In CBT, problem solving needs to focus on very specific and manageable problems that actually have potential solutions. When we’re depressed, there’s a tendency to try to solve the problems, “Why am I depressed?” and “How can I stop being depressed?” But these problems don’t have simple solutions. We can’t solve them all at once.
Trying to problem solve “Why am I depressed?” usually leads to rumination, thinking in circles getting nowhere, and making ourselves feel even worse. And trying to solve “How can I stop being depressed?” usually leads to similar results.
Treating depression involves a series of small steps and gradual changes in our behaviors and thoughts. This is why we start with behavioural activation and cognitive restructuring before attempting problem solving. Problem solving “depression” in one fell swoop doesn’t work.
Instead, we problem solve issues that arise from our attempts to modify our behaviors and our thoughts. In order for problem solving to be successful, we need to limit the scope of the problems we’re trying to solve. And then we come up with action plans to implement our solutions.
Problem Solving and Action Plans for Depression
This transcription was auto-generated by YouTube. I’ve only added minimal editing, so I apologize for any errors, run-on sentences, etc.
One of the main premises of both cognitive behavioral therapy and dialectical behavior therapy is that our emotional reactions start with a situation or event, that leads to certain thoughts and behavior, and it’s these thoughts and behaviors that are responsible for the emotion we feel. And we focus on changing these thoughts and behaviors in order to change the way we feel.
But if our thoughts are accurate and reflect reality, and our behavior is appropriate for the situation we find ourselves in, then there may not be much we can do to change our thoughts and behavior in order to help ourselves feel better. Or maybe our thoughts about a situation aren’t that accurate and we haven’t been acting in the most effective way to try to cope with things, but we’ve tried changing our thoughts and behavior and just haven’t had much success. So instead we focus on changing the situation that triggered these thoughts and behaviors in the first place. And we do this by problem solving and then coming up with an action plan.
So the first step in problem solving is to identify and then define or describe the problem or the situation that’s causing the problem. So for example, we’re feeling lonely or sad because we’ve just moved to a new city and we don’t really know anyone here yet. Now being lonely or sad in this situation is a natural way to feel, and so trying to change our thoughts about the situation probably isn’t going to be that successful or help that much.
And assuming our behavior isn’t contributing to the way we feel—for example we’re not just isolating ourselves and lying around on the couch when we’re not at work, we’re actually doing some activities and trying to meet people, we’re just not having much success—there may not be much about our behavior we can change that’s going to have an effect either.
So instead we need to engage in problem solving, and figure out a way to change the situation so we’re no longer feeling so lonely and sad. So the next step is to identify our goal in solving the problem and what needs to happen in order for us to start to feel better. And we want to keep the goal simple and realistic, and choose a short-term goal, because we want something that can start giving us some results right away.
Now if we think the solution is make lots of new friends here so I don’t feel so lonely all the time, well that’s a great goal, but it’s not something that’s going to happen right away. So instead, something like meet one or two new people here I can spend some time with. Then we come up with possible solutions or options to help us reach our goal. And we just brainstorm these, writing down as many things as we can think of without worrying about evaluating them yet.
And then we read over our entire list and select the best solution we’ve come up with. And if it’s not clear which option is the best solution, we can choose two or three and compare them with each other using a pros and cons list. So let’s say the solution we choose is to get involved with a group of people here with similar interests to our own and try to make some friends among them. So once we’ve chosen a solution to help us reach our goal we need to come up with a plan to implement that solution.
The key to creating a good action plan is to break it down into as many small steps as possible, so that each individual step is manageable. The biggest reason an action plan fails is that at some point, one of the steps creates a barrier we just can’t get around. And often it’s the first step that’s the biggest barrier, so make sure the initial step is really, really simple and manageable, because if this first step seems at all overwhelming, we can end up procrastinating and never get around to even trying to start on our plan. And just initiating this first step, no matter how small, often brings with it a sense of relief, because now we feel like we’re finally starting to do something about our problem, and we no longer feel so stuck or hopeless.
And when we come up with a plan we need to be specific about what each step entails and when we’re going to do it. We also want to anticipate possible problems or barriers that might come up, and have strategies ready to overcome them if they do arise. Otherwise it’s easy to get stuck and then just not know what to do next, or become so discouraged that we set aside our plan and stop working towards our goal altogether.
So let’s create an action plan to meet one or two new people where we’ve just moved who we can hang out with sometimes. So the option we evaluated as being the best solution is to get involved with a group of people with similar interests. So maybe we like playing board games and would like to get into a games night group. Or maybe we like sports and want to join a soccer or softball league. So step one is choose an activity.
And step two is to do some research and see what’s out there. Tonight when I get home from work, I’m going to spend an hour looking at the various options available to me. And then step three might be, tomorrow I’m going to evaluate the different options I found and select the one that looks most promising, as well as two others I can use as backup in case the first one doesn’t work out—so anticipating solutions to possible barriers we might face.
And then the next step might be this weekend I’m going to get in touch with a contact person or organizer and find out information about what I need to do to sign up and participate. And then after I hear back from the contact person. I’m going to write out the additional steps I need to take based on what i’ve learned from them. Leading up to the step where we show up at the first games night or practice.
And maybe we have a couple of other steps about strategies to connect with people once we’re there, or if for some reason it turns out our first choice isn’t an option. But we anticipated this barrier so we already have two backup options ready to go so we choose one of these and go back to the step where we contact the organizer and carry on from there.
Now one challenge with action plans is that they can seem really trivial—like do we really need a plan to figure out how to attend a board games night? But at the same time, in a lot of cases, as simple as the plan seems ,there can be issues like anxiety that get in the way of being able to complete it. If we’re an outgoing charming extrovert and want to meet people, maybe we can just show up to a games night and start talking to people and connecting with them. But if we’re more shy or introverted, when we get to the show up step, that can seem like an impossible hurdle to get over.
So part of doing all of the small steps is that it can help us become comfortable with the idea of doing something we’re a little apprehensive about. Each step gives us some exposure to the thing we fear, which can reduce the anxiety we experience when faced with the steps later on in the plan, which is something I talk more about in my video on systematic desensitization. But often we’ll get to the last step and still find it hard to follow through.
So we need to anticipate this barrier and try to have a solution ready. So maybe we could ask a friend to come visit us the first time and go to the board game night with us, so we don’t have to show up alone and we know at least one person there.
Or if we have a lot of social anxiety, maybe we’ve gotten ahead of ourselves, and before we can implement a plan to meet new people, we need to focus on an action plan to manage our social anxiety better. And maybe this entails working with a therapist for a while to learn strategies to overcome social anxiety, which as part of the therapy, could involve a plan to meet new people with the help of a therapist to support us through the steps.
And finally we evaluate the outcome and results of our action plan. And if it worked, that’s great. But if it didn’t, then we need to go back to step four and evaluate our possible solutions again and choose a new option, and come up with an action plan for that, keeping in mind the barriers we face this time, and trying to anticipate solutions to them so we don’t get stuck in a similar way next time around.
So action plans can seem really straightforward on the surface, but when it comes down to acting on the plan, it’s often not that simple. Let’s look at another example.
So let’s say we hate our current job, and the goal we’ve come up with is to find a new job. So we generate an action plan. What more do we need than step one, look at job listings; and step two, apply for jobs. But that’s a pretty common plan people use that often goes nowhere, because although it looks easy, just the thought of changing jobs can seem overwhelming, so we keep procrastinating. So we need to break it down into smaller more manageable gradual steps.
Step one: update my resume this Monday through Wednesday after work.
Step 2: Thursday and Friday after work find the best sites for job listings in my field.
Step 3: start looking at job listings this weekend and bookmark any that look promising and do the same thing every evening this week looking through any new job postings that come up;
Step 4: next week reach out to personal and professional connections to see if they know of any jobs available. I’m going to contact this person on Monday, and this person on Tuesday, and this person on Wednesday.
Step 5: I’m going to reach out to my references on Thursday and Friday next week.
Step 6: start applying for jobs I identified during the week. Apply for at least two jobs over the weekend, and at least two other jobs over the course of the next week.
And this is often where we hit a barrier. Maybe the idea of switching jobs is creating so much anxiety we can’t even bring ourselves to start applying. So then we need to come up with a strategy to manage our anxiety and realize that just because we apply for a job doesn’t mean we’re going to get it. And even if we do get it, that doesn’t mean we need to take it and leave our current job. And we can make that decision when we get there and we don’t have to worry about that yet.
Or maybe the thought of going to a job interview is too stressful and that’s what’s holding us back. So we need to back up and before we get to the apply for jobs step, we need a practice job interview step. So maybe step six, review potential interview questions, step 7 ask someone to do some mock interviews with us, and then step 8 start applying for new jobs.
And remember that changing problem situations is hard so try not to get discouraged if your plans don’t always work out exactly as planned. And if you ever get stuck always look for a smaller intermediate step you can take, even if this step seems trivial and insignificant, because when we hit a barrier or start to lose momentum, the best way to get going again is with a really small simple and manageable step.