   
   

Research shows that people’s ability to solve problems drops substantially when they are depressed.

They tend to:

• • See problems as insurmountable or unsolvable.
  • Feel stuck and avoid acting.
  • Make impulsive or poorly planned decisions.
  • Get trapped in rumination rather than actual problem-solving.

PST directly trains and improves problem-solving skills that aid in moving from helplessness (“I can’t fix this”) to action (“I have options and steps I can take”).

2. It builds control and competence

Feeling out of control is a huge driver of depression.

PST restores a sense of agency by teaching that, while you can’t control everything, you can control your approach to issues in life.

This perception of control is protective against depression, according to cognitive theories.

3. It stops the cycle of avoidance
   
   

When concerns feel too big, avoidance becomes the default coping strategy, and that only makes matters worse over time.

PST interrupts this pattern by encouraging small, achievable actions toward solutions.

Breaking that cycle of avoidance decreases feelings of failure and hopelessness.

4. It concentrates on the present and the future, not just the past

Unlike some therapies that heavily emphasize childhood experiences or analysis, PST is action-oriented and future-focused.

This can be refreshing for many people with depression because it gives them immediate tools to feel healthier and function better.

It aids in shifting from passive reflection to active change.

5. It teaches transferable life skills

The skills learned in PST, like defining problems clearly, brainstorming multiple solutions, and evaluating pros and cons, are useful across every area of life, such as relationships, work, finances, health, etc.

The effects of PST can last long after therapy ends because these are long-term coping strategies.

6. Evidence backs it up

Multiple studies have shown PST’s effectiveness:

• • A meta-analysis noted that PST notably reduces depressive symptoms, especially in primary care and older adult populations.
  • PST is as useful as antidepressant medication for some people with mild-to-moderate depression.
  • It’s even recommended in some clinical guidelines as a first-line treatment for depression in certain groups, like stroke survivors and caregivers.

How effective is problem-solving therapy in treating depression?

Problem-solving therapy is quite effective for treating depression, remarkably mild to moderately depressed individuals.

• Meta-analyses (studies of studies) consistently find that PST extensively lowers depressive symptoms compared to no treatment or placebo.

• For example, Bell and D’Zurilla (2009) reviewed multiple trials and found that PST had a moderate to large effect size (Cohen’s d = 0.54–0.84) in reducing depression.

(In research, a Cohen’s d of 0.5 is considered moderate; 0.8 is large — so that’s a solid effect.)

• In a randomized controlled trial, Areán and colleagues (2010) compared PST to antidepressant medication (citalopram) in older adults with major depression.

• PST was just as helpful as medication in reducing depressive symptoms after 12 weeks.

• Another study by Alexopoulos et al. (2011) discovered that PST diminished depression and improved executive function in elderly patients with cognitive impairment, meaning it helps even when depression is complicated by memory and thinking problems.

How does PST’s effectiveness compare to other therapies?

• PST vs. cognitive behavioral therapy (CBT)

CBT is still considered the “gold standard” for depression, but PST performs similarly to CBT in many studies, especially when it comes to treating people with fewer resources, chronic illness, or who need short-term interventions.

• PST vs. medication

As mentioned above, PST can be equally effective as antidepressants for many people with mild-to-moderate depression, without the side effects.

• PST combined with other treatments

PST is often used with medication or other therapies to boost effectiveness in more severe or treatment-resistant cases.

What disorders and problems can problem-solving therapy treat?

While it was originally developed for depression, research over the past few decades shows it can be adapted to help with a range of mental health disorders and life problems.

That’s notably true when those issues involve feeling stuck, weighed down, or helpless.

1. Major depressive disorder (MDD)
   • This is the original primary use.
   • PST is especially effective for mild to moderate depression.
2. Dysthymia (persistent depressive disorder)
   • Because it focuses on building daily coping skills, PST can help with the chronic, lower-grade sadness of dysthymia.
3. Anxiety disorders
   
   
   • Studies suggest PST can ease symptoms of anxiety, such as generalized anxiety disorder (GAD), by improving perceived control and problem-focused coping.
4. Post-stroke depression
   • Stroke survivors often develop depression due to disability and life changes. PST has been proven highly effective here.
5. Caregiver stress and depression
   • Caregivers benefit from PST because it helps manage the overwhelming demands of caregiving.
6. Adjustment disorders
   • When people struggle emotionally after major life changes, such as job loss and illness diagnosis, PST provides structure and coping strategies.
7. Chronic illness-related depression
   • PST has been used effectively with people facing illnesses like diabetes, cancer, and heart disease, where depression is often secondary to coping with a serious health problem.

Life problems PST can address:

1. Relationship conflicts
   
   
   • PST can assist in developing better conflict resolution and communication strategies.
2. Workplace stress
   • PST teaches strategic thinking to navigate work difficulties such as job loss, difficult coworkers, and burnout.
3. Financial difficulties
   • PST aims at breaking down large, seemingly insurmountable issues into small, solvable steps.
4. Parenting challenges
   • PST aids parents in developing solutions to daily parenting stressors.

This can be very helpful when raising children with behavioral issues.

5. Life transitions
   
   
   • PST is helpful during big life changes when uncertainty spikes, like moving, retirement, becoming a parent, or graduating.
6. Problematic decision-making patterns
   • People who tend to avoid, procrastinate, or panic when making decisions can benefit from PST’s structured approach.

Where PST might not be enough on its own:

• Severe depression with psychotic features.
• Bipolar disorder (especially manic phases).
• Complex PTSD or deep trauma (where trauma-focused therapies like EMDR or prolonged exposure are more appropriate).
• Severe cognitive impairments (like late-stage dementia, unless highly adapted).

PST can still be useful in these cases, but it’s typically combined with other treatments like medication, trauma therapy, or intensive case management.

How does problem-solving therapy work?

It’s a structured, step-by-step method that teaches how to tackle real-life problems causing emotional distress.

Rather than concentrating on emotions or past events (like some therapies do), PST focuses on action:

• Discovering problems.
• Finding workable solutions.
• Taking practical steps forward.

It’s about building skills to handle life challenges more effectively, which naturally reduces symptoms like helplessness, sadness, and anxiety.

The therapy usually follows six key steps:

1. Clarify and define the problem

• • The therapist helps to take the person from a vague sense of “everything is wrong” and narrow it down into a clear, specific
  • Example: Instead of “My life is a mess,” it might become “I’m struggling to meet work deadlines.”

2. Set a realistic goal
   
   

• • Define what would count as success.
  • Goals should be specific, measurable, and achievable, not fantasy fixes.
  • Example: “Submit next week’s report on time” is much better than “Be perfect at work.”

3. Brainstorm multiple solutions

• • No judging ideas yet, since the goal is quantity over quality.
  • Even “bad” ideas are welcomed because they can lead to better ones later.

4. Weigh the pros and cons
   
   

• • Look at the advantages, disadvantages, and practicality of each solution.
  • Avoid impulsive or unrealistic choices.

5. Choose the best solution and plan the steps

• • Pick the most doable, effective solution.
  • Break it down into little, manageable actions. This makes it less consuming.

6. Implement and review

• • Try the solution.
  • Afterwards, reflect:
  • What worked?
  • What didn’t?
  • What could be tweaked next time?

If the first solution didn’t work perfectly (and often it won’t), it’s seen as part of learning instead of failure.

Other important elements of PST

• Teaching a problem-solving mindset
  
  

It’s not just solving one or two issues; it’s changing the whole way someone approaches problems: with curiosity, flexibility, and persistence.

• Addressing negative thinking

Depressed people often automatically think, “I can’t fix this” or “It’s hopeless.”

PST gently challenges these assumptions by showing that small successes are possible.

• Homework between sessions
  
  

Real-life practice is critical.

Clients are usually given “homework” like trying out a solution or tracking their steps between sessions.

• Adaptable format

PST can be delivered in-person, over the phone, online, or even in self-help versions for motivated individuals.

Who is a good candidate for problem-solving therapy?

Problem-solving therapy is best for people who are:

1. Struggling with practical, everyday problems

• • Those who are overwhelmed by things like financial issues, relationship conflicts, work stress, and health challenges.
  • If depression or anxiety is mainly fueled by life problems, PST is a strong fit.
  • For example, a person feeling stuck after a divorce or losing a job.

2. Dealing with mild to moderate depression
   
   

• • PST is very beneficial when depression isn’t too severe or psychotic.
  • People with low motivation, negative thinking, and avoidance patterns benefit because PST teaches them to act step-by-step.
  • Studies indicate that PST trims down depressive symptoms extensively in mild-to-moderate cases.

3. Facing new life transitions or stressors

• • Moving, graduating, career changes, parenting challenges, and chronic illness diagnosis can all trigger emotional tension.
  • PST helps to adapt better by breaking down consuming changes into solvable pieces.

4. Motivated to take action (even if just a little)

• • PST requires active participation, such as brainstorming and trying small solutions.
  • Even if someone feels down, as long as they’re willing to try small steps, PST can build momentum.

5. Able to engage cognitively
   
   

• • People who can think through problems, weigh options, and make decisions will get the most out of PST.
  • It’s less about intense emotional insight and more about practical thinking.

6. Older adults and caregivers

• • PST is extremely effective in older populations and caregivers (like those caring for dementia patients).
  • It’s frequently recommended as a first-line treatment for late-life depression because it improves both mood and daily functioning.

Good candidates for PST are people who:

• Feel stuck by real-world problems.
• Have mild to moderate depression or anxiety.
• Are willing to take slight actionable steps.
• Can work through simple problem-solving tasks.
• Want a practical, skills-based approach instead of profound emotional analysis.

Who might not be a good candidate for problem-solving therapy?

Even though PST is flexible and helpful for many people, it’s not the best fit for everyone.

1. People with severe major depression (with psychotic features)

• • PST alone won’t be enough if someone has delusions, hallucinations, or is strongly impaired by their depression.
  • They usually need medication and/or intensive psychiatric care before or alongside any structured therapy.
  • For instance, someone believing they’re being punished by invisible forces wouldn’t benefit from a goal-setting session right away.

2. Individuals with severe cognitive impairments

• • PST requires the ability to think logically, analyze options, and make decisions.
  • Conditions like advanced dementia, intellectual disability, or severe brain injury might make the problem-solving steps too difficult without major adaptations.

3. People with acute suicidal risk
   
   

• • PST tries to solve day-to-day problems, but if someone is actively suicidal, safety planning and crisis intervention must come first.
  • PST can still be added later once the immediate danger has passed.

4. Those with severe trauma or PTSD (without trauma-focused therapy)

• • Trauma survivors regularly need therapies that specifically target trauma memories (like EMDR, prolonged exposure, or trauma-focused CBT).
  • PST might help later on to rebuild life skills, but it won’t directly deal with trauma symptoms like flashbacks or emotional numbness.

5. Highly unmotivated or resistant clients
   
   

• • PST needs at least a small willingness to engage in brainstorming and trying new steps.
  • If someone feels completely hopeless, refuses to participate, or deeply resists change, it can block progress.

It should still be noted that motivation can sometimes be built.

Therapists often start very small, but if there’s zero engagement, PST isn’t the right starting point.

6. People seeking deep emotional insight

• • If someone’s primary goal is emotional exploration (like uncovering childhood wounds or unconscious patterns), they might find PST too practical and structured.
  • Therapies like psychodynamic therapy or emotion-focused therapy would be a better fit for that purpose.

How to get started with problem-solving therapy?

1. Find a therapist trained in PST
   
   

The easiest and most efficient way to start is working with a therapist who knows the method well.

• • Look for clinical psychologists, licensed counselors, or occupational therapists trained in cognitive-behavioral therapies (CBT) since many have added PST to their abilities.
  • Some organizations also certify providers specifically in problem-solving therapy for depression treatment in primary care settings.
  • Search for terms like “problem-solving therapy depression,” “brief therapy,” or “CBT with problem-solving focus” to find someone local or online.

PST can even be delivered successfully over teletherapy, so finding the perfect local fit isn’t strictly necessary anymore.

2. Understand the basic PST steps

Even before starting formal therapy, it’s useful to know what PST looks like:

• • Define the problem clearly.
  • Set realistic goals.
  • Brainstorm possible solutions.
  • Weigh pros and cons.
  • Choose the best option.
  • Take action and review.

Learning the structure in advance can make the therapy itself feel a lot more natural and less intimidating.

3. Start practicing problem-solving on your own (optional)
   
   

You can even practice some PST skills independently to build confidence if you’re motivated.

• • Think of a minor, non-life-threatening problem (like organizing your workspace).
  • Write down the problem.
  • Set a small, achievable goal (“Clean my desk by Friday”).
  • List at least 3 possible ways to tackle it.
  • Pick one and try it.

The goal isn’t perfection, it’s action and learning.

4. Use self-help books or guides
   
   

Some excellent, research-based self-help materials teach PST skills if therapy isn’t accessible right away.

• • Problem-Solving Therapy: A Positive Approach to Clinical Intervention by Arthur Nezu and Christine Maguth Nezu.

This is the go-to manual for clinicians, but can be adapted for motivated individuals.

• • Overcoming Depression One Step at a Time by Michael Addis and Christopher Martell.

Concentrates on activity-based problem-solving for depression.

5. Set realistic expectations

PST isn’t magic overnight.

It’s about building a skill over time, like learning how to navigate issues instead of feeling paralyzed by them.

• • Expect to practice between sessions.
  • Expect to tweak strategies when things don’t work perfectly.
  • Expect tiny wins to build up into major improvements in mood, confidence, and daily functioning.

How do you find a therapist who specializes in problem-solving therapy?

1. Start with therapist directories
   
   

These databases let you filter by therapy type or issue. Look for:

• • Psychology Today: Use the filter to select “problem-solving therapy” or search for it in the therapist’s profile.
  • TherapyDen: More inclusive and detailed filtering.
  • GoodTherapy: Offers similar filtering.
  • Zencare: Focuses on quality-verified therapists, mostly in the US.

If “problem-solving therapy” isn’t a filter option, search for therapists who treat depression and mention cognitive-behavioral approaches.

PST is often listed under CBT or brief therapy.

2. Ask directly
   
   

If you find a few therapists that seem like a good fit, email or call them and ask:

• • “Do you have training or experience in problem-solving therapy or structured CBT-based approaches for depression?”

Many therapists don’t list every modality on their profile, but they might still be skilled in it.

3. Check professional organizations

Some therapists list their credentials on sites like:

• • Association for Behavioral and Cognitive Therapies (ABCT): abct.org.
  • National Register of Health Service Psychologists: nationalregister.org.

Use their “Find a Therapist” tools to locate CBT or PST-trained professionals.

4. Look into academic or medical centers

University hospitals or teaching hospitals often offer PST through:

• • Clinical psychology departments.
  • Psychiatry clinics.
  • Mental health research programs.

For example, in the U.S., places like the University of Washington have been involved in PST research and may offer therapy or referrals.

5. Teletherapy platforms
   
   

Online platforms often let you sort by approach or method:

• • BetterHelp and Talkspace may not label PST specifically, but might match you with a CBT therapist trained in it.
  • Some therapists offering brief, structured, goal-oriented sessions may already use PST without naming it directly.

What to look for in the bio or approach:

• Mentions of CBT, structured therapy, or brief interventions.
• An emphasis on depression, coping skills, or problem-solving.
• Trained in D’Zurilla & Nezu’s PST model or similar.

What are the benefits of problem-solving therapy?

It’s a structured and evidence-based psychological intervention that teaches practical coping skills to manage life’s challenges.

It aids in becoming more confident and efficient at solving real-life problems, which can reduce stress and depressive symptoms.

1. Reduces symptoms of depression
   
   

PST cuts down negative thinking by shifting focus from emotional exhaustion to actionable steps.

Studies have shown it’s effective for:

• • Mild to moderate depression.
  • Older adults with chronic illness and depression.
  • People with comorbid medical issues (e.g., cancer, diabetes).

A meta-analysis by Bell & D’Zurilla (2009) proved that PST substantially lowered depressive symptoms compared to no treatment or usual care.

2. Improves control

Depression often comes with feelings of helplessness or hopelessness.

PST gives people an organized way to:

• • Classify their problems.
  • Generate realistic solutions.
  • Act and evaluate results.

This boosts self-efficacy, the belief that you can do something about your situation.

3. Enhances coping skills
   
   

Instead of getting stuck in rumination or avoidance, PST teaches adaptive coping strategies like:

• • Breaking problems into manageable parts.
  • Evaluating the pros and cons of possible solutions.
  • Setting realistic goals.

This helps to deal better with both everyday hassles and major life stressors.

4. Structured and brief

PST is typically short-term, often 6 to 12 sessions, making it ideal for:

• • People who are looking for time-limited therapy.
  • Primary care settings.
  • Those who prefer a more practical, goal-focused approach.

This makes it accessible and cost-effective when compared to longer forms of psychotherapy.

5. Works well alongside other treatments
   
   

It can be used on its own or alongside:

• • Antidepressants.
  • Other therapies like CBT or ACT.
  • Medical treatments (notably in chronic illness or after a major diagnosis).

It’s very useful when problem-solving difficulties are causing depression.

6. Improves functioning in daily life

Beyond mood, PST can help improve:

• • Relationships.
  • Job performance.
  • Health behaviors such as adherence to medication and lifestyle changes.

People regularly report better overall life satisfaction by learning how to tackle real-life challenges.

What are the limitations, downsides, and potential risks of problem-solving therapy?

PST is generally considered safe and effective, especially for depression, but like any therapeutic approach, it’s not a one-size-fits-all solution.

1. Not ideal for severe mental illness

PST may not be useful on its own for:

• • Severe major depressive disorder.
  • Psychosis.
  • Bipolar disorder.
  • Acute suicidal ideation.

These conditions often require more intensive or comprehensive care, like medication, longer-term therapy, and crisis intervention.

Why? PST focuses on rational problem-solving. But in states of severe cognitive impairment or emotional dysregulation, clients might struggle to engage with the structured steps.

2. May overemphasize “fixing” problems

It teaches people to take practical action, but not all emotional pain can be “solved”.

Some issues (grief, trauma, existential crises) require:

• • Emotional processing.
  • Acceptance-based work.
  • Greater exploration of beliefs or patterns.

If a therapist pushes too hard for solutions without validating the emotional experience, clients may feel invalidated or rushed.

3. Cognitive demands can be too high for some
   
   

PST requires:

• • Goal setting.
  • Planning.
  • Decision-making.
  • Evaluating outcomes.

This can be too much for clients with executive dysfunction, cognitive decline, or brain fog (due to depression, ADHD, long COVID, or neurodegenerative disorders).

A study by Alexopoulos et al. noted that while PST can help elderly adults with cognitive decline, it must be adapted and simplified.

4. Risk of oversimplifying complex problems

Some life challenges aren’t easily broken down into “steps,” like:

• • Chronic relational patterns.
  • Identity issues.
  • Systemic oppression or poverty.

PST’s controlled approach can feel too narrow or surface-level for clients dealing with complex trauma or multilayered life issues.

5. Requires motivation and follow-through
   
   

Clients are expected to:

• • Practice skills between sessions.
  • Try solutions in real life.
  • Reflect on what works or doesn’t.

This assumes a baseline level of motivation, energy, and executive functioning, which may be hard for people with severe depression, burnout, or fatigue.

It may also reinforce feelings of helplessness or guilt if a client doesn’t complete homework or “fails” at solving problems.

6. Not aimed at emotional insight or relational patterns

Unlike psychodynamic or interpersonal therapies, PST doesn’t dive into:

• • Attachment issues.
  • Past trauma.
  • Relationship dynamics.
  • Core beliefs or unconscious drives.

This means that PST can feel too “mechanical” or “shallow” for clients wanting emotional depth.

7. Therapist skill matters
   
   

Poor delivery of PST can lead to:

• • Rigid or formulaic sessions.
  • Lack of empathy or emotional attunement.
  • Ignoring context in favor of “fixing”.

A well-trained therapist will still bring empathy, flexibility, and clinical judgment instead of just sticking to the protocol blindly.

PST works best when matched to the client’s needs, adapted when necessary, and delivered with flexibility and empathy.

How long will I need problem-solving therapy?

It is typically a short-term therapy, and that’s part of its appeal since it’s structured, goal-focused, and designed to teach you practical skills in a relatively brief time.

• Typical duration: 6 to 12 sessions

Most research-backed PST protocols last:

• • 6 to 8 weekly sessions for mild to moderate depression.
  • Up to 12 sessions if the issues are more complex or if progress is slower.

Each session is usually 45–60 minutes, and the focus is on:

• • Finding a current problem.
  • Breaking it down.
  • Brainstorming solutions.
  • Choosing and testing one.
  • Evaluating how it went.

• Can it be extended?

Yes, some people benefit from:

• • A few booster sessions (monthly check-ins after the initial course).
  • More sessions if life is particularly complex (multiple concurrent stressors).
  • Combining PST with another approach, like CBT, ACT, or supportive therapy, if more depth or flexibility is needed.
  • You might need fewer sessions if:
  • You’re highly motivated and practice between sessions.
  • You’re dealing with a single, clearly defined issue.
  • You’ve had therapy before and just need to refresh your skills.
  • You could need more sessions if:
  • Depression is moderate to severe.
  • You have co-occurring conditions, such as anxiety, ADHD, and chronic pain.
  • You struggle with follow-through or executive functioning.
  • Your problems are more systemic or relational than situational.

When to stop problem-solving therapy?

Knowing when to stop problem-solving therapy is important since it helps you wrap up at the right time, without cutting things short or dragging them out unnecessarily.

The endpoint is often built in because PST is a goal-oriented, time-limited therapy, but here’s how to recognize when you’re truly ready to stop (or take a pause):

1. You’ve achieved your therapy goals

The clearest sign it’s time to stop is if you’ve:

• • Learned and practiced the problem-solving steps.
  • Applied them successfully to real-life challenges.
  • Feel more confident in dealing with stress or decisions.
  • Notice improved mood, motivation, and functioning.

PST isn’t about solving every problem. It’s about building skills to handle future ones on your own.

2. You feel more in control

The main outcome of PST is a stronger sense of:

• • Agency.
  • Self-efficacy.
  • Confidence in your ability to cope.

If you’re making decisions more easily, acting when things go wrong, and not spiraling into helplessness, that’s a strong cue that you may be ready to stop or space out sessions.

3. You’re noticing less rumination and avoidance
   
   

Many people come into PST stuck in:

• • Overthinking.
  • Avoiding difficult tasks or decisions.
  • Feeling stunned by even small stressors.

The therapy has likely done its job if these patterns have eased and you’re facing issues head-on (even imperfectly).

4. Progress has plateaued

Sometimes, you reach a point where you’ve gained what you can from PST:

• • The structured method becomes second nature.
  • You’re not bringing new problems to work on.
  • Sessions feel more like check-ins than growth opportunities.

At this stage, it might make sense to end, pause, or transition to another type of therapy.

5. You and your therapist agree it’s time
   
   

You and your therapist will usually evaluate progress around sessions 5–8.

It’s probably a good time to start preparing for termination if both of you agree that:

• • Your depressive symptoms have improved.
  • You’re consistently using the tools on your own.
  • You’ve gained what you came for.

When not to stop PST:

Even if you’re feeling a bit better, don’t stop if:

• You still feel stuck on the same issues.
• You haven’t internalized the PST steps.
• You’re using therapy as a safety net because you’re afraid of relapsing.
• There’s been no measurable improvement in your daily functioning.

You might need more time, a booster session plan, or a therapy adjustment in these cases.

What to expect from problem-solving therapy?

1. What you’ll learn:

PST teaches a 6-step method to tackle problems systematically:

• • Clarify the problem. (What exactly is bothering you?)
  • Set a realistic goal. (What outcome are you aiming for?)
  • Brainstorm possible solutions. (No censoring since all ideas are welcome.)
  • Evaluate and choose the best one. (Advantages and disadvantages of each.)
  • Create and carry out an action plan. (Concrete steps.)
  • Review the outcome. (What worked? What didn’t? What’s next?)

You’ll apply this repeatedly across sessions and in daily life.

2. What to expect in a typical PST session

• • 1st session: Introduction to the PST model, identify a few target problems.
    
  • 2nd–4th sessions: Work on a current issue using the 6-step process.
  • Midway point: Review progress, adjust strategy, and address any stuck points.
  • Final sessions: Focus on self-directed use of PST, relapse prevention, and booster plans.

Therapists often assign home practice by trying out solutions between sessions and reflecting on outcomes.

3. What outcomes to expect
   
   

If PST is a good fit and you’re actively engaged, you can expect:

• • Reduced depressive symptoms (especially mild to moderate).
  • Improved coping skills and emotional regulation.
  • Greater confidence in decision-making.
  • Less avoidance, more proactive behavior.
  • Feeling more in control of your life.

What you won’t get from PST:

• • Deep trauma processing.
  • Exploration of unconscious dynamics or childhood roots.
  • Emphasis on identity, personality structure, or existential issues.

PST might be too surface-level if you’re looking for those, or it can be a complement to longer-term therapy.

• Therapist style in PST
  • Directive but collaborative.
  • Structured and goal-oriented.
  • Empathetic but aimed at solutions, not just feelings.
  • Often gives worksheets or tools (some use problem logs).

How much does problem-solving therapy cost?

The cost can vary quite a bit depending on:

• Where you live.
• How you access it.
• Whether it’s covered by insurance or a public healthcare system.

The price usually reflects general psychotherapy rates since PST isn’t always labeled as a distinct service (like CBT or psychodynamic therapy might be).

1. Average cost (private pay)
   

United States:

• • $100–$200 per session (45–60 mins).
  • Urban areas tend to be more expensive.
  • Sliding scale options are available with some therapists.

United Kingdom:

• • £40–£100 per session
  • PST might be obtainable free via the NHS under IAPT services (Improving Access to Psychological Therapies), particularly for depression.

Australia:

• • AUD 100–$200 per session
  • Medicare may cover up to 10 sessions per year with partial rebates (around AUD 80 per session) with a mental health care plan.

Canada:

• • CAD 100–$180 per session.
  • Often not covered by public healthcare unless provided in hospitals or community mental health centers.
  • Private insurance may help.

Belgium:

• • Rates vary but are often €50–€90 per session.
  • Some therapists offer reduced rates under convention agreements (via mutualiteit/ziekenfonds).

• • • PST might not be specifically listed but may be practiced under general psychotherapy.

2. Insurance and reimbursement
   
   

• • PST is covered under general psychotherapy when done by a licensed provider (psychologist, clinical social worker, or licensed therapist) in many countries.
  • In the U.S., it may be covered under CPT codes for psychotherapy (90834, 90837).
  • In Belgium and parts of Europe, reimbursement through public insurance may require referral or therapist accreditation.

3. Low-cost or free options

• • University clinics: Regularly offer PST by trainees at reduced rates.
  • Online platforms: Some guided PST programs are free or low-cost (SilverCloud, MoodGYM).
  • Community mental health centers or non-profits may suggest PST or similar skills-based therapies.

4. Digital or guided self-help PST
   
   

Some platforms offer PST in an online or workbook format:

• • Often $0–$50 total for access.
  • Good for people with mild to moderate depression.
  • Examples: MindSpot (AU), Woebot (US-based), NHS SilverCloud (UK).

PST is often cheaper in the long run because it’s short-term (6–12 sessions), but upfront costs can still be a barrier.

Always ask about:

• • Sliding scale options.
  • Package deals or session bundles.
  • Coverage through your health insurance or national health system.

Problem-solving therapy exercises and printable worksheets for depression

1. Problem-Solving Therapy Worksheet

This worksheet guides you through the PST process: defining a problem, brainstorming solutions, evaluating options, and implementing an action plan.

• • Download: Problem-Solving Therapy Worksheet​.

2. CBT Problem-Solving Worksheet

Based on cognitive behavioral therapy principles, this worksheet helps you objectively identify problems, list possible solutions, weigh pros and cons, and select the best course of action.

• • Download: CBT Problem-Solving Worksheet.​

3. Coping Skills: Depression Worksheet

This resource outlines four research-supported techniques to alleviate depression symptoms: behavioral activation, social support, positive journaling, and mindfulness.

• • Download: Coping Skills: Depression Worksheet​.

4. Depression Worksheets Collection

A comprehensive set of worksheets to classify triggers, develop coping strategies, and create a crisis plan.

Includes mood logs and cognitive restructuring tools.

• • Download: Depression Worksheets.

5. Free Depression Workbook

An extensive 80-page workbook featuring exercises on negative thought patterns, mood tracking, gratitude journaling, and more.

• • Download: Free Depression Workbook​.

6. Depression self-help resources
   
   

Offers various self-help worksheets, including mood diaries and strategies to challenge unhelpful thinking.

• • Download: Depression Self-Help Resources​.

7. Behavioral Activation Worksheets for Depression and Anxiety:

Provides worksheets aimed at behavioral activation and cognitive restructuring to combat depression.

• • Download: Behavioral Activation Worksheets for Depression and Anxiety.

8. Overcoming Depression Workbook

A vast 44-exercise workbook rooted in cognitive behavioral therapy (CBT) principles.

It covers understanding depression, increasing positive feelings, and developing new thinking patterns.

• • Download: Overcoming Depression Workbook.

9. Problem-Solving Worksheet

A concise worksheet guiding you through distinguishing issues, generating solutions, and implementing action plans.

• • Download: Problem-Solving Worksheet​.

10. Problem-Solving Packet

A five-page packet detailing each step of the problem-solving process with rationales, tips, and questions to guide you.

• • Download: Problem-Solving Packet​.

11. PST Hope Workbook

A comprehensive workbook introducing the S.O.L.V.E. model: State the problem, Options, List pros and cons, Visualize the plan, and Evaluate the outcome.

It includes weekly coping strategies and activity trackers.

• • Download: PST Hope Workbook.

12. Problem-Solving Therapy Worksheets and Activities

Offers a collection of problem-solving therapy worksheets and activities suitable for both individuals and professionals.

• • Download: Problem-Solving Therapy Worksheets & Activities.

13. Therapist Aid
    
    

Provides a variety of depression management worksheets, including mood trackers and cognitive restructuring tools.

• • Download: Depression Management Worksheets​.

Conclusion

Problem-Solving Therapy (PST) is an effective, short-term approach for managing depression.

It empowers them to make practical decisions, reduce feelings of helplessness, and improve their overall coping skills by teaching individuals to break down challenges into manageable steps.

While PST is concentrated on current problems rather than emotional exploration, its structured process helps individuals gain control and actively address the issues contributing to their depression.