PS

Question 1

Introduction

Answer 1

• Problem solving is an important life skill. Those experiencing low mood or high levels of anxiety often find this skill difficult
• May be due to skills deficits or symptoms associated with depression or anxiety, which prevents employment of existing skills e.g. decreased motivation, lack of energy, feelings of hopeless, poor concentration, low self-esteem, indecision.
o E- Ladouceur, 1998
o EE- Nezu (1986)
• Symptoms likely to interfere with dealing with difficulties as they arise, thus problem accumulate leading to overwhelming client and less able to manage
• Avoidance of PS is common in GAD as is worrying -these can be an attempt to anticipate all possible negative outcomes leading to a chain of worries becoming less and less relevant but increasingly catastrophic.

Question 2

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Answer 2

• Provides clients with structured way to approach problems -clients possess requisite skills, but symptoms stop them from being practised.
• Providing a clear structure is useful in orientating the clients to focus on difficulties and provide a clear framework to so do.
• Six stages to treatment (Papworth and Marrinan, 2018)
o Orientate the client to the approach
 Remind the client problems are a part of everyday and they already have experiences of managing these successfully. Explore how symptoms interfere and discuss avoidance = vicious cycle which leads to overwhelming
 Self help materials explain approach and orientate to steps involved.

Question 3

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Answer 3

o Identify a problem to work on
 Practitioner may need to provide guidance e.g. starting with problem least difficult to manage to build understanding and confidence. Problems that are more pressing/likely to lead to symptom relief. Ensure focus is on real/immediate problems rather than imagined events (hypothetical worries)

Question 4

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Answer 4

o Generate possible solutions
 Generate as many solutions possible.
 Include even those that are unlikely or extreme. -allows thinking outside the box and consider more creative solutions to help get them unstuck from what they may perceive as an unsolvable problem.

Question 5

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Answer 5

o Choose a Solution
 Consider the pros and cons of each solution and choose a solution most likely to have more pros and less cons or pros and cons that are most supportive for the client.

Question 6

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Answer 6

o Implement the solution
 Consider steps required to implement solution.
• Anxious clients may focus on worst case scenario and thus have an urge to avoid
• Depressed clients may be pessimistic or despondent about successful outcome, and thus motivation may be a barrier. (Becker-Weidman et al, 2010)
 Manageable goals can focus / motivate clients to take the next steps.
 May find you need to look back at problem to solve

Question 7

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Answer 7

o Review the outcome
 Consider learning points
 Consider both difficulties and achievements
 Key is the client has learnt taking an active approach is more helpful than avoidance, enabling them to break out of unhelpful cycles maintaining their mood.
 Demonstrates most problems can be managed if problem is broken down and initial anxiety associated with approaching problem will then dissipate.

Question 8

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Answer 8

• Nezu (1986)
• Bella and D’Zurilla, 2009; Cuijpers et al, 2007b
• Dugas et al, 2003
• Alexopoulos (2003)
• Warmerdam (2009)

Question 9

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Answer 9

• Clients may find it difficult to be creative and generate solutions so may get stuck at this point
o Practitioners may suggest ideas or client could ask for help from a friend or partner
• May feel initial increase in anxiety when approaching problems, could lead to avoidance
o Practitioners helps recognise obstacles and use formulation to illustrate how avoidance maintains the problem
• Clients may lack capability due to deficits in assertiveness skills as PS often requires asking for help off others
o Recognising this is important and in these situations, capability may be enhanced by directing client towards psychoeducation regarding assertiveness techniques (Michie et al, 2011)

Question 10

Conclusion

Answer 10

• PS is useful for when clients with depression and anxiety are struggling to deal with situations due to avoidance and a lack of problem-solving skills
• There is evidence to support the effectiveness of this technique and provide support for the mechanisms behind anxiety and low mood
• There may be difficulties in using PS but these can be overcome.