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Problem Solving as an Active Ingredient in Indicated Prevention and Treatment of Youth Depression and Anxiety: An Integrative Review

Research output: Contribution to journalReview articlepeer-review

Daniel Michelson, Eleanor Hodgson, Adam Bernstein, Bruce F. Chorpita, Vikram Patel

Original languageEnglish
Pages (from-to)390-405
Number of pages16
JournalJournal of Adolescent Health
Volume71
Issue number4
DOIs
PublishedOct 2022

Bibliographical note

Funding Information: This work was supported by a Wellcome Trust, United Kingdom Mental Health Priority Area “Active Ingredients” commission awarded to Dr Daniel Michelson (PI) at the University of Sussex. Funding Information: Disclaimer: The funder (Wellcome Trust) had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. V.P. is the recipient of a prior Wellcome Trust funding award (106919/Z/15/Z) that involved the development and evaluation of an adolescent mental health program with a problem-solving component. D.M. and B.C. are co-investigators on the same grant. None of these authors derive royalties from the program in question. Publisher Copyright: © 2022 Society for Adolescent Health and Medicine

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Abstract

Problem solving is a common focus of psychological interventions for young people. However, existing evidence syntheses are relatively limited in their scope and conclusions. Taking a transdiagnostic approach and incorporating diverse sources of evidence, we examined the role of problem solving as an active ingredient for the indicated prevention and treatment of depression and anxiety in 14–24-year-olds. Three information sources were integrated using framework synthesis: (1) a systematic review of randomized controlled trials of problem solving; (2) a metasynthesis of qualitative evidence on the therapeutic experience of problem solving; and (3) consultations with a Youth Advisory Group. Intervention protocols that included problem solving and no more than one other specific component appeared to be effective for depression but not anxiety. Larger multicomponent interventions with a problem-solving element achieved moderate effect sizes for both conditions. There was no clear evidence that effectiveness varied by population characteristics, intervention formats, or contextual factors. Qualitative evidence and youth consultations highlighted positive views about the practicality, simplicity, and flexibility of problem solving. Converging sources also suggested changes in problem orientation as a key transdiagnostic process contributing to positive outcomes. Problem solving is a widely applicable therapeutic approach that can help young people with emotional problems to resolve specific stressors and lead to a more hopeful mindset about managing future challenges. Implications for practice are discussed.

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