Objectives: This study aimed to evaluate the effectiveness of the Collaborative Problem Solving (CPS) approach in home-based family therapy and to explore two hypothesized mechanisms of change.Method: Sixty-seven families with children aged 3-12 years old completed a 12-week home-based CPS treatment program. Parent-report measures were completed pre-and post-intervention, including measures on parents' fidelity of using CPS, parents' empathy, children's executive functioning, children's behavioral difficulties, and parenting stress.Results: There were significant reductions in children's behavioral difficulties and parenting stress, and significant improvements in children's executive functioning and parents' empathy. These improvements were greatest for parents who had the greatest fidelity to CPS. Improvements in children's executive functioning and parents' empathy mediated the relationship between parents' CPS fidelity and outcomes.
Conclusions:These results provide evidence that home-based family treatment with CPS may achieve positive child and family outcomes by building children's executive function skills and improving parents' empathy.
K E Y W O R D SCollaborative Problem Solving, emotional and behavioral problems, empathy, executive functioning, parent stress 1 | INTRODUCTION Collaborative Problem Solving (CPS) is an approach for understanding and reducing emotional and behavioral difficulties among children and adolescents, and is frequently applied in family therapy to reduce parenting stress and family dysfunction. The philosophy of the CPS approach is that difficulties such as oppositionality, defiance, aggression, avoidance, and withdrawal are caused by the mismatch between an individual's neurocognitive skills and the skills needed to handle a demand (Greene, 1998;Greene & Ablon, 2005). The neurocognitive skills needed may be in executive functioning (including working memory, attention, emotion regulation, and cognitive flexibility), or in nonexecutive areas such as language/communication or social thinking.The practice of CPS includes two main phases: assessment and intervention. Specific activities within these two phases can be completed by any adult caregiver, including a parent, teacher, or mental health provider. In the assessment phase of the CPS approach, an adult caregiver identifies a target youth's lagging skills, and creates a list of expectations and triggers that are difficult for the youth to handle. These expectations and triggers comprise a list of "problems to solve" in the intervention phase of the approach. During the intervention phase, the youth and adult solve those problems collaboratively, at times also adjusting demands to match the skill level of the youth (Ablon, 2019).The CPS approach has been applied in a number of outpatient, inpatient, and school settings across North America with documented benefits (for a review of outcomes across settings, see Pollastri, Epstein, Heath, & Ablon, 2013).Evaluations of CPS in outpatient settings have found that CPS is effective fo...