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Social Problem Solving Therapy. Aim of the day.

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Aim of the day
Aim of the day

  • To produce an action plan aimed at consolidating social problem solving therapy as one of the Trust’s core therapies, with the view to achieving a sound base of practical skills that will permit research into the effectiveness of social problem solving therapy

  • Principles relate to other therapies, not only social problem solving therapy


Programme
Programme

Social problem solving – Past, present and future

Professor Mary McMurran

Division of Psychiatry, University of Nottingham

New roles and new ways of working in mental health: The challenge for education

Professor Ian Baguley

Director, Centre for Clinical and Academic Workforce Innovation, University of Lincoln

To accredit or not to accredit?  That is the question

Mr Lawrence Whyte

Workforce Development Dept, Nottinghamshire Healthcare NHS Trust

Supporting applied clinical research in NHS therapies: Towards practice based evidence

Professor Chris Evans

Research Programmes Director, Nottinghamshire Healthcare NHS Trust

Looking backwards in order to move forwards

Professor Conor Duggan

Chair of the Personality Disorder Institute, Division of Psychiatry & Nottinghamshire Healthcare NHS Trust


Social problem solving past present and future

Social problem solving:Past, present and future

Mary McMurran

University of Nottingham


Developments of social problem solving theory and therapy in East Midlands since mid 1990s

A collaboration between Nottinghamshire Healthcare NHS Trust and University of Nottingham

How research and practice need to develop in partnership

Plan


Esrc research seminar group
ESRC Research Seminar Group East Midlands since mid 1990s

  • Seminar Groups

    • multi-institutional

    • academic researchers

    • postgraduate students

    • non-academic users

  • Meet regularly to exchange information and ideas with the aim of advancing research within their fields


Social problem solving and personality disorder
Social problem solving and personality disorder East Midlands since mid 1990s

  • 2004 -2006

  • Award = £11,974

    • Meeting costs

    • Speakers’ costs

    • Organisers’ costs

  • Events

    • Research meetings

    • Conference

    • Training event

    • Today’s event


Seminar groups
Seminar Groups East Midlands since mid 1990s

  • Academics

    • Psychology, Psychiatry, Sociology

    • Cardiff University, University of Nottingham, University of Wales Institute Cardiff, University of Sheffield, University of Liverpool, Drexel University Philadelphia

  • Practitioners

    • Psychologists, Psychiatrists, Nurses, OTs, Social Workers, Probation Officers

    • Public and Private Sectors

    • Leicestershire, Lincolnshire, Nottinghamshire

  • Qualified, trainees, post-graduates

  • Service User


  • Past to present
    Past to Present East Midlands since mid 1990s

    • Seminars built on a body of local knowledge and experience

    • Maintained and developed an interest in the area

    • What was that body of local knowledge?

    • What is social problem solving therapy?


    Social problem solving
    Social problem solving East Midlands since mid 1990s

    • The self-directed cognitive-behavioural process by which a person attempts to identify or discover effective or adaptive solutions for specific problems encountered in everyday living

      D’Zurilla & Nezu


    Social problem solving1
    Social problem solving East Midlands since mid 1990s

    • The self-directed cognitive-behavioural-affective processes by which a person attempts to identify or discover effective or adaptive solutions for specific problems encountered in everyday living

      D’Zurilla & Nezu & McMurran


    Social problem solving skills
    Social problem solving skills East Midlands since mid 1990s

    • Ability to recognise emotional cues

    • Identify and define a problem

    • Specify goal for change

    • Generate options to attain goal

    • Consequential thinking

    • Selection of effective strategies

    • Means-end action planning


    Social problem solving and social adjustment
    Social problem solving and social adjustment East Midlands since mid 1990s

    • Social problem solving deficits evident in

      • Aggressive children

      • Suicidal prisoners

      • Depressed people

      • Personality disordered offenders

      • Child sex offenders

    • Social problem solving therapy reduces problems in these groups


    Social problem solving therapy1
    Social problem solving therapy East Midlands since mid 1990s

    • Teach skills of social problem solving

      • Problem recognition

      • Problem definition

      • Goal setting

      • Option generation

      • Consequential thinking

      • Means-end action planning

      • Solution implementation

      • Outcome evaluation


    Arnold lodge 1995 1999
    Arnold Lodge, 1995 - 1999 East Midlands since mid 1990s


    Pilot study
    Pilot study East Midlands since mid 1990s

    • Trainee psychologist looking for experience in delivering therapies

    • Small scale social problem solving intervention

    • Detained mentally disordered offenders

      • 6 mentally ill + 3 personality disordered

    • Showed pre- to post-intervention improvements on the Social Problem Solving Inventory – Revised (SPSI-R)


    Pilot study1
    Pilot study East Midlands since mid 1990s

    • SPSI-R

      • Positive Problem Orientation (PPO)

      • Negative Problem Orientation (NPO)

      • Rational Problem Solving (RPO)

      • Impulsive/careless style (ICS)

      • Avoidant style (AS)

      • Social problem solving index (SPS)


    Developments
    Developments East Midlands since mid 1990s

    • Began to use SPSI-R as part of general assessment of Arnold Lodge patients – database on MDOs

    • Personality Disorder Unit (PDU) opened and adopted Social Problem Solving Therapy, Stop & Think!, as a core part of treatment


    Arnold lodge cardiff university 2000 2005
    Arnold Lodge & Cardiff University, East Midlands since mid 1990s2000-2005


    Finding 1
    Finding #1 East Midlands since mid 1990s

    • Personality disordered offenders are poorer at social problem solving, as measured by the SPSI-R, than prisoners and mature students.


    Population comparisons
    Population comparisons East Midlands since mid 1990s

    PD (N=42) Prisoners (N=39) Mature students (N=70)

    PPO

    NPO

    RPS

    ICS

    AS

    SPS


    Finding 2
    Finding #2 East Midlands since mid 1990s

    • Personality traits are associated with social problem solving skills


    Traits
    Traits East Midlands since mid 1990s

    • Mentally disordered offenders

    • N=52; 38 MI and 14 PD

    • Big Five

      • Neuroticism

      • Extraversion

      • Openness

      • Agreeableness

      • Conscientiousness


    Traits1
    Traits East Midlands since mid 1990s

    • High N associated with poor social problem solving in MDOs

      • Less positive

      • More negative

      • Less rational

      • More impulsive/careless

      • More avoidant


    Impulsivity
    Impulsivity East Midlands since mid 1990s

    • Studies with students

      • Impulsiveness (BIS)

      • Social Problem Solving (SPSI-R)

      • Aggression (AQ)


    Impulsivity1
    Impulsivity East Midlands since mid 1990s

    Impulsivity

    Aggression


    Impulsivity2
    Impulsivity East Midlands since mid 1990s

    Social problem-

    solving

    Impulsivity

    Aggression


    Finding 3
    Finding #3 East Midlands since mid 1990s

    • Social problem solving therapy improves social problem solving, as measured by SPSI-R scores


    Social problem solving therapy2
    Social Problem Solving Therapy East Midlands since mid 1990s

    • PD Offenders

      SPS

      score

      Baseline 9m 15m 21m

      (N=42) (N=26) (N=15) (N=11)

    15

    14

    13

    12

    11

    10


    Sps conference nottingham 2001
    SPS Conference, Nottingham 2001 East Midlands since mid 1990s

    • James McGuire, University of Liverpool

    • Liisa Keltikangas-Järvinen, University of Helsinki

    • Steve Fyffe, Arnold Lodge PDU

    • Linda Blud & Rosie Travers, HM Prison Service

    • Debbie Fleck, Hutton Centre RSU

    • Fiona Biggam, Glasgow Caledonian University

    • Special issue of Criminal Behaviour & Mental Health, 2001, Vol. 11, No. 4 .


    Book East Midlands since mid 1990s

    • McMurran, M. & McGuire, J. (Eds) (2005). Social problem solving and offending: Evidence, evaluation and evolution. Chichester: Wiley.


    Contributors
    Contributors East Midlands since mid 1990s

    Fiona Biggam

    Conor Duggan

    Vince Egan

    Theresa Gannon

    James McGuire

    Kevin Power


    Contributors1
    Contributors East Midlands since mid 1990s

    Liisa Keltikangas-Järvinen

    Walter Matthys

    Friedrich Lösel

    Andreas Beelmann


    Contributors2
    Contributors East Midlands since mid 1990s

    Robin Harvey

    Tony Ward

    Devon Polaschek


    Contributors3
    Contributors East Midlands since mid 1990s

    Dan Antonowicz

    Shelley Brown

    Robert Ross

    Ralph Serin

    Laura Dreer

    Tom D’Zurilla

    Tim Elliott

    Warren Jackson

    John Lochman

    Christine Maguth Nezu

    Arthur M Nezu


    Nottingham 2006
    Nottingham, 2006 East Midlands since mid 1990s


    Landscaped project
    Landscaped project East Midlands since mid 1990s

    • Nick Huband et al. (2006) B J Psychiatry

    • Randomised controlled treatment trial

    • Stop & Think! + psychoeducation

    • Community adults with PD

    • Improved social problem solving (SPSI-R)

    • Improved social functioning (SFQ)


    Personality disorders spsi r
    Personality disorders & SPSI-R East Midlands since mid 1990s

    SPSI-R predictors

    Cluster A

    Paranoid None

    Schizoid None

    Schizotypal None

    Cluster B

    Antisocial None

    Borderline ↑ Impulsive ↓ Avoidant

    Histrionic ↑ Impulsive

    Narcissistic ↑ Impulsive ↑ Positive

    Cluster C

    Avoidant ↓ Impulsive ↑ Negative

    Dependent ↑ Negative

    Obsess/Comp None


    Problem solving model of personality disorder
    Problem solving model of personality disorder East Midlands since mid 1990s

    Traits

    e.g., High N;

    impulsivity

    Dysfunction, e.g.,

    Poor interpersonal

    skills; poor coping

    Poor social

    problem solving


    Problem solving model of personality disorder1
    Problem solving model of personality disorder East Midlands since mid 1990s

    Traits

    e.g., High N;

    impulsivity

    Information

    processing

    biases

    Dysfunction, e.g.,

    Poor interpersonal

    skills; poor coping

    Poor social

    problem solving


    Problem solving model of personality disorder2
    Problem solving model of personality disorder East Midlands since mid 1990s

    Maladaptive

    schemas

    Traits

    e.g., High N;

    impulsivity

    Information

    processing

    biases

    Dysfunction, e.g.,

    Poor interpersonal

    skills; poor coping

    Poor social

    problem solving


    Problem solving model of personality disorder3
    Problem solving model of personality disorder East Midlands since mid 1990s

    Maladaptive

    schemas

    Substance use

    Traits

    e.g., High N;

    impulsivity

    Information

    processing

    biases

    Distress

    Dysfunction, e.g.,

    Poor interpersonal

    skills; poor coping

    Poor social

    problem solving


    A testable model
    A testable model East Midlands since mid 1990s

    • Testable by whom?

    • A glimpse of the future


    Sps conference nottingham 2006
    SPS Conference, Nottingham 2006 East Midlands since mid 1990s

    Art Nezu, USA

    James McGuire, UK

    Chris Nezu, USA


    Future
    Future East Midlands since mid 1990s

    University of

    Liverpool

    Drexel University, USA

    University of Nottingham


    Future1
    Future East Midlands since mid 1990s

    University of

    Liverpool

    Drexel University, USA

    University of Nottingham

    Nottinghamshire Healthcare NHS Trust


    Future2
    Future East Midlands since mid 1990s

    University of

    Liverpool

    Drexel University, USA

    University of Nottingham

    Nottinghamshire Healthcare NHS Trust

    Personality Disorder

    Institute

    Nottingham Institute

    of Mental Health


    Acknowledgements

    Research colleagues East Midlands since mid 1990s

    Professor Conor Duggan

    Dr Nick Huband

    Professor Vince Egan

    Dr Jo Sellen

    Dr Lucy McCarthy

    Dr Shahla Ahmadi

    Dr Cathryn Richardson

    Dr Marie Blair

    Dr Gary Christopher

    Practitioner colleagues

    Cathy Wray

    Steve Fyffe

    Andy Latham

    Claudia Gerald

    Funders

    NHS National Programme on Forensic Mental Health R&D

    Home Office

    Acknowledgements


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