Problem-Solving Therapy

Definition

Problem-Solving Therapy (PST) is a structured treatment that teaches clients how to approach life problems constructively. It does not assume the therapist should solve the client's life. Instead, the therapist trains a repeatable skill: define a manageable problem, generate alternatives, choose a solution, implement it, and evaluate the result.

PST has two linked levels. The first is problem orientation: how the client understands problems and their own capacity to respond. The second is problem-solving skill: the step-by-step procedure.

Founder(s) and history

PST was developed in the second half of the twentieth century, especially through the work of Thomas D'Zurilla, Arthur Nezu, and Christine Maguth Nezu. It grew out of social problem-solving theory and became a practical clinical method for depression, stress, chronic illness, older adults, and primary-care settings.

Later adaptations include PST-PC for primary care, structured worksheets, homework logs, and protocols for medically ill or older clients.

Key concepts

Problem orientation

Problem orientation is the cognitive-emotional stance a person takes toward problems.

Positive orientation includes:

problems are a normal part of life;
a problem can be an opportunity for learning;
I can influence at least part of what happens;
action is possible.

Negative orientation includes:

avoidance;
catastrophizing;
helplessness;
low self-efficacy;
seeing the problem as proof of personal failure.

✅ Work with orientation through normalization, psychoeducation, and reinforcement of each small success.

⚠️ Do not rush into the five steps while the client is still in "nothing will work." First build a stance that allows problem solving.

Problem-solving skills

PST trains deliberate action rather than impulsive or avoidant reaction. The adaptive style is systematic, thoughtful, flexible, and testable.

Common unhelpful styles:

1. Impulsive/careless — first idea, no evaluation, abandoned quickly. 2. Avoidant — delay, hope it disappears, hand responsibility to others. 3. Rational/adaptive — define, generate, choose, plan, verify.

The five stages

Stage 1: problem definition

The therapist helps translate a vague emotional problem into a specific, workable definition.

Useful questions:

"Tell me one concrete example when this happened. What came before it became difficult?"

"If you described the problem to a friend in one sentence, what would you say?"

Break a mega-problem into smaller parts and work with one part at a time.

Stage 2: generating alternatives

The aim is to create many possible solutions without criticism during generation.

Rules:

1. Quantity first. 2. No criticism yet. 3. Combine ideas. 4. Realism comes later.

If the client is stuck, ask: what would be simpler, cheaper, faster, or opposite?

Stage 3: decision making

The client chooses one or two possible solutions through systematic evaluation.

Criteria:

chance of success;
available resources;
likely consequences;
fit with values;
side effects.

If the client hesitates, frame it as a trial for one week rather than a final life decision.

Stage 4: implementation

The chosen solution becomes an action plan:

1. first step; 2. preparation; 3. possible obstacles; 4. response to each obstacle; 5. tracking and review.

The plan should specify who, what, when, where, and how.

Stage 5: verification

At the next session, the therapist checks what happened. Did the solution work? What helped? What interfered? What would the client change next time?

Verification often leads to a better problem definition and a new cycle. That is not failure; it is learning.

Format of therapy

PST is commonly delivered in 6-12 sessions, though the format can be shorter in primary care or longer in complex situations.

A typical flow:

1. Normalize problems and assess problem orientation. 2. Choose one concrete problem. 3. Define the problem and goal. 4. Generate alternatives. 5. Evaluate and choose a solution. 6. Build a concrete action plan. 7. Practice or rehearse the first step in session. 8. Review homework and refine.

The therapist uses worksheets, homework logs, role-play, and repeated reinforcement of self-efficacy.

Evidence base

PST has evidence across depression, distress, chronic illness, older adults, and medical settings.

It has been used for:

depression in older adults, including primary-care studies;
distress in cancer and chronic illness;
suicidal ideation as part of crisis work;
diabetes, stroke, traumatic brain injury, chronic pain, and hypertension;
situational stressors such as unemployment, conflict, and life transitions.

The mechanism is practical: the client gains usable skills, experiences success, reduces avoidance, and regains a sense of agency.

Limitations

PST is not a universal tool. Acute trauma, acute suicidality, severe depression with high risk, major cognitive impairment, and complex relational patterns may require stabilization, medication, crisis intervention, or relational work before or alongside PST.

Common errors include rushing to solutions, choosing for the client, accepting vague plans, skipping homework review, and ignoring negative problem orientation.

If the client does not respond after 3-4 sessions, reconsider whether the main problem is actually a solvable life problem, a crisis state, trauma, relationship pattern, or another clinical target.

Problem orientationBefore solving, check whether the client is ready to solve

PST is not psychoanalysis or a conversation about the past. It is training. You help the client learn a skill they can take with them.

Problems are a normal part of life. Your task is not to remove all problems, but to help the client handle them independently.

Self-efficacy is not a fixed trait. It is trained through repeated successful steps.

Do not rush to a solution. A poorly defined problem gives a good solution to the wrong task.

Positive orientation

How the client relates to problems is more important than any worksheet. Without this foundation, the five steps do not hold.

"What does it mean to you to have a problem? Is it bad, normal, dangerous, shameful?"

"How do you usually react when something goes wrong?"

✅ Normalize problems. They are not weakness, punishment, or proof of failure.

⚠️ Do not jump to the five stages before you understand the client's orientation. Negative orientation sabotages solutions.

Unhelpful orientation	Positive orientation
"I cannot solve problems"	"I can learn, step by step"
"This will destroy me"	"This is hard, but workable"
"Better not think about it"	"If I face it, I can respond"
"Nothing helps"	"I can try one step and review it"

⚠️ Do not start problem solving. Stabilize first.

"Right now you need support, not a plan. Let's stay here first."

PST works best when the client has enough stability for deliberate action.

Problem definitionDo not solve what has not been defined

Clarify the problem

"Everything is bad" and "I am unhappy" are not PST problems. The method needs concrete, manageable situations.

"Tell me one concrete example. When did this last happen?"

"What exactly happens? With whom? When? Under what circumstances?"

"How would you describe this problem to a friend who knows nothing about your situation?"

✅ Break the mega-problem into parts. Choose one workable part for today.

⚠️ Do not move to alternatives until both of you agree: this is the problem.

"You feel overwhelmed; I understand. Try this: what specifically is not working in your life right now?"

"If this problem disappeared tomorrow, what would be different in concrete terms?"

Asking what would change is a gentle way to move from emotion to situation.

Define the goal

Once the problem is defined, ask what the client wants instead.

"What would need to change for you to feel this problem was solved?"

"How would you like to feel or act when this is behind you?"

✅ The goal should be concrete and realistic. "I want to be happy" is too broad. "I want to sleep without two hours of anxious planning" is workable.

Example:

T: You say everything collapsed after the divorce. C: Yes. I do not know how to live. T: What specifically does not work now? C: Weekends. I do not know what to do alone on weekends. T: So today's problem is how to organize weekends so loneliness is less overwhelming? C: Yes. Exactly.

Generating alternativesQuantity before quality

At this stage there are no bad ideas. Evaluation comes later.

"Name every option that comes to mind, even if it seems unrealistic or silly."

✅ Write everything down. The client must see that ideas are not rejected.

⚠️ Do not comment on feasibility yet. "That will not work" kills the process.

walkbookcinemaexercisefriendsdrawingcookingvolunteeringcoursemusicgardeningtravel

"What else?"

"What would your best friend suggest if they did not know all the details?"

"Is there something you once did that helped, even in a different situation?"

What else?

"What else?" is the workhorse of this stage. Repeat it several times and allow silence.

"Suppose there were more options. What could they be?"

"What is the opposite of the idea you already named? Could that help?"

✅ You can offer ideas, but only after the client has exhausted their own, and without implying that yours are correct.

Decision makingWeigh, do not choose for the client

Now there is a list. The task is to choose one or two options to test this week.

"Look at the list. Which option has the most pull for you?"

"Which one seems realistic for you, with your current energy, time, and resources?"

✅ The criteria belong to the client. Help weigh, do not choose.

⚠️ Do not push the "best" solution according to your view.

"Imagine you already chose option A. What do you feel? Now imagine option B."

"Which one would you least regret trying?"

A trial solution reduces pressure: not forever, just one experiment.

Evaluation table

For complex decisions, evaluate the options together.

Criterion	What to check
Chance of success	How likely is this to work for you?
Resources	Do you have time, energy, money, skills?
Consequences	Effects on relationships, health, work
Values	Does it fit what matters?
Side effects	What could go wrong?

ImplementationA solution without a plan is only an intention

The client has chosen. Now build a concrete plan.

"What exactly will you do? When? Where? With whom?"

✅ The more concrete the first step, the higher the chance of action.

⚠️ Do not accept vague wording. "I will try" is not a plan.

Plan structure:

1. First step — what I will do. 2. When — day and time. 3. Preparation — what must happen beforehand. 4. Obstacles — what may interfere. 5. Response — how I will handle each obstacle.

"Let's make it smaller. What is the tiniest first action, something that takes five minutes?"

The first step should be small enough that it is hard not to do.

"What exactly will block it? Name the most likely obstacle."

"How have you handled something similar before?"

✅ Work through obstacles in session rather than waiting for them to appear at home.

Rehearsal

Rehearse the first step in session. It reveals problems before real-world practice.

T: You said you will text your friend. Let's try it now. What will you write? C: "Hi, do you want to meet?" T: Good. What could make it clearer: when and where? C: "On Saturday, maybe at a cafe?" T: Exactly. That is the message.

VerificationWithout review, there is no learning

Start the next session by reviewing the homework. This is mandatory.

"How did it go? Were you able to carry out the plan?"

"What percentage of the problem is solved now, from 0 to 100?"

✅ If it worked, mark that. "You did something that felt impossible. What does that say about you?"

⚠️ If it did not work, do not criticize. Investigate.

"What got in the way? Was the plan too difficult, or was it something else?"

"What needs to change so we can try again?"

Failure is information. Return to stage 1 or 2 with a better understanding.

"Do you want to expand this? Try the next level?"

"Which problem should we work on next?"

What worked?

Ending the sessionSummary, homework, next meeting

"What are you taking from our meeting today?"

"What will you practice before next time?"

✅ The client states the homework in their own words; this increases engagement.

Homework is central in PST. Skill forms in life, not only in the room.

1. The client repeats the plan. 2. The client names likely obstacles. 3. You agree when it will be reviewed.

Positive Problem Orientation TrainingPositive Problem Orientation Training

A Problem-Solving Therapy technique focused on positive problem orientation training. It helps the therapist and client turn an emotionally loaded difficulty into a defined problem, generate options, choose a workable response, act, and learn from the result.

Choose one concrete, manageable problem rather than the whole life situation.
Define the goal in observable terms: what should be different if this improves.
Generate several possible responses before evaluating any of them.
Choose one trial solution using resources, consequences, and values as criteria.
Turn the solution into a specific action plan with obstacles and responses.
Review the result and repeat the cycle with better information.

When to use:

Concrete life problems that maintain distress
Depression, stress, chronic illness, or life transitions
Clients who benefit from structured skills practice

Key phrases:

Let us use positive problem orientation training to make this problem more workable.

Follow-up questions:

What exactly is the problem, in one concrete situation?

What options can we list before judging them?

Which option is realistic enough to test this week?

Warnings:

⚠️ Do not rush to solutions before the problem is defined.
⚠️ Do not choose the solution for the client.
⚠️ Stabilize acute crisis before skills training.

D'Zurilla & Nezu; Nezu, Nezu & D'Zurilla; PST treatment manuals and social problem-solving research

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Negative Problem Orientation RestructuringNegative Problem Orientation Restructuring

A Problem-Solving Therapy technique focused on negative problem orientation restructuring. It helps the therapist and client turn an emotionally loaded difficulty into a defined problem, generate options, choose a workable response, act, and learn from the result.

Choose one concrete, manageable problem rather than the whole life situation.
Define the goal in observable terms: what should be different if this improves.
Generate several possible responses before evaluating any of them.
Choose one trial solution using resources, consequences, and values as criteria.
Turn the solution into a specific action plan with obstacles and responses.
Review the result and repeat the cycle with better information.

When to use:

Concrete life problems that maintain distress
Depression, stress, chronic illness, or life transitions
Clients who benefit from structured skills practice

Key phrases:

Let us use negative problem orientation restructuring to make this problem more workable.

Follow-up questions:

What exactly is the problem, in one concrete situation?

What options can we list before judging them?

Which option is realistic enough to test this week?

Warnings:

⚠️ Do not rush to solutions before the problem is defined.
⚠️ Do not choose the solution for the client.
⚠️ Stabilize acute crisis before skills training.

D'Zurilla & Nezu; Nezu, Nezu & D'Zurilla; PST treatment manuals and social problem-solving research

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Stop–Slow Down–Think–Act (SSTA)Stop–Slow Down–Think–Act (SSTA)

A Problem-Solving Therapy technique focused on stop–slow down–think–act (ssta). It helps the therapist and client turn an emotionally loaded difficulty into a defined problem, generate options, choose a workable response, act, and learn from the result.

Choose one concrete, manageable problem rather than the whole life situation.
Define the goal in observable terms: what should be different if this improves.
Generate several possible responses before evaluating any of them.
Choose one trial solution using resources, consequences, and values as criteria.
Turn the solution into a specific action plan with obstacles and responses.
Review the result and repeat the cycle with better information.

When to use:

Concrete life problems that maintain distress
Depression, stress, chronic illness, or life transitions
Clients who benefit from structured skills practice

Key phrases:

Let us use stop–slow down–think–act (ssta) to make this problem more workable.

Follow-up questions:

What exactly is the problem, in one concrete situation?

What options can we list before judging them?

Which option is realistic enough to test this week?

Warnings:

⚠️ Do not rush to solutions before the problem is defined.
⚠️ Do not choose the solution for the client.
⚠️ Stabilize acute crisis before skills training.

D'Zurilla & Nezu; Nezu, Nezu & D'Zurilla; PST treatment manuals and social problem-solving research

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Problem PsychoeducationProblem Psychoeducation

A Problem-Solving Therapy technique focused on problem psychoeducation. It helps the therapist and client turn an emotionally loaded difficulty into a defined problem, generate options, choose a workable response, act, and learn from the result.

Choose one concrete, manageable problem rather than the whole life situation.
Define the goal in observable terms: what should be different if this improves.
Generate several possible responses before evaluating any of them.
Choose one trial solution using resources, consequences, and values as criteria.
Turn the solution into a specific action plan with obstacles and responses.
Review the result and repeat the cycle with better information.

When to use:

Concrete life problems that maintain distress
Depression, stress, chronic illness, or life transitions
Clients who benefit from structured skills practice

Key phrases:

Let us use problem psychoeducation to make this problem more workable.

Follow-up questions:

What exactly is the problem, in one concrete situation?

What options can we list before judging them?

Which option is realistic enough to test this week?

Warnings:

⚠️ Do not rush to solutions before the problem is defined.
⚠️ Do not choose the solution for the client.
⚠️ Stabilize acute crisis before skills training.

D'Zurilla & Nezu; Nezu, Nezu & D'Zurilla; PST treatment manuals and social problem-solving research

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Problem Definition and FormulationProblem Definition and Formulation

A Problem-Solving Therapy technique focused on problem definition and formulation. It helps the therapist and client turn an emotionally loaded difficulty into a defined problem, generate options, choose a workable response, act, and learn from the result.

Choose one concrete, manageable problem rather than the whole life situation.
Define the goal in observable terms: what should be different if this improves.
Generate several possible responses before evaluating any of them.
Choose one trial solution using resources, consequences, and values as criteria.
Turn the solution into a specific action plan with obstacles and responses.
Review the result and repeat the cycle with better information.

When to use:

Concrete life problems that maintain distress
Depression, stress, chronic illness, or life transitions
Clients who benefit from structured skills practice

Key phrases:

Let us use problem definition and formulation to make this problem more workable.

Follow-up questions:

What exactly is the problem, in one concrete situation?

What options can we list before judging them?

Which option is realistic enough to test this week?

Warnings:

⚠️ Do not rush to solutions before the problem is defined.
⚠️ Do not choose the solution for the client.
⚠️ Stabilize acute crisis before skills training.

D'Zurilla & Nezu; Nezu, Nezu & D'Zurilla; PST treatment manuals and social problem-solving research

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Generation of Alternatives (Brainstorming)Generation of Alternatives (Brainstorming)

A Problem-Solving Therapy technique focused on generation of alternatives (brainstorming). It helps the therapist and client turn an emotionally loaded difficulty into a defined problem, generate options, choose a workable response, act, and learn from the result.

Choose one concrete, manageable problem rather than the whole life situation.
Define the goal in observable terms: what should be different if this improves.
Generate several possible responses before evaluating any of them.
Choose one trial solution using resources, consequences, and values as criteria.
Turn the solution into a specific action plan with obstacles and responses.
Review the result and repeat the cycle with better information.

When to use:

Concrete life problems that maintain distress
Depression, stress, chronic illness, or life transitions
Clients who benefit from structured skills practice

Key phrases:

Let us use generation of alternatives (brainstorming) to make this problem more workable.

Follow-up questions:

What exactly is the problem, in one concrete situation?

What options can we list before judging them?

Which option is realistic enough to test this week?

Warnings:

⚠️ Do not rush to solutions before the problem is defined.
⚠️ Do not choose the solution for the client.
⚠️ Stabilize acute crisis before skills training.

D'Zurilla & Nezu; Nezu, Nezu & D'Zurilla; PST treatment manuals and social problem-solving research

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Decision Making and Cost-Benefit AnalysisDecision Making and Cost-Benefit Analysis

A Problem-Solving Therapy technique focused on decision making and cost-benefit analysis. It helps the therapist and client turn an emotionally loaded difficulty into a defined problem, generate options, choose a workable response, act, and learn from the result.

Choose one concrete, manageable problem rather than the whole life situation.
Define the goal in observable terms: what should be different if this improves.
Generate several possible responses before evaluating any of them.
Choose one trial solution using resources, consequences, and values as criteria.
Turn the solution into a specific action plan with obstacles and responses.
Review the result and repeat the cycle with better information.

When to use:

Concrete life problems that maintain distress
Depression, stress, chronic illness, or life transitions
Clients who benefit from structured skills practice

Key phrases:

Let us use decision making and cost-benefit analysis to make this problem more workable.

Follow-up questions:

What exactly is the problem, in one concrete situation?

What options can we list before judging them?

Which option is realistic enough to test this week?

Warnings:

⚠️ Do not rush to solutions before the problem is defined.
⚠️ Do not choose the solution for the client.
⚠️ Stabilize acute crisis before skills training.

D'Zurilla & Nezu; Nezu, Nezu & D'Zurilla; PST treatment manuals and social problem-solving research

Details →

Solution Implementation and Action PlanningSolution Implementation and Action Planning

A Problem-Solving Therapy technique focused on solution implementation and action planning. It helps the therapist and client turn an emotionally loaded difficulty into a defined problem, generate options, choose a workable response, act, and learn from the result.

Choose one concrete, manageable problem rather than the whole life situation.
Define the goal in observable terms: what should be different if this improves.
Generate several possible responses before evaluating any of them.
Choose one trial solution using resources, consequences, and values as criteria.
Turn the solution into a specific action plan with obstacles and responses.
Review the result and repeat the cycle with better information.

When to use:

Concrete life problems that maintain distress
Depression, stress, chronic illness, or life transitions
Clients who benefit from structured skills practice

Key phrases:

Let us use solution implementation and action planning to make this problem more workable.

Follow-up questions:

What exactly is the problem, in one concrete situation?

What options can we list before judging them?

Which option is realistic enough to test this week?

Warnings:

⚠️ Do not rush to solutions before the problem is defined.
⚠️ Do not choose the solution for the client.
⚠️ Stabilize acute crisis before skills training.

D'Zurilla & Nezu; Nezu, Nezu & D'Zurilla; PST treatment manuals and social problem-solving research

Details →

Solution Verification and Self-MonitoringSolution Verification and Self-Monitoring

A Problem-Solving Therapy technique focused on solution verification and self-monitoring. It helps the therapist and client turn an emotionally loaded difficulty into a defined problem, generate options, choose a workable response, act, and learn from the result.

Choose one concrete, manageable problem rather than the whole life situation.
Define the goal in observable terms: what should be different if this improves.
Generate several possible responses before evaluating any of them.
Choose one trial solution using resources, consequences, and values as criteria.
Turn the solution into a specific action plan with obstacles and responses.
Review the result and repeat the cycle with better information.

When to use:

Concrete life problems that maintain distress
Depression, stress, chronic illness, or life transitions
Clients who benefit from structured skills practice

Key phrases:

Let us use solution verification and self-monitoring to make this problem more workable.

Follow-up questions:

What exactly is the problem, in one concrete situation?

What options can we list before judging them?

Which option is realistic enough to test this week?

Warnings:

⚠️ Do not rush to solutions before the problem is defined.
⚠️ Do not choose the solution for the client.
⚠️ Stabilize acute crisis before skills training.

D'Zurilla & Nezu; Nezu, Nezu & D'Zurilla; PST treatment manuals and social problem-solving research

Details →

ADAPT — Attitude–Define–Alternatives–Predict–TryADAPT — Attitude–Define–Alternatives–Predict–Try

A Problem-Solving Therapy technique focused on adapt — attitude–define–alternatives–predict–try. It helps the therapist and client turn an emotionally loaded difficulty into a defined problem, generate options, choose a workable response, act, and learn from the result.

Choose one concrete, manageable problem rather than the whole life situation.
Define the goal in observable terms: what should be different if this improves.
Generate several possible responses before evaluating any of them.
Choose one trial solution using resources, consequences, and values as criteria.
Turn the solution into a specific action plan with obstacles and responses.
Review the result and repeat the cycle with better information.

When to use:

Concrete life problems that maintain distress
Depression, stress, chronic illness, or life transitions
Clients who benefit from structured skills practice

Key phrases:

Let us use adapt — attitude–define–alternatives–predict–try to make this problem more workable.

Follow-up questions:

What exactly is the problem, in one concrete situation?

What options can we list before judging them?

Which option is realistic enough to test this week?

Warnings:

⚠️ Do not rush to solutions before the problem is defined.
⚠️ Do not choose the solution for the client.
⚠️ Stabilize acute crisis before skills training.

Nezu, Nezu & D'Zurilla (2007). Solving life's problems: A 5-step guide to enhanced well-being. VA Moving Forward Guidebook (2021)

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Problem-Solving Multitasking ToolkitProblem-Solving Multitasking Toolkit

A Problem-Solving Therapy technique focused on problem-solving multitasking toolkit. It helps the therapist and client turn an emotionally loaded difficulty into a defined problem, generate options, choose a workable response, act, and learn from the result.

Choose one concrete, manageable problem rather than the whole life situation.
Define the goal in observable terms: what should be different if this improves.
Generate several possible responses before evaluating any of them.
Choose one trial solution using resources, consequences, and values as criteria.
Turn the solution into a specific action plan with obstacles and responses.
Review the result and repeat the cycle with better information.

When to use:

Concrete life problems that maintain distress
Depression, stress, chronic illness, or life transitions
Clients who benefit from structured skills practice

Key phrases:

Let us use problem-solving multitasking toolkit to make this problem more workable.

Follow-up questions:

What exactly is the problem, in one concrete situation?

What options can we list before judging them?

Which option is realistic enough to test this week?

Warnings:

⚠️ Do not rush to solutions before the problem is defined.
⚠️ Do not choose the solution for the client.
⚠️ Stabilize acute crisis before skills training.

D'Zurilla & Nezu; Nezu, Nezu & D'Zurilla; PST treatment manuals and social problem-solving research

Details →

Externalize–Simplify–VisualizeExternalize–Simplify–Visualize

A Problem-Solving Therapy technique focused on externalize–simplify–visualize. It helps the therapist and client turn an emotionally loaded difficulty into a defined problem, generate options, choose a workable response, act, and learn from the result.

Choose one concrete, manageable problem rather than the whole life situation.
Define the goal in observable terms: what should be different if this improves.
Generate several possible responses before evaluating any of them.
Choose one trial solution using resources, consequences, and values as criteria.
Turn the solution into a specific action plan with obstacles and responses.
Review the result and repeat the cycle with better information.

When to use:

Concrete life problems that maintain distress
Depression, stress, chronic illness, or life transitions
Clients who benefit from structured skills practice

Key phrases:

Let us use externalize–simplify–visualize to make this problem more workable.

Follow-up questions:

What exactly is the problem, in one concrete situation?

What options can we list before judging them?

Which option is realistic enough to test this week?

Warnings:

⚠️ Do not rush to solutions before the problem is defined.
⚠️ Do not choose the solution for the client.
⚠️ Stabilize acute crisis before skills training.

D'Zurilla & Nezu; Nezu, Nezu & D'Zurilla; PST treatment manuals and social problem-solving research

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Impulsive/Careless Style TrainingImpulsive/Careless Style Training

A Problem-Solving Therapy technique focused on impulsive/careless style training. It helps the therapist and client turn an emotionally loaded difficulty into a defined problem, generate options, choose a workable response, act, and learn from the result.

Choose one concrete, manageable problem rather than the whole life situation.
Define the goal in observable terms: what should be different if this improves.
Generate several possible responses before evaluating any of them.
Choose one trial solution using resources, consequences, and values as criteria.
Turn the solution into a specific action plan with obstacles and responses.
Review the result and repeat the cycle with better information.

When to use:

Concrete life problems that maintain distress
Depression, stress, chronic illness, or life transitions
Clients who benefit from structured skills practice

Key phrases:

Let us use impulsive/careless style training to make this problem more workable.

Follow-up questions:

What exactly is the problem, in one concrete situation?

What options can we list before judging them?

Which option is realistic enough to test this week?

Warnings:

⚠️ Do not rush to solutions before the problem is defined.
⚠️ Do not choose the solution for the client.
⚠️ Stabilize acute crisis before skills training.

D'Zurilla & Nezu; Nezu, Nezu & D'Zurilla; PST treatment manuals and social problem-solving research

Details →

Avoidance Style TrainingAvoidance Style Training

A Problem-Solving Therapy technique focused on avoidance style training. It helps the therapist and client turn an emotionally loaded difficulty into a defined problem, generate options, choose a workable response, act, and learn from the result.

Choose one concrete, manageable problem rather than the whole life situation.
Define the goal in observable terms: what should be different if this improves.
Generate several possible responses before evaluating any of them.
Choose one trial solution using resources, consequences, and values as criteria.
Turn the solution into a specific action plan with obstacles and responses.
Review the result and repeat the cycle with better information.

When to use:

Concrete life problems that maintain distress
Depression, stress, chronic illness, or life transitions
Clients who benefit from structured skills practice

Key phrases:

Let us use avoidance style training to make this problem more workable.

Follow-up questions:

What exactly is the problem, in one concrete situation?

What options can we list before judging them?

Which option is realistic enough to test this week?

Warnings:

⚠️ Do not rush to solutions before the problem is defined.
⚠️ Do not choose the solution for the client.
⚠️ Stabilize acute crisis before skills training.

D'Zurilla & Nezu; Nezu, Nezu & D'Zurilla; PST treatment manuals and social problem-solving research

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Healthy Thinking and Positive Imagery ToolkitHealthy Thinking and Positive Imagery Toolkit

A Problem-Solving Therapy technique focused on healthy thinking and positive imagery toolkit. It helps the therapist and client turn an emotionally loaded difficulty into a defined problem, generate options, choose a workable response, act, and learn from the result.

Choose one concrete, manageable problem rather than the whole life situation.
Define the goal in observable terms: what should be different if this improves.
Generate several possible responses before evaluating any of them.
Choose one trial solution using resources, consequences, and values as criteria.
Turn the solution into a specific action plan with obstacles and responses.
Review the result and repeat the cycle with better information.

When to use:

Concrete life problems that maintain distress
Depression, stress, chronic illness, or life transitions
Clients who benefit from structured skills practice

Key phrases:

Let us use healthy thinking and positive imagery toolkit to make this problem more workable.

Follow-up questions:

What exactly is the problem, in one concrete situation?

What options can we list before judging them?

Which option is realistic enough to test this week?

Warnings:

⚠️ Do not rush to solutions before the problem is defined.
⚠️ Do not choose the solution for the client.
⚠️ Stabilize acute crisis before skills training.

D'Zurilla & Nezu; Nezu, Nezu & D'Zurilla; PST treatment manuals and social problem-solving research

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Problem-Solving Self-Monitoring Form (PSSM)Problem-Solving Self-Monitoring Form (PSSM)

A Problem-Solving Therapy technique focused on problem-solving self-monitoring form (pssm). It helps the therapist and client turn an emotionally loaded difficulty into a defined problem, generate options, choose a workable response, act, and learn from the result.

Choose one concrete, manageable problem rather than the whole life situation.
Define the goal in observable terms: what should be different if this improves.
Generate several possible responses before evaluating any of them.
Choose one trial solution using resources, consequences, and values as criteria.
Turn the solution into a specific action plan with obstacles and responses.
Review the result and repeat the cycle with better information.

When to use:

Concrete life problems that maintain distress
Depression, stress, chronic illness, or life transitions
Clients who benefit from structured skills practice

Key phrases:

Let us use problem-solving self-monitoring form (pssm) to make this problem more workable.

Follow-up questions:

What exactly is the problem, in one concrete situation?

What options can we list before judging them?

Which option is realistic enough to test this week?

Warnings:

⚠️ Do not rush to solutions before the problem is defined.
⚠️ Do not choose the solution for the client.
⚠️ Stabilize acute crisis before skills training.

D'Zurilla & Nezu; Nezu, Nezu & D'Zurilla; PST treatment manuals and social problem-solving research

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Problem Normalization and ReframingProblem Normalization and Reframing

A Problem-Solving Therapy technique focused on problem normalization and reframing. It helps the therapist and client turn an emotionally loaded difficulty into a defined problem, generate options, choose a workable response, act, and learn from the result.

Choose one concrete, manageable problem rather than the whole life situation.
Define the goal in observable terms: what should be different if this improves.
Generate several possible responses before evaluating any of them.
Choose one trial solution using resources, consequences, and values as criteria.
Turn the solution into a specific action plan with obstacles and responses.
Review the result and repeat the cycle with better information.

When to use:

Concrete life problems that maintain distress
Depression, stress, chronic illness, or life transitions
Clients who benefit from structured skills practice

Key phrases:

Let us use problem normalization and reframing to make this problem more workable.

Follow-up questions:

What exactly is the problem, in one concrete situation?

What options can we list before judging them?

Which option is realistic enough to test this week?

Warnings:

⚠️ Do not rush to solutions before the problem is defined.
⚠️ Do not choose the solution for the client.
⚠️ Stabilize acute crisis before skills training.

D'Zurilla & Nezu; Nezu, Nezu & D'Zurilla; PST treatment manuals and social problem-solving research

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Visualization of Successful CopingVisualization of Successful Coping

A Problem-Solving Therapy technique focused on visualization of successful coping. It helps the therapist and client turn an emotionally loaded difficulty into a defined problem, generate options, choose a workable response, act, and learn from the result.

Choose one concrete, manageable problem rather than the whole life situation.
Define the goal in observable terms: what should be different if this improves.
Generate several possible responses before evaluating any of them.
Choose one trial solution using resources, consequences, and values as criteria.
Turn the solution into a specific action plan with obstacles and responses.
Review the result and repeat the cycle with better information.

When to use:

Concrete life problems that maintain distress
Depression, stress, chronic illness, or life transitions
Clients who benefit from structured skills practice

Key phrases:

Let us use visualization of successful coping to make this problem more workable.

Follow-up questions:

What exactly is the problem, in one concrete situation?

What options can we list before judging them?

Which option is realistic enough to test this week?

Warnings:

⚠️ Do not rush to solutions before the problem is defined.
⚠️ Do not choose the solution for the client.
⚠️ Stabilize acute crisis before skills training.

D'Zurilla & Nezu; Nezu, Nezu & D'Zurilla; PST treatment manuals and social problem-solving research

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Reverse Role-Play and Perspective SwitchReverse Role-Play and Perspective Switch

A Problem-Solving Therapy technique focused on reverse role-play and perspective switch. It helps the therapist and client turn an emotionally loaded difficulty into a defined problem, generate options, choose a workable response, act, and learn from the result.

Choose one concrete, manageable problem rather than the whole life situation.
Define the goal in observable terms: what should be different if this improves.
Generate several possible responses before evaluating any of them.
Choose one trial solution using resources, consequences, and values as criteria.
Turn the solution into a specific action plan with obstacles and responses.
Review the result and repeat the cycle with better information.

When to use:

Concrete life problems that maintain distress
Depression, stress, chronic illness, or life transitions
Clients who benefit from structured skills practice

Key phrases:

Let us use reverse role-play and perspective switch to make this problem more workable.

Follow-up questions:

What exactly is the problem, in one concrete situation?

What options can we list before judging them?

Which option is realistic enough to test this week?

Warnings:

⚠️ Do not rush to solutions before the problem is defined.
⚠️ Do not choose the solution for the client.
⚠️ Stabilize acute crisis before skills training.

D'Zurilla & Nezu; Nezu, Nezu & D'Zurilla; PST treatment manuals and social problem-solving research

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In-Session Behavioral RehearsalIn-Session Behavioral Rehearsal

A Problem-Solving Therapy technique focused on in-session behavioral rehearsal. It helps the therapist and client turn an emotionally loaded difficulty into a defined problem, generate options, choose a workable response, act, and learn from the result.

Choose one concrete, manageable problem rather than the whole life situation.
Define the goal in observable terms: what should be different if this improves.
Generate several possible responses before evaluating any of them.
Choose one trial solution using resources, consequences, and values as criteria.
Turn the solution into a specific action plan with obstacles and responses.
Review the result and repeat the cycle with better information.

When to use:

Concrete life problems that maintain distress
Depression, stress, chronic illness, or life transitions
Clients who benefit from structured skills practice

Key phrases:

Let us use in-session behavioral rehearsal to make this problem more workable.

Follow-up questions:

What exactly is the problem, in one concrete situation?

What options can we list before judging them?

Which option is realistic enough to test this week?

Warnings:

⚠️ Do not rush to solutions before the problem is defined.
⚠️ Do not choose the solution for the client.
⚠️ Stabilize acute crisis before skills training.

D'Zurilla & Nezu; Nezu, Nezu & D'Zurilla; PST treatment manuals and social problem-solving research

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📋 Structured diary

Problem-Solving Diary

PST is a step-by-step method for solving life problems.

By following the steps, you turn a problem into an action plan.

Write the problem → options → choice → plan → result.

Problem

Goal

What I tried

Result

Satisfaction (1-10)

12345678910

Materials are informational and educational and summarize publicly available scientific sources. They are not medical or psychological advice, are not intended for self-diagnosis or self-treatment, and do not replace consultation with a qualified professional.

Problem orientation

Problem-solving skills

The five stages

Stage 1: problem definition

Stage 2: generating alternatives

Stage 3: decision making

Stage 4: implementation

Stage 5: verification

Positive orientation

Clarify the problem

Define the goal

Evaluation table

Rehearsal

ALLIANCE

FOCUS

INTERVENTIONS

PRESENCE

ENDING