Efficacy of a Problem-Solving Therapy for Depression and Suicide Potential in Adolescents and Young Adults

Abstract

Short-term and structured cognitive behavioral problem-solving therapy (PST) is a developmentally relevant mode of action for the treatment of emotional problems in young people. This study aimed at testing the efficacy of a problem-solving therapy in treating depression and suicide potential in adolescents and young adults. A total of 46 self-referred high school and university students who were randomly assigned to a problem-solving therapy (n = 27) and a waiting list control (n = 19) conditions completed a controlled cognitive behavioral problem-solving treatment trial. Participants were administered the measures of depression, suicide potential, problem solving, self-esteem and assertiveness. Twenty-two of the 27 participants from the PST condition could be reached after 12-months for follow-up. Participants completed depression and problem-solving measures at follow-up. Results showed that post-treatment depression and suicide risk scores of participants within the PST condition decreased significantly compared to the pre-treatment scores but post-waiting and pre-waiting depression and suicide risk scores of participants within the WLC condition were unchanged. Likewise, post-treatment self-esteem and assertiveness scores of participants within the PST condition increased significantly compared to the pre-treatment scores while post-waiting and pre-waiting self-esteem and assertiveness scores of participants within the WLC condition were unchanged. At post-treatment, 77.8% of the participants in the PST but only 15.8% of those in the WLC condition achieved full or partial recovery according to BDI scores. Similarly, 96.3% of participants in the PST but only 21.1% of those in the WLC condition achieved full or partial recovery according to HDRS scores. The improvements were maintained at 12-months follow-up. Therefore, it is concluded that problem-solving therapy should be considered as a viable option for the treatment of depression and suicide potential in adolescents and young adults.

Psychosocial interventions for self-harm, suicidal ideation and suicide attempt in children and young people: What? How? Who? and Where?

“…Two trials have investigated a PST approach 42 43. Both trials followed the standard approach of D'Zurilla and Goldfried (1971) and D'Zurilla and Nezu (1999) which includes highly structured stages of problem solving 44 45.…”

“…In the two trials delivering PST, one delivered the intervention face-to-face42 while the other used a 35-minute video 43. Trials implementing supportive therapy and IPT, all did so using the face-to-face method 47 48 52…”

“…Some trials recruited young people who had been admitted to the emergency department (ED),46 an inpatient mental health facility,36 47 48 53 both,37 and outpatient mental health clinics 38 39 54. Universities that contain research-based outpatient clinics have also been the location of recruitment 42 43…”

Problem solving moderates the effects of life event stress and chronic stress on suicidal behaviors in adolescence

“…Suicide screening strategies may wish to incorporate problem-solving skills as a means of identifying at-risk youth, and prevention programs may target problem-solving skills in an effort to reduce the risk of suicidal behaviors in the context of stressful conditions (e.g., Eskin, Ertekin, & Demir, 2008). Identification and treatment of depressive symptoms and hopeless cognitions also represent crucial steps in reducing the proximal risk of suicidal behaviors in adolescence.…”

Psychotherapy: Playing the Three Monkeys in Mental Health Service Provision?

“…Likewise, recent reviews have supported the efficacy of cognitive behaviour therapy on depression, bipolar disorders, schizophrenia, and other psychotic disorders (8,9,10). Relevant literature contains several Turkish studies reporting the beneficial effects of psychotherapy on various conditions and populations, including psychodrama on alcohol and drug addiction; psycho-social training utilizing cognitive/behaviour techniques on schizophrenia; problem-solving therapy on depression and suicide rates of high school and university students; cognitive behaviour group therapy on adolescents with social anxiety; cognitive behaviour therapy on physical and emotional stress due to university entrance exams; group cognitive behaviour therapy added to the regular treatment on anxiety levels of patients with schizophrenia and schizoaffective disorders; group cognitive behaviour therapy on anger and aggressive behaviour of adolescents; school-based cognitive behaviour therapy on anxiety, depression and low self-esteem of the elementary students; and cognitive-behaviour group therapy on obsessive-compulsive disorder (11,12,13,14,15,16,17,18,19).…”