Briefly

Fight stress with problem solving training

Fight stress with problem solving training

We can define problem like "failure to find an effective answer". Problem solving is useful for reducing anxiety associated with the inability to make decisions.

The term problem solving It refers to the process of solving problems that take place in our natural environment. It can be described as a skill composed of different components. The problem-solving process is mainly determined by two partially independent processes: problem orientation and problem solving style.

The type of problem orientation

Problem orientation is a metacognitive process determined by the functioning of cognitive-emotional schemes (beliefs, emotions, etc.) which largely reflect the perception of the individual about the problems that occur in his life and about his own ability to solve them.

To successfully carry out the problem orientation phase we must:

  1. Identify problematic situations
  2. Describe in detail the problem and the usual response to that problem. When describing the situation and the answer in terms of who, what, where, when, how and why, the problem will be seen more clearly.
  3. Make a list with the alternatives. In this phase the strategy called "brainstorm" is used to achieve the recently formulated objectives. This technique has four basic rules: criticism is excluded, everything goes, the best is the quantity and the important thing is the combination and improvement. The brainstorm technique should be limited, during this phase, to general strategies to achieve the objectives.
  4. See the consequences. This step consists in selecting the most promising strategies and assessing the consequences of implementing them.
  5. Evaluate the results: Once the new response has been tried, the consequences should be observed, for example: Do things happen as planned? If not, we will look for new alternatives to the problem.

Problem solving styles refer to the specific way of articulating the different phases of the problem solving process and the way in which they are carried out. There are three main styles: Rational problem solving, impulsive-careless style and avoidance style.

  • The rational problem solving It consists in the rational, controlled and systematic application of problem-solving skills, which includes a definition of the problem, generation of alternatives, decision-making and their implementation.
  • The style impulsive-careless It is characterized by the application of problem-solving skills but in a rigid, impulsive, careless, fast and incomplete manner. They tend to consider few alternative solutions and act impulsively according to the first idea that comes to mind.
  • The style avoider It is characterized by procrastination (systematic postponement of activities and neglect), passivity or inactivity and dependence. Avoiders prefer to avoid rather than confront, postpone their problems as much as possible, expect problems to resolve themselves and try to get other people to take responsibility for their problems.

Troubleshooting Therapy

In order to train problem-solving skills, a program is proposed in which different techniques are used for the acquisition of basic problem-solving skills and the correction of possible deficits related to dysfunctional styles.

Problem Orientation Training

The problem orientation component reflects a set of beliefs or perceptions that influence understanding and reaction to stressful situations. The constructive orientation to the problem It is characterized by the following components:

  • Acceptance of the problems as a normal and expected part of life.
  • Belief in one's ability to solve problems effectively.
  • Use and label discomfort and physiological symptoms as keys to identify the presence of a problem. It is about using them as warning signs that allow us to start the problem solving process or even anticipate.
  • Inhibit the natural tendency to respond emotionally before the problem situations. It is about using the "stop and think" principle in these situations.
  • Take a realistic stance regarding the problem solving process, assuming that time and effort are important in the identification and implementation of effective solutions.

The main strategies to generate or reinforce an adequate orientation to the problem are the following:

  1. The Devil's Advocate Technique. The objective is to test the validity of the beliefs that give rise to the negative orientation by treating them as hypotheses and focusing on the utility in order to solve the problem for which they were generated. The therapist temporarily adopts a position towards the clearly irrational person (eg, the problems are not normal, almost nobody has them, it is catastrophic that things do not go well, it is better to avoid than to face the problems). The person should try to find arguments to refute these beliefs. It is important that the person does not perceive the therapist's posture as a mockery or criticism of their way of thinking. Together with this strategy, cognitive restructuring techniques and registers aimed at strengthening positive orientation to problems can be used.
  2. “Make the horoscope” of the problem. The objective of this technique is to help recognize the existence of a problem. Labeling situations as a problem is the first step to inhibit previous trends that maintained or amplified those situations. It is about building a list with several areas where problems occur (eg, work, family, friendship, economy, health). From this initial list a second more specific list is constructed with specific problems that the person is experiencing in the different areas or those that he anticipates he could have and to whom he feels vulnerable.
  3. Use emotions as clues or keys to identify the problem. One of the main obstacles in solving problems is the tendency to act impulsively to reduce a negative emotional state. When this occurs, negative emotions or feelings tend to increase and the problem remains unresolved. It is about fostering the belief that experiencing certain emotions can be positive and useful in detecting the problem. The main strategy is to collect information through records of situations in which discomfort has been experienced and try to clarify what the underlying problem was or is. People should use emotions as signals (eg, as traffic lights) to implement the “STOP and THINK” strategy. Giving the instruction "Stop" reduces the likelihood of acting impulsively. The "Think" instruction points to the need to activate and engage in a positive orientation to the problem and implement the rest of the problem solving strategies.

Training in definition and formulation of the problem

Collect all relevant information

People with emotional problems often have a tendency to selectively seek information that confirms their feelings of hopelessness. They also often confuse facts with opinions. At this stage it is useful assume the role of researchers or journalists. When acting as researchers we must answer the following questions: Who ?, What ?, When ?, Where ?, Why ?, and How? It is important to remember that when collecting this information we look for facts, and that if we have certain beliefs or suspicions, every good journalist needs to contrast them.

Describe the facts clearly and unambiguously

It is about using precise language to refer to the facts that form the problem (internal and external events). Along with the attempts to operatively define the events that are part of the problem (eg, my marriage is a ruin vs. we do not agree on which school to take the child), it is important to help separate the relevant information for its solution from that accessory or irrelevant information. This should lead to a better ability to discriminate the type of problem it faces:

Main types of problems

  • Behavioral deficit (Eg lack of social skills).
  • Mismatches in personal expectations (Eg, "I thought I would enjoy this job more")
  • Cognitive distortions (Eg, "I have failed as a woman because of my son's behavior")
  • Confusion due to conflicts between different objectives or goals (Eg, working more to earn more money means being less with the family)

Minimize cognitive distortions

Once the person begins to have a list of relevant information, the therapist should help you reorganize, select and discard, summarize and try to observe and correct the existence of errors or cognitive biases that impair the perception of the problem.

Understand the nature of a problem

It is about specifying with greater precision the reference to the goals. For this the use of imagination is important. To the use the imagination and fantasy of the person to specify the nature of the goals, the discrepancy between the current situation and the patient's goal or goal becomes more accessible. The perception of this discrepancy allows to clarify some of the obstacles that the person is encountering. In addition, raising the objectives as a fantasy usually allows depressive patients to overcome the initial despair in setting the goals and facilitates motivation. In this strategy the therapist asks the person to describe with great detail the image of a future in which their main problems are solved. If the image is incomplete the therapist can ask questions to clarify the less developed points.

Set realistic goals

Starting from the previous exercise, the person must specify in more detail the main goals or objectives in relation to the problems, and starting from these, sub-goals will be established. According to these sub-goals, the main obstacles (eg, lack of skills, resources, uncertainty, fears, etc.) that the person encounters when trying to reach them will be determined. Problems can be grouped into emotion-oriented objectives and problem-oriented objectives. At this stage, cognitive distortions or unrealistic beliefs related to self-efficacy are likely to appear. To solve them, it is often useful to reduce the perfectionism and the high demand.

Training in alternative generation

During this phase you have to train in the generation of a wide range of solutions for the problem. The main strategy for generating alternatives is the brainstorming (brainstorming). This strategy consists in the production of alternative solutions according to 3 principles: principle of quantity, postponement of judgment and distinction between strategies and tactics.

Alternative strategies to help the person generate alternatives

StrategyDescription
CombinationsA list with multiple alternatives is constructed, each element of the list is reviewed thinking if it would be combinable with some other element of the list. Combine the proposed alternatives as much as possible.
ModificationsOn the initial list of solutions, each item is reviewed trying to see if there are any modifications that could make it effective (eg, increase or decrease the intensity, frequency or duration of the response, the time it takes place, etc. ).
ModelsThe person is asked to think of someone they admire or respect (acquaintances or fictional characters, politicians, etc.) a lot and think about how that person would solve the problem.
DisplayThe person is asked to, with closed eyes, imagine successfully facing the problem. While imagining you are asked to think about the different response options you would have.
  1. Quantity principle. It consists in facilitating the creation of a large number of hypothetical solutions, although many of them seem unfeasible or extravagant. You should generate as many solutions as possible and so that you can combine the solutions already generated at other times, resulting in other more complex solutions. The person must make lists of solutions for each objective that is raised.
  2. Postponement of the trial. It consists in suspending or inhibiting the tendency to evaluate possible solutions. The person should limit themselves to generating them knowing that they will be evaluated at a later stage.
  3. Distinction between strategies and tactics. Strategies are understood as more general lines of action, while tactics or techniques are specific procedures within each strategy. Teaching the person this distinction favors the generation of alternatives as it can produce solutions at both levels. If there are several concrete or tactical solutions, they can be grouped into a strategy (naming it) and from it generate additional solutions. If what is generated are general solutions or strategies, the person can be asked to specify these strategies in more specific solutions or tactics.

Training in decision making

The objective of this phase is select the best alternative or combination of alternatives to maximize positive results or consequences and minimize negative ones. Therefore, the prediction of these consequences is a central activity of the process.

  1. Prediction of the probability of reaching the objective. It is about helping the person to predict how likely each of the alternatives can achieve the goal. The person can complete a worksheet like the one presented in Figure 3. The process begins by discarding those alternatives that are clearly ineffective or crazy. Once these options are ruled out, the person can assess the adequacy of each alternative in the dimensions relevant to it.
  2. Evaluation of the possibility of implementation. It is a process in which the difficulties or obstacles of carrying out each of the proposed alternatives are evaluated in detail.
  3. Cost / benefit analysis. The person must evaluate the importance of the different dimensions of the consequences previously assessed, assigning weights to each of them. This strategy conveys respect to the values ​​of each one. The person assigns a score (0, 1 or 2) according to the valence of the consequences analyzed, that is, once the probability of an alternative of place to a result (objective of the previous phase), in this phase is assessed It is about determining to what extent that effect occurs is positive (2), negative (1) or neutral (0).
  4. Summarize and make final adjustments. The options that have received a higher score will be the candidates for implementation. A final review with the person can make certain adjustments in the form of the alternatives to facilitate its implementation.
  5. Plan the strategy. Finally, the action plan is prepared to implement the solution. This plan should be as concrete as possible. It should also contain an analysis of the possible obstacles, of the most important sub-objectives as well as an assessment of the possible areas of uncertainty. In addition, the implementation of different alternatives can be programmed at the same time to attack the problem from different perspectives.

Training in solution implementation and verification

In this phase the person carries out the selected solution or solutions and evaluates the effect that said solutions produce. The feedback that is obtained allows to observe both the effectiveness of the solutions themselves, as well as the abilities or deficits of the person in the different phases of the solution process. This phase consists of five components: implementation, observation of the result, evaluation of the effectiveness of the solution and self-reinforcement / identification of difficulties.

  1. Implementation. If the person doubts or resists when implementing the solution, a motivational strategy based on the analysis of the consequences of not solving the problem against the consequences of implementing the designed plan can be used.
  2. Monitoring and evaluation of the results. It is about evaluating for a period of time (long enough to be able to verify all the effects sought), the results or consequences produced by the implemented solution. The evaluation should not be restricted to the achievement or not of the desired goal, but should also include parameters related to the general satisfaction of the person and other emotional or social criteria relevant to him / her. To achieve this objective, the person can be asked to carry out a registry in which he assesses the different variables considered on a subjective scale. Figure 4 shows an example of a registration template.
  3. Self-reinforcement problem identification. Once the solution is implemented, if the results are satisfactory, the person must reinforce himself. This self-reinforcement can range from simple self-messages (eg, "I got it"), to the planning of rewarding activities or the purchase of material objects. If the results are not satisfactory, the problem that generated them must be analyzed. If it is a problem of the process itself (eg, deficit in any of the stages of the problem-solving process) it returns to the phase in which the problem has been identified. If it is a deficit of skills necessary to carry out the solution, training in that specific skill or abilities should be carried out. To strengthen and automate the problem-solving process D'Zurilla (1989) proposes an algorithm along with a series of example problems that the person must solve in increasingly smaller periods of time. Table 4 presents the scheme for quick troubleshooting.

Summary Procedure for Troubleshooting

Phase 1Make the following self-statements:

(a) take a deep breath and try to calm yourself down
(b) nothing catastrophic will happen immediately
(c) Pose this problem as a challenge
(d) I can with it!
(e) Stop and think

Phase 2Ask yourself the following questions:

(a) What is the problem? (Think about the discrepancy between how things are and how you would like them to be).
(b) What do I want to achieve? (set the goal or objective)
(c) Why do I want to achieve this goal? (expand your goal)

Phase 3Think of one solution, and then think of many more alternative solutions (at least two or three).
Phase 4Think about the most important criteria to evaluate your alternative solutions (eg, will it allow me to reach my goal? What effect will it have on others? How much time and effort will it entail?). Then quickly think about the solution that seems the best. Finally think of one of two ways to improve the solution
Phase 5Carry out the solution you have chosen. Are you satisfied with the results? If the answer is no, try the next option (alternative solution) that you had chosen.

If the person finds it difficult to carry out this process in two or three minutes, steps 2 and 4 can be suppressed. By eliminating these two steps the procedure can improve its effectiveness under conditions of time pressure.

To automate and expedite the implementation of the process D'Zurilla proposes to select examples of everyday problems (eg, spilling a cup of coffee on an important document that must be delivered urgently; realize that we have forgotten the portfolio just when there is to pay on a first date, etc.). It involves choosing a large number of possible problems and asking the person to solve them in less than 5, 3, 2 and 1 minute (D'Zurilla, 1986).

Main problems in problem solving training and possible solutions

Posible problemsProposed Solutions
(1) The person shows conformity with the therapist when he performs the technique of the devil's lawyer.Assume the role of a hypothetical friend of the person whom he should help because he is in a bad time.
(2) With depressed patients in the application of brainstorming They may have problems in postponement of the trial.Do not pose the answer as a solution that should work, insist that a solution be "invented." Emphasizing the invented nature of the solution inhibits the tendency to negatively assess the probability of success.
(3) There are high levels of emotional distress during the process of generating alternatives. This discomfort translates into catastrophic expectations about the result, fear of failure, etc.Address emotional problems before training (e.g., cognitive restructuring, relaxation training or self-instructions).
(4) There are strong habits or rigid social conventions that inhibit the generation of alternatives.Examples of very impersonal problems are selected to train the patient. For example, it generates different uses for everyday objects (eg, a clothes rack, a soap dish, etc.).
(5) When dealing with very specific problems or high technical complexity, the person may not have enough information about possible response options.It is possible to offer possible solutions or refer the person to other professionals (eg, vocational advisor) or use the possible institutional aids offered for similar problems.
(6) In the implementation phase, the person experiences difficulties in putting themselves into practice due to fear of failure, lack of confidence in their abilities, etc.Resort to the orientation phase. Restructure negative ideas about avoidance. Insist through adaptive contrast strategies on the ineffectiveness of not launching new solutions (eg, "So far how things have gone?"). Pose the implementation as an experiment, (eg, "let's see what happens, if it doesn't go well we can always look again and in the worst case, we can stay as we were"). Do an exercise in which you try to predict the consequences of not changing (implement the new solution), and assess them according to the parameters considered in the decision-making phase.
(7) There is a lack of specific skills that makes it difficult to implement the selected solution.Consider selective training in deficit skills. The main skills can be grouped into problem-oriented or emotion-oriented. The main ones are shown below:


Problem Oriented Skills
- Assertiveness
- Job search skills
- Educational skills (for parents)
- Economics management skills.
- Academics
- Conflict resolution
- Communication
- Self help
- Social skills
Emotion-oriented skills

- Cognitive restructuring
- Relaxation
- Positive imagination
- Auto induced desensitization
- Distraction and perspective taking
- Physical exercise
- Positive and / or rational self-instructions.

References

Avia, M. D. (1990). Cognitive and self-control techniques. In J.Mayor & F. J. Labrador (Eds.), Manual of Behavior Modification Techniques (pp. 330-360). Madrid: Alhambra.

D'Zurilla, T. J. (1986). Problem Solving Therapy. New York: Springer.

D'Zurilla, T. J., Nezu, A. M., & Maydeu-Olivares, A. (2004). Social Problem Solving: Theory and Assessment. In E.C. Chang, T. J. D'Zurilla, & L. J. Sanna (Eds.), Social Problem Solving: Theory, Research and Training (pp. 11-28). Washington: APA.

Nezu, A. M., Nezu, C. M., & Perri, M. G. (1989). Problem Solving Therapy for Depression. New York: Wiley.

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