How Problem-Solving Therapy Benefits Older Adults

Problem solving therapy, or PST, is a short-term, evidence-based form of psychotherapy that helps older adults develop clear, practical strategies to manage stress and symptoms of depression. Rather than emphasizing emotional analysis, PST focuses on identifying problems and taking meaningful action.

Therapy doesn’t need to focus on the past to be effective. Sometimes, what’s most helpful is a practical approach that addresses the challenges you’re facing right now. If that resonates with you, problem solving therapy may be a good fit.

Key takeaways

• Problem solving therapy is a short-term therapy approach that may alleviate depression and stress in older adults
• With practical guidance, it can help to boost seniors’ confidence and emotional well-being 
• PST helps seniors regain a sense of control when life changes feel disruptive or limiting

What is problem solving therapy?

Problem solving therapy is a structured therapeutic approach that teaches people how to identify their problems, then come up with solutions. Patients leave sessions with a game plan, and learn reasonable ways for handling life’s challenges instead of feeling stuck or overwhelmed by them.

PST is an evidence-based form of therapy and is considered to be an effective form of treatment for seniors. PST is typically a short-term intervention, with many patients concluding treatment after six to 12 sessions. It focuses on what’s currently happening in your life, instead of past events such as childhood trauma or long-term behavior patterns. 

Why the PST approach works well for seniors

For many seniors, revisiting experiences from decades ago may be less helpful than learning how to adapt to age-related changes such as downsizing, mobility limitations, or increased daily stress. Problem solving therapy is particularly effective for older adults because it focuses on navigating real-life challenges, including loss of independence and complex decision-making.

Research shows that PST reduces depression in older adults, especially when everyday demands feel overwhelming or anxiety-provoking. It’s well suited for individuals who prefer leaving therapy with concrete next steps rather than engaging solely in open-ended emotional discussions. This practical, solutions-focused approach may feel more approachable than the stereotypical idea of “seeing a shrink,” helping seniors feel they are leaving each session with a clear plan.

PST also helps restore a sense of control and confidence. As life circumstances change, many older adults begin to doubt their competence. Successfully addressing even small problems can rebuild confidence and reinforce their ability to manage daily life.

In addition, aging can affect executive functioning, including planning, prioritizing, and decision-making. PST provides structure that supports these skills and helps individuals follow through on plans. This can be especially beneficial for seniors experiencing mild cognitive changes or mental fatigue related to stress or illness. 

A 2021 study found that when PST was used alongside antidepressants, patients experienced improved cognitive performance and greater reductions in depressive symptoms compared to those taking antidepressants alone.

Common problems faced in later life

Problem solving therapy is designed to address the emotional and practical challenges that commonly arise in later adulthood. It helps seniors navigate life transitions by focusing on what can be changed, managed, or adapted.

PST can be especially helpful for older adults adjusting to retirement or a loss of purpose. By exploring what brings them joy and sparks interest, this therapy approach supports the process of identifying meaningful next steps and redefining purpose in this stage of life.

Older adults may also experience conflict or communication challenges with loved ones and caregivers. PST helps seniors learn how to express their needs confidently, improve communication, and explore realistic compromises that support healthier relationships.

For practical concerns such as transportation limitations, housing decisions, or managing finances, PST provides a structured framework for evaluating options without becoming overwhelmed. This approach helps seniors move forward with clarity and confidence rather than feeling stuck.

Seniors living with chronic health conditions often face ongoing anxiety and uncertainty. PST shifts the focus away from symptoms that are outside their control and toward actionable steps within their control, such as scheduling appointments, managing symptoms, or strengthening support systems.

A core principle of PST is breaking large, intimidating problems into smaller, manageable pieces. Rather than trying to “solve everything” at once, therapy focuses on one solvable step at a time, making progress feel achievable and restoring a sense of momentum.

The 7-step model explained

Problem solving therapy follows a seven-step process. The typical PST steps include:

1. Defining the problem
2. Setting a realistic goal
3. Brainstorming solutions
4. Naming the pros and cons of each option
5. Choosing the most sensible solution
6. Creating a detailed, concrete action plan
7. Reviewing the outcome and pivoting if necessary

This structure works because it breaks down problem solving into manageable action items. The process encourages forward progress and learning through action.

PST is especially effective for stress related to life transitions, health changes, interpersonal challenges, and day-to-day decision fatigue—areas where seniors often feel stuck.

Problem solving therapy vs CBT

While PST and cognitive behavioral therapy (CBT) are both evidence-based, they differ in focus and complexity. CBT emphasizes identifying and restructuring unhelpful thought patterns, while PST centers on action-oriented problem management.

Many people find PST simpler and easier to learn than CBT, particularly when cognitive load or emotional exhaustion is a concern. It requires less abstract thinking and less focus on internal dialogue.

The two approaches can also be used together. CBT may help address deeply entrenched negative beliefs, while PST provides a practical roadmap for handling immediate stressors.

In cases where distorted thinking patterns are the primary driver of distress, CBT may be the better standalone option. When life circumstances are the main source of stress, PST often shines.

Adapting the process for older adults

PST can be adapted to accommodate common age-related changes, such as lower energy levels, changes in hearing or vision, or mild cognitive impairment. Sessions can move more slowly, include written notes, and repeat key ideas to make them easier to remember and use.

PST also works well in virtual therapy, since the clear steps translate easily to a telehealth platform. Tools like visual aids, shared documents, and simple between-session checklists can help seniors stay engaged.

When appropriate, involving family members or caregivers can be very helpful. Loved ones can help seniors follow through on plans, practice new skills between sessions, and make sure solutions fit into their daily routines.

At its core, PST treats older adults as capable of solving problems. It offers practical tools that help restore a sense of control, dignity, and hope during a stage of life when those feelings can be especially important.

A practical path forward with Sailor Health

Problem solving therapy offers older adults more than symptom relief. It offers a clear, empowering way to handle the real-life challenges that can make later life feel overwhelming. With the right structure and support, seniors can rebuild confidence, improve mood, and regain a sense of control over daily life.

At Sailor Health, we specialize in evidence-based mental health care tailored to seniors, which includes problem solving therapy delivered by experienced providers who accept Medicare and understand the unique challenges of aging. Whether navigating health changes, life adjustments, or ongoing stress, Sailor Health helps seniors move forward with clarity and practical support—one solvable step at a time. Getting started is easy, and we take pride in making therapy more accessible by working with Medicare to cover up to 100% of the cost for most patients.

FAQ 

Is problem solving therapy for older adults covered by insurance?

Oftentimes, yes. Problem solving therapy is an evidence-based treatment commonly delivered by licensed mental health providers, which means it is often covered by Medicare and other insurance plans. Coverage depends on the provider, setting, and individual plan. We’re happy to review your insurance coverage and explain your eligibility.

Do I need to have depression to benefit from problem solving therapy?

No. While PST is well-known for treating depression, it is also effective for managing stress, life transitions, and day-to-day problem-solving difficulties. Many seniors use PST simply to feel more confident and capable in navigating everyday decisions.

What if my problems feel too small or too overwhelming to bring to therapy?

PST is designed for exactly that. Therapy focuses on breaking problems into manageable pieces—whether they seem minor or enormous at first. Even small, practical issues can significantly affect quality of life, and PST provides a structured way to address them without feeling judged or rushed.

References

1. Jiang, C., Zhou, H., Chen, L., & Zhou, Z. (2021). problem solving therapy Improves Effortful Cognition in Major Depression. Frontiers in psychiatry, 12, 607718. https://doi.org/10.3389/fpsyt.2021.607718 
2. Kirkham, J. G., & Seitz, D. P. (2022). More evidence for problem-solving therapy: Improving access is still a problem in need of solving. International Psychogeriatrics, 34(2), 105–107. https://doi.org/10.1017/S1041610221000077