Here at Think:Kids, we are dedicated to studying everything we do in order to guide refinements to the Collaborative Problem Solving® (CPS) approach and training methods. Our program partners with the Laboratory for Youth Behavior in the Department of Psychiatry at Massachusetts General Hospital on all research and evaluation activities. We put these resources to work every day to help us study and refine CPS.
Massachusetts General Hospital is consistently ranked by U.S. News and World Reports as one of the top hospitals in the nation. MGH also has the largest hospital-based research program in the country.
MGH Research Institute
At Think:Kids, we believe that there are many ways we can better understand and improve Collaborative Problem Solving® (CPS), including the use of rapid-cycle quality improvement studies, outcome evaluations, observational studies, randomized clinical trials, and implementation science. Each of these tells us something different, and together they provide a complete picture that informs our work.
Whether you are here to learn about studies that have already been completed or because you are hoping to start a research study of your own on CPS, we think you will find the information on this page useful.
reduction in school office referrals.
Significant improvements in children’s executive functioning skills.
71% fewer
self-inflicted injuries.
6 out of 10 teachers report reduced stress.
Significant reductions in parents’ stress.
74% average reduction
in use of seclusion.
73% reduction in oppositional behaviors during school.
Parents report improvements in parent-child interactions.
86% average reduction in physical restraint.
If you are looking to evaluate the impact of CPS at your organization:
As part of organization-wide implementation of CPS, Think:Kids will fully support your organization in evaluating the impact of the approach. We will help you identify key areas of impact, select measures, plan data collection, and analyze results, providing you with annual reports to guide decision-making. For more information on organization-wide implementation, contact us.
If you are looking to conduct academic research:
We regularly collaborate with academics and service providers to answer important, generalizable questions about Collaborative Problem Solving®. If you are a student, faculty, or service provider with a research idea, or with a desire to collaborate, email the research team.
If your organization is learning CPS but is not currently engaged with us in an organization-wide implementation plan, we recommend this resource for planning your evaluation of impact.
CPS is listed on the Blue Menu of Evidence-Based Psychosocial Interventions for Youth from the PracticeWise Evidence-Based Services Database, and on the California Evidence-Based Clearinghouse for Child Welfare.
Yes, this RCT was the first RCT on CPS. This study compared Collaborative Problem Solving to a common parenting approach called Parent Management Training (PMT). Children who learned CPS had significant improvements in many areas of functioning at the end of treatment and four months later. These improvements were equal to, or better than, the improvements for children who received PMT.
Research tells us that CPS benefits depend on who is being studied and in what context. Some benefits in school settings have included improved child behavior, reductions in teacher stress, and decreases in restrictive disciplinary practices. In clinical settings, some benefits have included reductions in restraint/seclusion and self-inflicted injuries, as well as improvements in children’s emotional distress. With families, some benefits have included improved parent-child relationships, reductions in parent stress, and improvements in children’s executive functioning skills. You can find more information on these and other published findings below.
Multiple studies on Collaborative Problem Solving have been done in schools. One study found an association between CPS and lower rates of restrictive discipline and teachers’ stress. Another found associations between CPS and improved student behavior, as well as improvements in thinking skills. A third study examined how teachers’ beliefs regarding students’ thinking skills may affect how they respond to classroom misbehavior.
Many studies on CPS have been conducted in clinical/mental health settings. This includes studies on the impact of CPS in outpatient therapy for Oppositional Defiant Disorder, ADHD, and a range of other related conditions; on restraints and seclusions in inpatient psychiatry and residential and day treatment programs; how CPS was used to eliminate points-and-levels in residential treatment; and studies on the implementation and evaluation of CPS in inpatient and residential programs.
There have been multiple studies on the reduction of restraint and/or seclusion in organizations that are using CPS. These studies have been conducted in inpatient units in the U.S. and New Zealand and residential and day treatment programs.
Yes. We have a paper on our Thinking Skills Inventory (TSI), a tool that evaluates strengths and struggles in five areas of thinking skills. The TSI is a valid and reliable way to identify variation in skill domains relevant to a range of psychological difficulties, which may be useful for treatment planning and making referrals for further evaluation.
There are three versions of the CPS-AIM: one for Parents, one for Educators, and one for Clinical Staff. Each CPS-AIM measures factors believed to be directly impacted by receiving CPS training, including adherence to the philosophy that ‘skill not will’ is the root of challenging behavior. Our research team has made this report available; it describes the psychometric properties of these measures, including reliability and validity.
Yes, for conducting research, we recommend this validated and published audio coding system, called the Collaborative Problem Solving Manualized Expert-Rated Integrity Coding System (CPS-MEtRICS). In service settings, we recommend using the shorter CPS-Practice Integrity Tool (CPS-PIF), which you can read about here.
Think:Kids follow the latest research in implementation science to help inform and direct our work implementing CPS in schools and a variety of other agencies. We recently published an article that describes how we use the Active Implementation Frameworks to help guide the implementation of CPS throughout an entire system.
Yes, you can find these in the “Research Tools” section at the bottom of this page. Once you have received training and coaching in CPS, you will receive additional materials and measures relevant to your setting.
Ashworth, K., Tapsak, S., & Li, S. T. (2012). Collaborative Problem Solving: Is empathy the active ingredient? Graduate Student Journal of Psychology, 14, 83-92.
Basso, R. V. J. & Graham, J. W. (2016). A longitudinal intervention study to reduce aggression by children ages 4-11. Journal of Behavior Therapy and Mental Health, 1(2):12-23.
Becker, K. D., Chorpita, B. F., & Daleiden, E. L. (2011). Improvement in symptoms versus functioning: How do our best treatments measure up? Administration and Policy in Mental Health and Mental Health Services Research, 38(6), 440-458.
Black, V., Bobier, C., Thomas, B., Prest, F., Ansley, C., Loomes, B., Eggleston, G., & Mountford, H. (2020). Reducing seclusion and restraint in a child and adolescent inpatient area: implementation of a collaborative problem-solving approach. Australasian Psychiatry, 1-7.
Bonnell, W., Alatishe, Y. A., & Hofner, A. (2014). The effects of a changing culture on a child and adolescent psychiatric inpatient unit. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 23(1), 65.
Epstein, T., & Saltzman-Benaiah, J. (2010). Parenting children with disruptive behaviors: Evaluation of a Collaborative Problem Solving pilot program. Journal of Clinical Psychology Practice, 1(1), 27-40.
Ercole‐Fricke, E., Fritz, P., Hill, L. E., & Snelders, J. (2016). Effects of a Collaborative Problem‐Solving approach on an inpatient adolescent psychiatric unit. Journal of Child and Adolescent Psychiatric Nursing, 29(3), 127-134.
Gathright, M. M., Holmes, K. J., Morris, E. M., & Gatlin, D. A. (2016). An innovative, interdisciplinary model of care for inpatient child psychiatry: An overview. The journal of behavioral health services & research, 43(4), 648-660.
Greene, R. W., Ablon, J. S., & Goring, J. C. (2003). A transactional model of oppositional behavior: Underpinnings of the Collaborative Problem Solving approach. Journal of Psychosomatic Research, 55(1), 67-75.
Greene, R. W., Ablon, J. S., Goring, J. C., Raezer-Blakely, L., Markey, J., Monuteaux, M. C., … & Rabbitt, S. (2004). Effectiveness of Collaborative Problem Solving in affectively dysregulated children with oppositional-defiant disorder: Initial findings. Journal of consulting and clinical psychology, 72(6), 1157.
Greene, R. W., Ablon, J. S., & Martin, A. (2006). Use of Collaborative Problem Solving to reduce seclusion and restraint in child and adolescent inpatient units. Psychiatric Services, 57(5), 610-612.
Hart, S. C., & DiPerna, J. C. (2017). Teacher beliefs and responses toward student misbehavior: Influence of cognitive skill deficits. Journal of applied school psychology, 33(1), 1-15.
Heath, G. H., Fife‐Schaw, C., Wang, L., Eddy, C. J., Hone, M. J., & Pollastri, A. R. (2020). Collaborative Problem Solving reduces children’s emotional and behavioral difficulties and parenting stress: Two key mechanisms. Journal of Clinical Psychology.
Holmes, K. J., Stokes, L. D., & Gathright, M. M. (2014). The use of Collaborative Problem Solving to address challenging behavior among hospitalized children with complex trauma: A case series. Residential Treatment for Children & Youth, 31(1), 41-62.
Johnson, M., Östlund, S., Fransson, G., Landgren, M., Nasic, S., Kadesjö, B., … & Fernell, E. (2012). Attention‐deficit/hyperactivity disorder with oppositional defiant disorder in Swedish children–an open study of Collaborative Problem Solving. Acta Paediatrica, 101(6), 624-630.
Kulkarni, G., Deshmukh, P., & Barzman, D. (2010). Collaborative Problem Solving (CPS) as a primary method of addressing acute pediatric pathological aggression along with other modalities. Psychiatric quarterly, 81(2), 167-175.
Martin, A., Krieg, H., Esposito, F., Stubbe, D., & Cardona, L. (2008). Reduction of restraint and seclusion through Collaborative Problem Solving: A five-year prospective inpatient study. Psychiatric Services, 59(12), 1406-1412.
Mohr, W. K., Martin, A., Olson, J. N., Pumariega, A. J., & Branca, N. (2009). Beyond point and level systems: Moving toward child‐centered programming. American Journal of Orthopsychiatry, 79(1), 8-18.
Open Arms Program of the Cambridge Hospital Child Assessment Unit, Cambridge, Massachusetts. (2003). 2003 APA Gold Award: A more compassionate model for treating children with severe mental disturbances. Psychiatric Services, 54(11), 1529-1531.
Pollastri, A. R., Epstein, L. D., Heath, G. H., & Ablon, J. S. (2013). The Collaborative Problem Solving approach: Outcomes across settings. Harvard Review of Psychiatry, 21(4), 188-199.
Pollastri, A. R., Lieberman, R. E., Boldt, S. L., & Ablon, J. S. (2016). Minimizing seclusion and restraint in youth residential and day treatment through site-wide implementation of Collaborative Problem Solving. Residential Treatment for Children & Youth, 33(3-4), 186-205.
Pollastri, A. R., Rosenbaum, C., & Ablon, J. S. (2019). Disruptive Behavior Disorders. In The Massachusetts General Hospital Guide to Learning Disabilities (pp. 207-220). Humana Press, Cham.
Pollastri, A.R., Wang, L., Eddy C.J., Ablon, J. S. An open trial of Collaborative Problem Solving in a naturalistic outpatient setting. Clinical Child Psychology and Psychiatry 2022; 28(2): 512-524.
Pollastri, A. R., Wang, L., Raftery-Helmer, J. N., Hurley, S., Eddy, C. J., Sisson, J., Thompson, N., & Ablon, J. S. (2022). Development and evaluation of an audio coding system for assessing providers’ integrity to Collaborative Problem Solving in youth-service settings. Professional Psychology: Research and Practice, online first.
Pollastri, A. R., Wang, L., Youn, S. J., Ablon, J. S., & Marques, L. (2020). The value of implementation frameworks: Using the active implementation frameworks to guide system‐wide implementation of Collaborative Problem Solving. Journal of Community Psychology.
Regan, K. M., Curtin, C., & Vorderer, L. (2006). Paradigm shifts in inpatient psychiatric care of children: approaching child‐and family‐centered care. Journal of Child and Adolescent Psychiatric Nursing, 19(1), 29-40.
Schaubman, A., Stetson, E., & Plog, A. (2011). Reducing teacher stress by implementing Collaborative Problem Solving in a school setting. School Social Work Journal, 35(2), 72-93.
Stetson, E. A., & Plog, A. E. (2016). Collaborative Problem Solving in schools: Results of a year-long consultation project. School Social Work Journal, 40(2), 17-36.
Stewart, S. L., Rick, J., Currie, M., & Rielly, N. (2009). Collaborative Problem Solving approach in clinically referred children: A residential program evaluation. Unpublished manuscript, Department of Applied Research and Education Child and Parent Resource Institute, London, Ontario, Canada.
Stoll, S. J., Hartman, J. D., Paxton, D., Wang, L., Ablon, J. S., Perry, B. D., & Pollastri, A. R. (2023). De-Implementing a Point and Level System in Youth Residential Care without Increased Safety Risk: A Case Study. Residential Treatment for Children & Youth. Online first.
Valenkamp, M., Delaney, K., & Verheij, F. (2014). Reducing seclusion and restraint during child and adolescent inpatient treatment: Still an underdeveloped area of research. Journal of Child and Adolescent Psychiatric Nursing, 27(4), 169-174.
Wang, L., & Pollastri, A. R. (2019). User’s Guide to the Collaborative Problem Solving Adherence & Impact Measures (CPS-AIMs). Think:Kids, Massachusetts General Hospital, Harvard Medical School.
Wang, L., Pollastri, A. R., Vuijk, P. J., Hill, E. N., Lee, B. A., Samkavitz, A., … & Doyle, A. E. (2019). Reliability and Validity of the Thinking Skills Inventory, a Screening Tool for Cross-Diagnostic Skill Deficits Underlying Youth Behavioral Challenges. Journal of Psychopathology and Behavioral Assessment, 41(1), 144-159.
Wang, L., Stoll, S. J., Eddy, C. J., Hurley, S., Sisson, J., Thompson, N., Raftery-Helmer, J. N., Ablon, J. S., Pollastri, A. R. (2023). Pragmatic fidelity measurement in youth service settings. Implementation Research and Practice, 4, 1-13.
Wang, L., Stoll, S., Hone, M., Ablon, J. S., & Pollastri, A. R. (2022). Effects of a Collaborative Problem Solving parent group on parent and child outcomes. Child & Family Behavior Therapy, 44(4), 241-258.
