Turn a worry into next steps
Writing a problem down and choosing one workable step is a tested way to lift low mood.
The number, drawn
Problem solving therapy improved depression by 0.34 standard deviations in low bias trials
Why it matters
Problem solving means naming the problem, listing your options, picking one, trying it and reviewing what happened. Across 30 randomised trials with 3530 patients, problem solving therapy improved depression by 0.34 standard deviations in the nine trials at low risk of bias, comparable to other psychotherapies. NICE lists individual problem solving as a depression treatment, usually 6 to 12 sessions, and guided self help materials can use the same method. The structured version was studied, so doing it loosely in your head is not the same thing.
How to do it
- Write the problem in one sentence, as concretely as you can.
- Split it into the parts you can change and the parts you cannot.
- List several options for one changeable part without judging them yet.
- Pick one, decide when you will do it, and do it.
- Review what happened, then repeat with the next part.
If low mood or hopelessness persists, ask a professional about problem solving therapy or another treatment rather than working through it alone.
Do it
Pick the time you have. Anything beats nothing.
Start with the time you have
1 minute
Put one current problem into a single sentence, then name the part you can influence rather than everything that worries you.
5 minutes
List three possible responses to that small problem without judging them yet.
15 minutes
Compare the options for effort, likely benefit and help needed; pick one and specify when you will try it.
30 minutes
Work through one problem on paper, make a practical first step such as an enquiry, and set a time to review the result.
A plan
One problem, one experiment, one review
- Describe a specific problem and separate what you can influence from what you cannot.
- List options, choose a feasible one and try it at a planned time.
- Review what happened, keep what helped and adjust the next step; seek therapy if symptoms persist.
In real life
- Turn "Everything is a mess" into "I need help getting to Tuesday's appointment."
- Compare asking for a lift, checking community transport and requesting a remote appointment, then try one option.
Watch out for
- Common mistakeTrying to fix your whole life at once can stall you: work on one small, changeable problem.
- Common mistakeSelf-help is not the same as therapy: seek professional help if low mood or hopelessness persists.
Trusted guides
Check usSources
- Evidence grade
- A Meta-analyses of randomised trials, or a major guideline consensus.
- Basis
- Meta analysis of 30 randomised trials, 3530 patients; 0.34 in the nine trials at low risk of bias
- The number
- Problem solving therapy improved depression by 0.34 standard deviations in low bias trials (European Psychiatry, via PubMed, 2018)
- Tier 2 studyProblem-solving therapy for adult depression: An updated meta-analysisEuropean Psychiatry, via PubMed, 2018
- Tier 1 guidelineDepression in adults: treatment and management, NG222NICE, 2022
General health information, not a diagnosis or an individual treatment plan. Personalization changes the order of suggestions; it does not assess your medical risks. Follow the cautions and consult a qualified clinician when needed.