Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Strategies for Using a Problem Solving Approach to Solution

A. Identify Problem

  1. Ask the client to describe what is happening. Who are the other people involved?
  2. Help the client break down the problem to focus on the immediate issue (priority).
  3. What are the triggers and patterns of possible self-destructive acts?
  4. Assist the client to self-monitor through the use of diaries to recall and detail relationships, moods, triggers, and patterns of self-harm behaviour.

B. Explore Past Attempts to Address Issue

  1. Help the client identify what has worked in the past.
  2. Help the client identify supports/resources/personal strengths.

C. Explore Alternatives/Challenges to Determine Solutions

  1. Identify small steps that will provide change and some control.
  2. Examine the role of medications to reduce anxiety (APA, 2003).
  3. Explore safe alternatives, such as breathing and relaxation (Frazier et al., 2003).

D. Choose Solutions

  1. Focus on helping the client identify small steps, coping strategies, stress reduction, problem-solving and self-examination of results.

E. Implement Process

  1. Identify when patient will “stop and think” and use collaboratively agreed upon action.
  2. Journaling successes, emotions, and learning is helpful (Fontaine, 2003).
  3. Provide time limited therapeutic sessions to assist the client in resolving current interpersonal problems (Gaynes, West, Ford, Frame, Klein & Lohr, 2004).

F. Evaluate Outcomes

  1. Promote realistic self-appraisal through discussing with the client their abilities and limitations.  Help the client reflect outcomes of purposeful tasks.
  2. Encourage – point out small successes and reinforce the client’s ability to appraise themselves (Fontaine, 2003).