Problem Solving Therapy for Parents and Families of Youth with Chronic Medical Conditions

Editors: Emily F. Law, Ph.D.; Emma Fisher, Ph.D.

Date: July, 2019

Empirical review statusVery strong recommendation.

Summary of sample characteristics across studies:

Variable

Example

Child Age

Across trials, there was variability in the age range of children:

  1. Toddler to Adolescence (0-14 years) (Seid et al., 2010)
  1. Elementary to Adolescence (5-16 years) (Nansel et al., 2012; Wade et al., 2005; Wade et al., 2006)
  1. Adolescence (11-18 years) (Sahler et al., 2013; Wade et al., 2011)

Child Sex

All trials enrolled both male and female children

Parent Sex

Three studies enrolled only mothers (Sahler et al., 2002; Sahler et al., 2005; Sahler et al., 2013). The remaining studies enrolled >90% mothers (e.g., Seid et al., 2010; Wade et al., 2005).

Family Ethnicity/Race

The majority of trials enrolled primarily Caucasian/Non-Hispanic families. In two trials, participants were primarily Hispanic (Sahler et al., 2013; Seid et al., 2010).

Therapist type

In the majority of trials, treatment was delivered by master’s level therapists or Ph.D. students.

Presenting problem

  1. Asthma: Seid et al., 2010
  2. Cancer: Sahler et al., 2002; Sahler et al., 2005; Sahler et al., 2013
  3. Diabetes: Nansel et al., 2012
  4. Heart Disease: McCusker et al., 2010
  5. Traumatic Brain Injury: Wade et al., 2005; Wade et al., 2006; Wade et al., 2011

Socioeconomic status

In the majority of trials, average socioeconomic status of families was middle to upper class. In a few trials, families were from predominantly lower socioeconomic backgrounds (e.g., Nansel et al., 2012; Sahler et al., 2013; Seid et al., 2010)

Language

In two trials, the intervention was delivered in English and Spanish (Sahler et al., 2005; Sahler et al., 2013; Seid et al., 2010). In all other trials the intervention was delivered in English.

 

Brief summary of treatment:

  • Basic premise: Psychological distress in response to a child’s chronic medical condition is influenced by the ability to use constructive social problem solving attitudes and skills to cope with stressful events.
  • Essence of therapy: Problem solving therapy teaches a structured approach to responding to real-life problems. Skills are typically taught in a sequence including identifying the problem, brainstorming solutions, decision making, solution implementation and evaluation/revision. Modeling, behavioral rehearsal, in-vivo practice, and performance feedback are used to support acquisition and generalization of skills.
  • Length: Treatment duration for children: 0-11 hours. Treatment duration for parents:  4-11 hours.

 

Treatment resources:

Treatment Manual Available For Purchase
Problem Solving Therapy: A Treatment Manual (Nezu, Nezu & D’Zurilla, 2012)

Self-Help Books
Solving Life’s Problems: A 5-Step Guide to Enhanced Well-Being (Nezu, Nezu & D’Zurilla, 2006)

Training Resources
APA Psychotherapy Training Video: Problem Solving Therapy, with Drs. Arthur Nezu & Christine Maguth Nezu (2009)

Worksheets/Handouts
Social Problem-Solving Inventory Revised (SPSI-R; D’Zurilla, Nezu & Maydeu-Olivares, 2007)

Worksheets/Handouts
See Worksheets/Handouts in Problem Solving Therapy: A Treatment Manual (Nezu, Nezu & D’Zurilla, 2012) and Solving Life’s Problems: A 5-Step Guide to Enhanced Well-Being (Nezu, Nezu & D’Zurilla, 2006)

 

Key reviews:

  1. Law, E., Fisher, E., Eccleston, C., & Palermo, T. M. (2019). Psychological interventions for parents of children and adolescents with chronic illness. The Cochrane database of systematic reviews, 3, CD009660.
  2. Law, E.F., Fisher, E., Fales, J., Noel, M., & Eccleston, C. (2014). Systematic review and meta-analysis of parent and family-based interventions for children and adolescents with chronic medical conditions. Journal of Pediatric Psychology 39(8), 866-886.

 

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