Table 2. Description of PSST treatment goals and content by session.

Session	Goals and Content
1	The primary goal of the first session is to establish a positive therapeutic relationship through demonstrating understanding of the child’s pain problem and impact on parent and family. A secondary goal is to present PSST rationale and overall treatment program goals. -Therapist obtains story of child’s pain, and focuses on establishing rapport -Therapist provides general explanation of the goals of the training, the problem solving model of stress, and the structure of the treatment program and ground rules
2	The primary goal of the second session is to provide a core introduction to the problem-solving process for the caregiver to acquire instruction in learned optimism and problem orientation. -Therapist provides instruction in how to identify connections between automatic thoughts and feelings, and how to generate and use positive self statements
3	By the end of the third training session, a complete introduction is made to all of the problem-solving steps. The primary goal is for the caregiver to acquire instruction in Identifying Problems, Defining Options, Evaluating Options, and Act. -Therapist collaborates with caregivers to identify problems to solve, and to break up complex problems into manageable parts -Therapist introduces each problem solving step by working through a problem identified by caregiver
4 - 6	The goal of these treatment sessions is to describe solution verification and continue to practice the problem solving steps working through the same problem or new problems -Therapist reviews solution verification and discusses caregiver’s level of satisfaction with the solution -Therapist helps caregiver to select alternative solution if caregiver not satisfied with outcome or to identify new problem to be worked on if satisfied with first outcome
6 - 8	The goals for these sessions are to discuss progress and plan for therapy termination and to review skill maintenance and relapse prevention strategies. -Therapist emphasizes using emotional distress as a cue for initiating problem solving strategies in the future. -Therapist emphasizes the importance of skilled persistence and self-efficacy for solving problems on own.