Cognitive Problem-Solving Skills Training
A Cognitive Therapy Approach
CPSST aims to decrease a young person’s inappropriate or disruptive behaviors by teaching new, constructive ways to manage thoughts and feelings and interact appropriately with others. CPSST therapy focuses on the child or adolescent (rather than on the parents or family), teaching them skills to develop new perspectives and problem-solve new solutions.
According to CPSST’s underlying principles, children have problematic behaviors because their ways of interpreting reality and responding to the world are limited and involve negative responses. In this way, CPSST expands the “behavioral repertoire”—the range of ways of behaving that an individual possesses—through cognitive processing. CPSST is effective in treating young people with:
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- Conduct disorder (CD)
- Intermittent explosive disorder (IED)
- Oppositional-defiant disorder (ODD)
- Attention-deficit/hyperactivity disorder (ADHD) with disruptive behavior
- Antisocial behaviors or aggressive acting-out
- Anxiety
- Depression
Research on CPSST
In outcome studies, CPSST has been found to be effective in reducing or eliminating problematic behaviors in many children and adolescents. Its success is even greater when combined with parent management training. Although CPSST originally focused on children with problem behaviors or poor relationships with others, it has generalized to a variety of different disorders in children, adolescents and adults.
Treatment
CPSST therapy includes weekly individual sessions with the child or adolescent, for a duration of 3-12 months. Through modeling, role-playing, games, real-life experiments and positive reinforcement, treatment helps them:
- Think differently, challenge unhelpful assumptions, confront irrational interpretations of others’ actions and change inaccurate or narrow views of situations
- Internalize and apply problem-solving skills to generate alternative, positive solutions and avoid physical aggression, resolve conflict and keep out of trouble
For example:
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- A child, suspended from school for becoming physically aggressive with a teacher, is asked by the clinician to describe his thoughts and feelings about the experience. The child says, “My teacher hates me. She always yells at me.”
- The clinician helps the child explore supporting evidence to confirm or disconfirm that assumption, so the child can see his part in the problem and ways he can influence better interactions in the future.
Homework component: The young person is given between-session homework, including keeping a log of negative thoughts, conducting a real-life experiment or trying a new option and comparing results to prior activity. In this way, they learn to apply problem-solving skills when faced with problematic situations in school, with peers or at home. Beginning with the easiest ways of thinking, the young person gradually progresses to more complex or challenging circumstances.
Parental support: Parents or other family members may be brought in to observe and to learn how to assist in reinforcing new skills. Parents learn how to remind their child to use CPSST problem-solving techniques in daily living, as well as how to provide age-appropriate positive reinforcement for trying new techniques and options through praise, affection or other desirable rewards.
The aim of therapy is to help a young person change perceptions and develop different options for how to respond in difficult situations. Gradually, they shift from making global, negative attributions—“It’s someone else’s fault,” perhaps—to identifying ways to improve a specific outcome. Ultimately, the child or teen gains a sense of efficacy in achieving reliably more positive outcomes in future situations.
Learn more about Cognitive Therapies offered at CFI…