Monday, August 1, 2011

Structured Problem Solving... CBT strategy


"God grant me the serenity
to accept the things I cannot change;
courage to change the things I can;
and wisdom to know the difference."  The Serenity Prayer


The serenity prayer for me captures the essence of what we are trying to convey when we counsel people with depression and anxiety.  We help people learn how to fix things through structure problem solving, helping them to accept the things which they cannot change through Acceptance Commitment Therapy (ACT), and helping them to develop an in depth understanding of self and the people around them in order to increase their own awareness of when to fix and when to accept.

In this article, we are going to concentrate on the "fixing" through structured problem solving.

So what is it?

Structured problem solving is a simple process that we all do subconsciously when we are "well".  When we are faced with a problem, we automatically assess the situation, we identify the cause of the problem, we work out our available options with its pros and cons, and then finally, we pick out the best option and follow through with this option.  We usually do this quickly and subconsciously.

However, when we are stressed, depressed and anxious, this process tends to "malfunction".  We become confused, overwhelmed, indecisive and then ultimately procrastinate.  We are forever searching for the perfect solution and unfortunately, there isn't any.

So what can we do?
  1. First of all stop, think before we act
  2. Think about "What is/are the issues here?"
  3. What are my options?
  4. Write down the pros and cons with each option
  5. Try to pick out the "best option" ie the one with the most pros and the least cons.  Please remember that the "best option" may still not be a good option but, it is still the "best option".
  6. Take action (be realistic and take baby steps first and gradually work towards your goal)
  7. Reflect and review the process above and reimplement as appropriate
Doing this with a Psychologist, Counselor or Therapist will help further....

Hope this has been helpful.

Dr Vin Tran
Family Doctor
MBBS FRACGP University of Qld
http://www.priorityhealthmedicalcentre.com.au/