5 - Collaborative Problem Solving
1. Introduction
People experiencing mental health difficulties often face practical problems alongside their emotional symptoms. These may include difficulties with daily routines, relationships, housing, education, employment, finances, medication, physical health or accessing services. Sometimes the problem itself contributes to distress. At other times, low mood, anxiety, emotional dysregulation or executive functioning difficulties make an ordinary problem feel impossible to manage.
Collaborative problem solving is a structured way of helping someone understand a difficulty, identify possible responses and choose a manageable next step. The word collaborative is important. The practitioner does not take control, impose a solution or assume that they know what is best. Instead, the practitioner works alongside the person, combining professional knowledge with the person’s understanding of their own circumstances, priorities and needs.
This approach fits naturally with psychologically informed care. It promotes autonomy, hope and self-efficacy while providing enough structure to prevent the conversation from becoming overwhelming. It can be used during routine appointments, reviews, goal-setting work and periods when progress has stalled.
Collaborative problem solving is not the same as solving every difficulty for the person. The purpose is to help them develop confidence and practical skills while recognising when a problem requires advocacy, safeguarding action or escalation to a senior clinician.
2. Learning Outcomes
By the end of this lesson, learners should be able to:
Explain the principles of collaborative problem solving.
Distinguish between a problem, an emotional response and an immediate risk.
Define a problem in specific, neutral and manageable terms.
Help a person generate and evaluate possible solutions without taking over.
Agree a realistic action plan and review its effectiveness.
Recognise when barriers, risks or unmet needs require escalation to a senior clinician.
3. The Lecture
What Is Collaborative Problem Solving?
Collaborative problem solving is a structured conversation in which the practitioner and the person work together to address a clearly defined difficulty.
A useful sequence is:
Listen → Define → Explore → Choose → Plan → Review
The practitioner provides curiosity, structure and support. The person contributes their experiences, preferences, strengths and understanding of what is likely to work in their life.
This approach rests on several principles:
The person should be actively involved in decisions affecting them.
Behaviour usually makes more sense when understood in context.
Difficulties should be explored before solutions are proposed.
There is rarely only one possible solution.
Small, achievable changes are often more helpful than ambitious plans.
A plan should be reviewed rather than treated as a test of success or failure.
Some problems cannot be resolved solely through individual effort and may require changes from families, services, schools, employers or other systems.
Collaborative problem solving is therefore both practical and relational. The quality of the collaboration matters just as much as the action plan produced.
Why Problem Solving Can Become Difficult
When someone feels calm and supported, they may be able to consider different options and anticipate consequences. During distress, this ability may reduce significantly.
Anxiety may cause the person to focus on danger or uncertainty. Low mood may make every option appear pointless. Emotional dysregulation may create pressure for an immediate response. ADHD-related executive functioning differences may make it difficult to organise, prioritise or begin a task. Autistic people may find an uncertain or poorly defined problem especially difficult to navigate. Trauma may lead someone to perceive offers of help as controlling, unsafe or critical.
Practical disadvantages can also restrict the available options. A person cannot simply think their way out of poverty, discrimination, unsafe housing or inadequate service provision. Good problem solving must therefore remain grounded in the person’s actual circumstances.
When a person seems unable to generate solutions, practitioners should avoid assuming that they are unmotivated. They may be overwhelmed, exhausted, frightened, unsure what is expected or facing barriers that have not yet been understood.
Begin by Listening
The first task is not to solve the problem. It is to understand the person’s experience of it.
Allow them to describe what has been happening and how it has affected them. Listen for the facts, emotions, meanings and practical consequences. Reflect back what you have heard and check that your understanding is accurate.
Helpful questions include:
“What has been happening?”
“Which part of this is most difficult for you?”
“What usually happens just before the problem occurs?”
“What have you already tried?”
“What would you most like to be different?”
“Is there anything that makes the situation easier or worse?”
“Would it be helpful for us to think through some options together?”
Validation is important at this stage. A person is more likely to engage in problem solving when they feel understood.
Validation does not mean agreeing with every interpretation or action. It means recognising that the person’s feelings and responses make sense in the context of their experience.
For example:
“It sounds as though you have been trying to manage several demands at once, and it has started to feel overwhelming.”
This is likely to be more helpful than immediately saying:
“You need to make a timetable.”
The timetable may eventually be useful, but proposing it too early can leave the person feeling unheard.
Check Whether This Is the Right Time to Problem-Solve
Not every moment is suitable for problem solving. If someone is extremely distressed, agitated, intoxicated, dissociated or unable to engage, they may first need support to feel safer and more regulated.
You might say:
“I can see that this feels very intense at the moment. Would it help if we slowed things down before deciding what to do next?”
Immediate risks must also be considered before beginning routine problem-solving work. If there are concerns about suicide, self-harm, harm to others, abuse, neglect, exploitation, acute psychosis, mania or serious physical illness, follow the appropriate risk, safeguarding or emergency procedure.
Collaborative practice remains important during risk assessment, but risk should not be reduced to an ordinary problem-solving exercise. The practitioner must follow their professional responsibilities and escalate concerns.
Define the Problem Clearly
People often begin with a broad statement such as:
“Everything is going wrong.”
“School is impossible.”
“Nobody listens to me.”
“I cannot cope.”
“My routine is a mess.”
“My family is the problem.”
These statements communicate genuine distress, but they are too broad to guide an action plan. The practitioner’s role is to help turn the concern into a specific and manageable description without dismissing the wider experience.
A well-defined problem describes:
What is happening.
When and where it happens.
Who is involved.
How often it occurs.
What impact it has.
What the person would like to change.
For example, “I cannot cope with college” might become:
“On most mornings, I feel overwhelmed when I think about travelling to college and arriving in a busy classroom. I have missed three mornings this week and am worried that I will fall behind.”
This clearer description identifies several possible areas to explore, including the journey, the classroom environment, morning anxiety, attendance expectations and catching up with work.
Separate Problems, Feelings and Risks
A useful skill is distinguishing between the practical problem, the emotional response and any associated risk.
For example:
“I have received a letter about unpaid rent” is the practical problem.
“I feel ashamed and frightened” is the emotional response.
“I am thinking about ending my life because I cannot see a way out” is an immediate safety concern.
All three require attention, but they require different responses. Emotional support alone will not resolve the rent issue. Practical advice alone will not adequately address suicidal thoughts.
The practitioner should acknowledge the emotion, identify the practical problem and assess or escalate risk appropriately.
Decide What Is Within the Person’s Influence
Some difficulties can be changed directly. Others can be influenced but not fully controlled. Some may currently be outside the person’s control.
Helping someone distinguish between these can reduce frustration and self-blame.
For example, a person cannot control whether an employer offers them a job. They may, however, be able to update their application, request interview support or apply for additional roles.
Similarly, a young person may not be able to change a school policy themselves, but they may be able to describe the difficulty, involve a trusted adult and request reasonable adjustments.
This stage should not become an exercise in telling the person to accept unfair circumstances. Where appropriate, the practitioner may need to support advocacy, involve other services or escalate systemic barriers.
Agree a Specific Goal
Once the problem has been defined, ask what the person would like to be different.
A useful goal should be:
Personally meaningful.
Specific enough to guide action.
Realistic in the current circumstances.
Small enough to begin.
Capable of being reviewed.
Instead of “sort out my sleep”, the first goal might be:
“For the next week, I will aim to get out of bed by 10.00 am on four mornings.”
Instead of “go back to school normally”, the initial goal might be:
“Attend the first lesson on Tuesday with support from the pastoral lead.”
The person should have genuine influence over the goal. A plan is unlikely to work when it reflects only what the practitioner, parent, school or service wants.
Generate Possible Solutions
The next stage is to generate several possible responses. Initially, encourage ideas without evaluating them too quickly. Premature criticism can stop the person from contributing and may reinforce the belief that nothing will work.
Questions may include:
“What are all the possible ways of approaching this?”
“What has helped, even slightly, in the past?”
“What might make the first step easier?”
“Who could support you?”
“What would you suggest to someone else in the same situation?”
“Would you like me to offer a few ideas as well?”
The practitioner can contribute suggestions, but should ask permission before doing so. This preserves collaboration and reduces the risk of taking over.
For example:
“You have identified speaking with your tutor and changing your morning routine. Would it be helpful if I suggested another possibility?”
Creativity can be useful at this stage. A possible solution does not need to be perfect before it is considered.
Build on Strengths and Previous Successes
Problem-solving conversations can become dominated by what is not working. This may unintentionally reinforce helplessness.
Ask about previous successes, existing skills and supportive relationships:
“Have you managed anything similar before?”
“What was different on the days when it went slightly better?”
“Who understands this difficulty well?”
“What personal strengths could help here?”
“What support is already available?”
Strengths may include persistence, humour, creativity, insight, practical knowledge, supportive relatives, good relationships with professionals or the ability to ask for help.
The purpose is not to force positivity. It is to ensure that the plan reflects the person’s capabilities and available resources.
Evaluate the Options Together
Once several possibilities have been identified, help the person consider each one.
Useful considerations include:
How likely is this to help?
What are the possible benefits?
What difficulties might arise?
Is it safe?
Is it affordable and accessible?
Does it depend on another person?
Does it fit with the person’s values and preferences?
What support would be needed?
Could it be tried on a small scale?
The practitioner should provide relevant information where this falls within their role. However, they should be transparent when they do not know something or when specialist advice is required.
Avoid directing the person towards the option that appears easiest for the service. The preferred option should be clinically appropriate and workable in the person’s real life.
Choose a Manageable First Step
Large problems often become more manageable when converted into a small first action.
For example, “deal with my debt” may become:
“Put all unopened letters in one place this evening.”
The next step might be:
“Telephone the debt advice service with support on Thursday morning.”
A good first step should be clear enough that both people understand exactly what will happen.
Clarify:
What will be done?
Who will do it?
When will it happen?
Where will it happen?
What support is needed?
What might get in the way?
What is the alternative if the original plan cannot happen?
This is sometimes described as making the plan specific and achievable. In practice, the most important question is:
“Can the person realistically do this in their current circumstances?”
Anticipate Barriers
A plan can appear straightforward during an appointment but become difficult once the person returns to everyday life.
Explore likely barriers without sounding pessimistic:
“What might make this difficult?”
“What tends to get in the way?”
“What could help if your motivation is low?”
“How will you remember?”
“What could you do if the other person does not respond?”
“Would breaking this into a smaller step help?”
For someone with executive functioning difficulties, verbal agreement may not be enough. They may benefit from a written plan, reminder, checklist, calendar entry, visual prompt or support from another person.
For someone who becomes anxious during telephone calls, the plan might include writing down what they want to say, practising the call or asking an appropriate supporter to be present.
Anticipating barriers is not the same as expecting failure. It makes the plan more realistic.
Record the Plan
A short written summary can help the person remember what was agreed. It also supports continuity between practitioners.
The record should include:
The problem identified.
The person’s preferred goal.
The options considered.
The agreed action.
Who is responsible for each action.
Any risks or barriers identified.
When progress will be reviewed.
Any concerns escalated to a senior clinician.
Documentation should be factual and respectful. Avoid language suggesting that the person is “non-compliant” simply because a plan was not completed. Record what happened and explore the reasons.
Review What Happened
Collaborative problem solving is a cycle rather than a one-off event. At the next contact, review the plan with curiosity.
Ask:
“What happened when you tried the plan?”
“Which part helped?”
“What made it difficult?”
“Did anything unexpected happen?”
“What have we learned?”
“Should we continue, adapt or choose another option?”
If the plan did not work, this does not necessarily mean that the person failed. The plan may have been too large, poorly timed, based on an incorrect understanding or dependent on support that was not available.
A helpful response might be:
“It sounds as though the first step was still too difficult while your anxiety was so high. Let us think about how we can make it smaller or add more support.”
This approach preserves hope and encourages learning.
Collaborative Problem Solving with Children and Young People
Children and young people should be involved in decisions in a way that reflects their age, communication style, developmental level and individual needs.
Adults may be tempted to define the problem without first hearing the young person’s perspective. For example, a parent may identify “refusing school” as the problem, while the young person identifies sensory overload, bullying or fear of being asked to speak in class.
Both perspectives may contain important information.
Helpful approaches include:
Using clear, concrete language.
Discussing one problem at a time.
Offering extra processing time.
Using written choices if verbal discussion is difficult.
Checking what the young person wants adults to understand.
Identifying what is negotiable and what is not.
Avoiding blame-based language.
Involving parents or carers appropriately while maintaining the young person’s voice.
Where adults retain responsibility for safety or care, collaboration does not mean that the young person carries responsibility alone. Adults may need to make or support changes within the environment.
Working with Families and Carers
Different family members may define the same problem differently. One person may prioritise school attendance, another may prioritise reduced distress, and another may want fewer arguments at home.
The practitioner can help each person describe their concerns without immediately deciding who is correct.
Useful questions include:
“How does each person understand the difficulty?”
“What does everyone agree on?”
“What would a small improvement look like?”
“What could each person do differently?”
“How can the plan avoid placing all responsibility on one family member?”
Avoid positioning the child, young person or identified patient as the sole source of the problem. Consider communication patterns, expectations, unmet needs and environmental pressures.
If family discussions become highly conflictual, coercive or unsafe, seek support from a senior clinician rather than attempting to mediate beyond your competence.
Neuroaffirmative Problem Solving
Neuroaffirmative practice recognises neurological differences without assuming that the person must become more typical in order to succeed.
For an autistic person, the aim may be to reduce unnecessary sensory demands or increase predictability rather than expecting them simply to tolerate distress.
For someone with ADHD, the plan may include external reminders, body doubling, shorter tasks, movement breaks or environmental changes rather than relying on willpower.
Ask:
“What would make this task work better for your brain?”
“Is there a sensory, communication or organisational barrier?”
“Would written information be easier than verbal instructions?”
“Would you prefer time to consider the options before deciding?”
“Does the environment need to change?”
The goal is not to remove all challenge. It is to find fair and workable strategies that respect the person’s needs.
When the Person Does Not Want to Problem-Solve
A person may not be ready to look for solutions. They may want to be heard, feel uncertain about change or have experienced repeated unsuccessful interventions.
Do not force the process. Explore what they need from the conversation:
“Would you prefer me to listen for now, or would it be helpful to think about possible next steps?”
If they do not want to make a plan, clarify any safety concerns and leave the door open for future discussion.
Repeatedly pushing solutions can damage the therapeutic relationship. Sometimes the most useful intervention is to listen, validate and help the person feel less alone.
The Limits of the Case Worker’s Role
Case workers can support people to understand problems, organise options, make practical plans and access appropriate resources. They should not independently provide specialist legal, financial or medical advice unless qualified and authorised to do so.
A case worker should seek senior advice or escalate when:
There is an immediate or increasing risk of harm.
Safeguarding concerns are identified.
The person’s mental state is deteriorating.
There are possible symptoms of psychosis or mania.
The problem involves medication or treatment decisions.
The person requires diagnostic or specialist clinical assessment.
There is serious family conflict or possible coercion.
The proposed plan could create significant risk.
The practitioner is being asked to work outside their competence.
Repeated plans are failing and the clinical formulation may need to be reviewed.
Collaborative problem solving supports clinical care, but it does not replace assessment, formulation, safeguarding procedures or senior clinical decision-making.
Clinical Example
A young adult with depression states that their flat is “completely out of control”. They feel ashamed and have stopped inviting support workers inside. They agree that the immediate problem is a large accumulation of washing and rubbish in the living room.
The case worker initially asks what would feel most useful. The person says that being told to clean the entire flat would feel impossible, but they would like to make the sofa usable.
Together, they consider several options: cleaning the whole room, asking a relative to help, completing ten minutes of tidying each day or beginning with the rubbish around the sofa. The person chooses to fill one rubbish bag that afternoon while listening to a podcast. They set a telephone reminder and agree to message their support worker once it is done.
At the next appointment, the person reports that they filled half a bag and then became tired. The case worker recognises this as useful progress rather than failure. They review what helped and agree to repeat the same task twice during the following week.
The intervention is modest, but it reduces avoidance, increases the person’s sense of control and creates evidence that change is possible.
4. Clinical Perspective
Clinical Pearls
Understanding comes before planning. If the person does not feel understood, even a sensible solution may be rejected.
Define one problem at a time. Broad difficulties become easier to approach when translated into a specific situation.
Ask permission before offering advice. This simple step protects the collaborative nature of the conversation.
Start smaller than you think necessary. A small completed action is usually more valuable than an ambitious plan that cannot be started.
Treat unsuccessful plans as information. Review the barriers rather than blaming the person.
Consider the environment. The solution may involve changing demands, support or surroundings rather than changing the person.
Write plans down. Clear written actions can be particularly helpful when anxiety, low mood or executive functioning difficulties affect memory and organisation.
Practical Tips for Everyday Practice
Use the person’s own words when defining the problem and goal. Check whether your summary feels accurate to them.
Keep the conversation focused, but do not rush. If several problems are raised, acknowledge them and agree which one to explore first.
When the person repeatedly says, “I don’t know”, offer structure rather than pressure. You could provide two or three broad options and invite them to add, reject or adapt these.
End by asking the person to explain the plan back in their own words. This can reveal misunderstandings without making the interaction feel like a test.
Arrange a realistic point for review. Plans are more likely to be attempted when the person knows that progress, barriers and support will be discussed again.
Common Pitfalls and Misconceptions
Moving to solutions too quickly
The practitioner may identify a practical answer before fully understanding the difficulty. This can make the person feel dismissed and may result in a plan that does not address the real problem.
Taking over
Completing every task for the person may provide short-term relief but reduce confidence and increase dependence. Support should be proportionate to the person’s needs and circumstances.
Giving too many suggestions
A long list of options can overwhelm someone who is already struggling. Generate possibilities, then narrow them down together.
Assuming that lack of action means lack of motivation
The person may have encountered fear, fatigue, executive functioning difficulties, practical barriers or an unclear plan. Explore before drawing conclusions.
Focusing only on the individual
Some problems arise from inaccessible services, unreasonable demands, discrimination or a lack of resources. Individual coping strategies should not replace appropriate advocacy or systemic change.
Treating risk as an ordinary practical problem
Serious risk, abuse, exploitation or acute deterioration requires appropriate assessment and escalation.
Advice for Newly Qualified Practitioners
You do not need to have an immediate answer. A calm, curious conversation can be more valuable than a rapid solution.
Be honest about the limits of your knowledge and role. It is appropriate to say:
“I am not able to advise on that independently, but I can discuss it with the senior clinician.”
Pay attention to your own urge to rescue, persuade or fix. This often arises from concern, but it can unintentionally reduce the person’s involvement.
Remember that collaboration does not mean agreeing to unsafe or clinically inappropriate requests. You can remain respectful and transparent while following professional responsibilities.
Situations Requiring Escalation
Seek advice from a senior clinician when:
The person expresses suicidal thoughts, self-harm intentions or thoughts of harming someone else.
There is evidence of abuse, neglect, exploitation or another safeguarding concern.
The person’s functioning or mental state is deteriorating significantly.
There are concerns about psychosis, mania, severe depression or substance-related risk.
The issue involves starting, stopping or changing medication.
The person cannot meet essential needs such as food, shelter, hydration or urgent healthcare.
The plan involves significant clinical, legal, financial or interpersonal risk.
Family disagreement prevents a safe plan from being developed.
You are uncertain whether the proposed action is appropriate.
The difficulty persists despite repeated problem-solving attempts and requires further assessment or reformulation.
5. Summary
Collaborative problem solving is a structured and respectful way of helping someone address a difficulty without taking control away from them.
The process can be remembered as:
Listen → Define → Explore → Choose → Plan → Review
Effective problem solving begins with understanding and validation. The practitioner then helps the person define one specific problem, agree a meaningful goal, generate possible solutions and select a manageable first step.
Plans should reflect the person’s strengths, preferences, neurodevelopmental profile, available support and real-life circumstances. Barriers should be anticipated, actions should be clearly recorded and progress should be reviewed with curiosity.
An unsuccessful plan is not proof that the person has failed. It provides information that can be used to adjust the next step.
Case workers must remain within their competence and escalate concerns relating to risk, safeguarding, acute deterioration, medication or complex clinical decision-making.
6. Further Reading
National Institute for Health and Care Excellence. Depression in adults: treatment and management (NG222).
National Institute for Health and Care Excellence. Shared decision making (NG197).
National Institute for Health and Care Excellence. Patient experience in adult NHS services: improving the experience of care for people using adult NHS services (CG138).
National Institute for Health and Care Excellence. Service user experience in adult mental health: improving the experience of care for people using adult NHS mental health services (CG136).
D’Zurilla, T. J. and Nezu, A. M. Problem-Solving Therapy: A Positive Approach to Clinical Intervention.
Greenberger, D. and Padesky, C. A. Mind Over Mood: Change How You Feel by Changing the Way You Think.
NHS. Every Mind Matters: practical guidance on managing worries, low mood and everyday difficulties.
Centre for Clinical Interventions. Problem Solving Workbook and Worksheets.
The Challenging Behaviour Foundation. Resources on person-centred approaches and understanding behaviour.
National Autistic Society. Guidance on communication, sensory needs and reasonable adjustments.
7. Knowledge Check
Question 1
What is the main purpose of collaborative problem solving?
A. To give the person the solution most likely to work
B. To help the person understand a problem and participate in choosing a manageable response
C. To persuade the person to follow professional advice
D. To transfer responsibility for the problem entirely to the person
Correct answer: B
Explanation: Collaborative problem solving brings together the practitioner’s support and the person’s knowledge of their own life. The person participates actively in understanding the difficulty and selecting the next step.
A is incorrect because directly giving a solution can reduce autonomy and may overlook important information. C is incorrect because collaboration is not simply a technique for obtaining agreement. D is incorrect because the practitioner continues to provide appropriate support and retains professional responsibilities.
Question 2
A person begins an appointment by saying, “Everything in my life is a disaster.” What is the most helpful initial response?
A. Tell them to make a daily timetable
B. Explain that everyone experiences difficulties
C. Explore what has been happening and identify which issue feels most important
D. Ask them to list ten possible solutions immediately
Correct answer: C
Explanation: The practitioner should first understand the person’s experience and help define a specific problem.
A moves to a solution before the problem has been understood. B may feel dismissive and minimises the person’s distress. D introduces a demanding task too early and may increase feelings of being overwhelmed.
Question 3
Which is the clearest definition of a problem?
A. “I am useless at managing things.”
B. “Nobody ever helps me.”
C. “I have not opened three letters about my rent because I become anxious when I see them.”
D. “My life needs to improve.”
Correct answer: C
Explanation: C identifies a specific behaviour, context and emotional barrier. This makes it possible to consider a manageable next step.
A is a negative judgement about the self rather than a problem definition. B is broad and absolute. D describes a general wish but does not identify what needs to change.
Question 4
During a discussion about debt, a person says that they intend to end their life that evening. What should the case worker do?
A. Continue generating solutions to the financial problem
B. Ask the person to promise not to harm themselves
C. Follow the risk procedure and escalate the concern immediately
D. Arrange to discuss the issue at the next routine appointment
Correct answer: C
Explanation: An expressed intention to end one’s life requires immediate risk assessment and escalation in accordance with organisational procedures.
A fails to prioritise immediate safety. B is not an adequate risk-management intervention. D creates an unsafe delay.
Question 5
Why should practitioners initially avoid criticising possible solutions as they are generated?
A. Every proposed solution must eventually be attempted
B. Evaluation is outside the practitioner’s role
C. Early criticism can restrict creativity and discourage the person from contributing
D. All solutions are equally safe and effective
Correct answer: C
Explanation: Generating and evaluating options are usually more effective when treated as separate stages. This allows ideas to emerge before their practicality is considered.
A is incorrect because only selected options need to be tried. B is incorrect because the practitioner should help evaluate safety and feasibility. D is incorrect because options differ significantly in their risks and likely effectiveness.
Question 6
A person agrees to “sort out the entire house this weekend” but has severe depression and very little energy. What would be the best response?
A. Praise the ambition and end the discussion
B. Suggest breaking the goal into a much smaller first step
C. Tell the person that they are unlikely to succeed
D. Complete the housework for them
Correct answer: B
Explanation: A smaller task, such as clearing one surface or filling one rubbish bag, is more likely to be achievable and can build momentum.
A does not test whether the plan is realistic. C is discouraging and does not support problem solving. D may not be appropriate or sustainable and could reduce the person’s involvement.
Question 7
A person did not complete an agreed telephone call. What is the most collaborative response?
A. “Why did you refuse to follow the plan?”
B. “You clearly were not motivated enough.”
C. “Let us look at what happened and what made the call difficult.”
D. “I will make every future call for you.”
Correct answer: C
Explanation: This response approaches the outcome with curiosity and treats the difficulty as information that can improve the next plan.
A and B introduce blame and make assumptions about motivation. D takes over without first understanding the barrier or considering the person’s preferences and capabilities.
Question 8
Which plan is most consistent with neuroaffirmative practice?
A. Asking an autistic person to tolerate a distressing sensory environment without adjustments
B. Telling a person with ADHD to use more willpower
C. Exploring environmental changes, reminders and practical support that fit the person’s needs
D. Requiring everyone to use the same organisational strategy
Correct answer: C
Explanation: Neuroaffirmative problem solving recognises individual needs and considers adjustments to tasks, communication and environments.
A may unnecessarily increase distress. B misrepresents executive functioning difficulties as a lack of effort. D ignores differences in how people process information and organise tasks.
Question 9
Which action best maintains collaboration when the practitioner has an idea to suggest?
A. Present the idea as the only sensible solution
B. Ask whether the person would like to hear an additional suggestion
C. Add the idea to the plan without discussing it
D. Ask a family member to enforce the idea
Correct answer: B
Explanation: Asking permission respects the person’s autonomy while allowing the practitioner to contribute useful knowledge.
A narrows choice and may feel controlling. C excludes the person from the decision. D is coercive and may create conflict unless family involvement has been appropriately agreed.
Question 10
When should collaborative problem solving be reviewed?
A. Only when the plan has failed
B. Only at the end of treatment
C. After an agreed period, whether or not the plan was completed
D. It does not require review once the person has agreed to it
Correct answer: C
Explanation: Review allows the practitioner and the person to identify progress, barriers and new information. They can then continue, adapt or replace the plan.
A overlooks the value of understanding successful plans. B delays learning and adjustment. D assumes that agreement guarantees that a plan will be practical or effective.
