Research

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Evidence Base for Collaborative Problem Solving

Collaborative Problem Solving is one of only a few approaches that has demonstrated remarkable effectiveness in a number of different settings.  Below you’ll find a comprehensive review of research across all settings, as well as other published research studies listed by the settings in which they were conducted. 

Across Settings

The Collaborative Problem Solving Approach: Outcomes Across Settings.

By Alisha Pollastri, Larry Epstein, Georgina Heath, & J. Stuart Ablon, 2013.

This article reviews all known research on outcomes related to the use of Collaborative Problem Solving in outpatient, inpatient, and residential treatment programs, schools, and juvenile justice facilities through the Summer of 2013.  It gives brief descriptions of the other research articles listed on this webpage (published prior to 2013) as well as a number of unpublished studies that were made known to Think:Kids staff through personal communications.  It is a great place to start, in order to understand the range and scope of research related to CPS.   

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Outpatient Therapy

Effectiveness of Collaborative Problem Solving in Affectively Dysregulated Children With Oppositional-Defiant Disorder: Initial Findings.

By Ross Greene, J. Stuart Ablon, Jennifer C. Goring, Lauren Raezer-Blakely, Jennifer Markey, Michael Monuteaux, Aude Henin, Gwenyth Edwards, & Sarah Rabbitt, 2004

This study was the first empirical study of the CPS approach – a randomized, controlled clinical trial conducted in the Department of Psychiatry at Massachusetts General Hospital. This study compared CPS to a commonly used and empirically supported treatment called Parent Management Training with 47 affectively dysregulated children with Oppositional Defiant Disorder.CPS produced significant improvements across multiple domains of functioning at posttreatment and at 4-month follow-up. These improvements were in all instances equivalent, and in many instances superior, to the improvements produced by PT.

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Attention-deficit/hyperactivity disorder with oppositional defiant disorder in Swedish children – an open study of collaborative problem solving

By Mats Johnson, Sven Östlund1, Gunnar Fransson, Magnus Landgren, SalmirNasic, BjörnKadesjö, Christopher Gillberg, & Elisabeth Fernell
An additional outpatient study was performed in Sweden and published in 2012. In this study, 17 children with both Oppositional Defiant Disorder (ODD) and ADHD received 6 to 10 weeks of outpatient family therapy using CPS.

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Inpatient Psychiatry Units

Use of Collaborative Problem Solving to Reduce Seclusion and Restraint in Child and Adolescent Inpatient Units

By Ross W. Greene, Ph.D., J. Stuart Ablon, & Andres Martin, M.D., M.P.H.
This empirical study examined changes on the first child inpatient psychiatry unit to implement Collaborative Problem Solving- the Child Assessment Unit at Cambridge City Hospital.

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Reduction of Restraint and Seclusion Through Collaborative Problem Solving: A Five-Year Prospective Inpatient Study

By Andres Martin, M.D., M.P.H., Heidi Krieg, R.N., Frank Esposito, M.A., Dorothy Stubbe, M.D., & Laurie Cardona, Psy.D.
This study was conducted by independent investigators who were interested in determining whether results from the previous study could be replicated at the Yale – New Haven’s Children’s Hospital.

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Beyond Points and Levels Systems: Moving Toward Child-Centered Programming

By Wonda K. Mohr, PhD, APRN, FAAN, James Olson, PhD, Nicole Branca, MSN, APRN, Andres Martin, MD, & Andres Pumariera, MD.

This article should be of great interest to those working in residential treatment facilities and inpatient psychiatry units – as well as schools.The article provides a critical review of the theory behind and use of motivational systems in such settings.It then goes on to describe the process of implementing Collaborative Problem Solving as a child-centered alternative to point and level systems at the Yale Child Study Center. The process of implementation was conducted with extensive training and consultation from Dr. Ablon, and many of the details of the culture change that took place and the critical ingredients that made it successful are detailed in the article. This article is a great addition to the literature that should be a huge help to others interested in implementing the model in their programs.

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Residential Treatment Programs

Collaborative Problem-Solving Approach in Clinically-Referred Children: A Residential Program Evaluation

By Shannon Stewart, PhD, C. Psych., Julia Rick, BACS, BA, Melissa Currie, MSc, & Niki Reilly, Phd, C. Psych
Our Canadian colleagues submitted a final report to the Centre of Excellence in Children’s Mental Health at the Children’s Hospital of Eastern Ontario that documents the effectiveness of the approach in a residential setting. The report is exciting not only because it is the first systematic study to demonstrate effectiveness of Collaborative Problem Solving in settings where it is often implemented – residential treatment, but also because it documented improvement in child functioning across several areas including significant gains in the development of specific social skills through implementation of the approach. This was the first such study to validate the skills training aspect of the approach empirically. Other exciting findings: children and adolescents in the study showed enhanced participation in their communities after treatment and many gains were maintained at six-month follow up including a further reduction in behavioral outbursts.

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Parenting Groups

Parenting Children with Disruptive Behaviours: Evaluation of a Collaborative

Problem Solving Pilot Program

Trina Epstein and Jennifer Saltzman-Benaiah
A new area of research on the approach focuses on parenting group interventions. Our colleagues from Toronto published a study attesting to the effectiveness of a parenting group intervention based on the CPS model and evaluated its feasibility and efficacy. Significant improvements in child behavior were reported by both mothers and fathers at the end of the intervention and follow-up. There were also significant reductions in mothers’ stress.

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Schools

Reducing Teacher Stress

By Averi Schaubman and Erica Stetson
The most recent published research comes from two Think:Kids Certified Trainers, Averi Schaubman and Erica Stetson, who work in the Cherry Creek Schools in Colorado. They piloted using the approach in an alternative middle school setting and showed significant reductions in teacher stress and office referrals for disciplinary reasons.

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Symptom Improvement vs. Functioning

By Kimberly D. Becker, Bruce F. Chorpita, & Eric L. Daleiden
This article highlights the CPS approach as one of the few of over 750 different treatment protocols targeting child mental health problems that demonstrated improvements in functioning as opposed to simply symptom reduction. While we’d like to think that these exciting results are due to our emphasis on skills training rather than simply symptom reduction, future research is needed to test this hypothesis.

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Due to data like these, Think:Kids is now listed on the California Evidence-Based Clearinghouse for Child Welfare. Status as evidence-based practice has been achieved in places like the state of Oregon where the Division of Addictions and Mental Health is helping sponsor training throughout their children’s mental health system with our help. We are thrilled that training in our approach has recently been written into the administrative rules in Oregon due to the evidence base. Impressive results have also been documented in many other systems such as adolescent inpatient psychiatric units, residential and day treatment programs, juvenile detention facilities and schools. Data from these settings have been collected and with your help we hope they will be published soon. If you are interested in studying your use of the approach or already have data to share from your setting, please email us (LINK to email). In the meantime, you can also click here to download a current list of references of publications related to the work.

Click here to watch video of Dr. Ablon describing results in restrictive facilities that have implemented the model.