Topic: Behavioral Problems
Target Population: Early Childhood, Middle Childhood, Adolescents, Young Adults, Parents, Providers
Sector: Community-Based
This program is for youth who are 3 to 21 years old and are experiencing behavioral challenges and may carry a psychiatric diagnosis such as attention-deficit/hyperactivity disorder, autism spectrum disorder, conduct disorder, mood disorders, or oppositional defiant disorder, and their parents, caregivers, or teachers.
Collaborative Problem Solving® (CPS), a community- or school-based program, is designed to help adults understand, empathize with, and support youth who are experiencing social, emotional, and behavioral difficulties.
A number of evaluations of CPS have been conducted in community, school, and clinical settings, and outcomes focus on youth behavior, teacher and parenting stress, and restraint and seclusion. Results from one randomized trial in a group of children with oppositional defiant disorder indicated improvements in multiple domains of youth functioning at post-treatment and 4-month follow-up in the CPS group compared to those in a parent training group. Results from quasi-experimental studies with nonequivalent groups in mental health agencies indicated reductions in rates of seclusion and restraint and decreases in self-inflicted injury, length of stay, and need for security staff involvement. Results from single-group studies indicated significant reductions in the frequency of restrictive events and the duration of restraints and seclusions, improvements in child behaviors, and decreases in teacher stress.
CPS embraces the philosophy that “kids do well if they can” and that youth who display disruptive or challenging behaviors are lacking the skill, not the will, to behave appropriately. Program content focuses on fostering collaborative conflict resolution between adults and youth and teaching youth skills they may be lacking related to problem solving, flexibility, emotion regulation, and frustration tolerance. The program is delivered through the following:
Caregivers and parents create a list of unmet expectations and behavioral triggers (e.g., unmet academic, self-care, or safety expectations; social triggers) and identify specific thinking skills that youth may be lacking. Caregivers/parents then follow a framework of three distinct plans for how to respond to these situations:
Plan B is the teaching tool of CPS in which a youth’s concerns are defined, adults’ concerns are stated, and youth and adults work together to create and test potential mutually satisfactory solutions. During this collaborative problem-solving task, skills, which youth may be lagging in, are modeled and practiced in a process of experiential skills training.
The CPS approach was developed by the Massachusetts General Hospital; however, the extent to which the program has been implemented was not located.
There are no minimal educational requirements for those who deliver CPS; however, facilitators must be certified. Training ranges from 2 hours to 2.5 days and may be delivered on-site, off-site, online, or via video or phone. Please visit https://thinkkids.org/CPStrainings-certification or use details in the Contact section to learn more.
Considerations for implementing this program include recruiting facilitators and ensuring they complete certification; understanding funding for training may be necessary; acquiring buy-in from parents, caregivers, agency staff, teachers, and participants; realizing facilitating this program may be expensive if salaries are considered and funding may be required; and making time and locating space for therapy sessions and parent groups.
The Clearinghouse can help address these considerations. Please call 1-877-382-9185 or email clearinghouse@psu.edu
If you are interested in implementing CPS, the Clearinghouse is interested in helping you! Please call 1-877-382-9185 or email clearinghouse@psu.edu
Family therapy and in-home therapy are 8 to 12 weeks each, and parent training groups are 4 to 8 weeks.
Information on implementation costs was not located. Please use details in the Contact section to learn more.
To move CPS to the Promising category on the Clearinghouse Continuum of Evidence, at least one evaluation with a strong study design that uses a comparison group should be performed demonstrating positive effects lasting at least one year from the beginning of the program or at least six months from program completion.
The Clearinghouse can help you develop an evaluation plan to ensure the program components are meeting your goals. Please call 1-877-382-9185 or email clearinghouse@psu.edu
Contact the Clearinghouse with any questions regarding this program. Phone: 1-877-382-9185 Email: clearinghouse@psu.edu
You may also contact Think:Kids by mail 151 Merrimac Street, 2nd Floor, Boston, MA 02114, phone 1-617-643-6030, fax 1-617-643-2502, or visit https://thinkkids.org/contact
https://www.cebc4cw.org/program/collaborative-problem-solving/detailed; https://thinkkids.org/; and Pollastri, Lieberman, Boldt, and Ablon (2016).
Black, V., Bobier, C., Thomas, B., Prest, F., Ansley, C., Loomes, B., … Mountford, H. (2020). Reducing seclusion and restraint in a child and adolescent inpatient area: Implementation of a Collaborative Problem-Solving approach. Australasian Psychiatry: Bulletin of the Royal Australian and New Zealand College of Psychiatrists, 28(5), 578-584. https://doi.org/10.1177/1039856220917081
Ercole-Fricke, E., Fritz, P., Hill, L. E., & Snelders, J. (2016). Effects of a Collaborative Problem-Solving approach on an inpatient adolescent psychiatric unit. Journal of Child and Adolescent Psychiatric Nursing, 29(3), 127-134. https://doi.org/10.1111/jcap.12149
Greene, R. W., Ablon, J. S., Goring, J. C., Raezer-Blakely, L., Markey, J., Monuteaux, M. C., … Rabbitt, S. (2004). Effectiveness of Collaborative Problem Solving in affectively dysregulated children with oppositional-defiant disorder: Initial findings. Journal of Consulting and Clinical Psychology, 72(6), 1157-1164. https://doi.org/10.1037/0022-006X.72.6.1157
Heath, G. H., Fife‐Schaw, C., Wang, L., Eddy, C. J., Hone, M. J. G., & Pollastri, A. R. (2020). Collaborative Problem Solving reduces children's emotional and behavioral difficulties and parenting stress: Two key mechanisms. Journal of Clinical Psychology, 76(7), 1226-1240. https://doi.org/10.1002/jclp.22946
Johnson, M., Östlund, S., Fransson, G., Landgren, M., Nasic, S., Kadesjö, B., … Fernell, E. (2012). Attention‐deficit/hyperactivity disorder with oppositional defiant disorder in Swedish children – an open study of Collaborative Problem Solving. Acta Paediatrica, 101(6), 624-630. https://doi.org/10.1111/j.1651-2227.2012.02646.x
Martin, A., Krieg, H., Esposito, F., Stubbe, D., & Cardona, L. (2008). Reduction of restraint and seclusion through Collaborative Problem Solving: A five-year prospective inpatient study. Psychiatric Services, 59(12), 1406-1412. https://doi.org/10.1176/appi.ps.59.12.1406
Pollastri, A. R., Lieberman, R. E., Boldt, S. L., & Ablon, J. S. (2016). Minimizing seclusion and restraint in youth residential and day treatment through site-wide implementation of Collaborative Problem Solving. Residential Treatment for Children & Youth, 33(3-4), 186-205. https://doi.org/10.1080/0886571X.2016.1188340
Schaubman, A., Stetson, E., & Plog, A. (2011). Reducing teacher stress by implementing Collaborative Problem Solving in a school setting. School Social Work Journal, 35(2), 72-93.
Stetson, E. A., & Plog, A. E. (2016). Collaborative Problem Solving in schools: Results of a year-long consultation project. School Social Work Journal, 40(2), 17-36.
Epstein, T., & Saltzman-Benaiah, J. (2010). Parenting children with disruptive behaviours: Evaluation of a Collaborative Problem Solving pilot program. Journal of Clinical Psychology Practice, 1(1), 27-40.
Greene, R. W., Ablon, J. S., & Goring, J. C. (2003). A transactional model of oppositional behavior: Underpinnings of the Collaborative Problem Solving approach. Journal of Psychosomatic Research, 55(1), 67-75. https://doi.org/10.1016/S0022-3999(02)00585-8
Greene, R. W., Ablon, J. S., & Martin, A. (2006). Use of Collaborative Problem Solving to reduce seclusion and restraint in child and adolescent inpatient units. Psychiatric Services, 57(5), 610-612. https://doi.org/10.1176/appi.ps.57.5.610
Holmes, K. J., Stokes, L. D., & Gathright, M. M. (2014). The use of Collaborative Problem Solving to address challenging behavior among hospitalized children with complex trauma: A case series. Residential Treatment for Children & Youth, 31(1), 41-62. https://doi.org/10.1080/0886571X.2014.878581
Pollastri, A. R., Epstein, L. D., Heath, G. H., & Ablon, J. S. (2013). The Collaborative Problem Solving approach: Outcomes across settings. Harvard Review of Psychiatry, 21(4), 188-199.
