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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

slide5
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
  • 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
  • 2004 -2006
  • Award = £11,974
    • Meeting costs
    • Speakers’ costs
    • Organisers’ costs
  • Events
    • Research meetings
    • Conference
    • Training event
    • Today’s event
seminar groups
Seminar Groups
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • Teach skills of social problem solving
    • Problem recognition
    • Problem definition
    • Goal setting
    • Option generation
    • Consequential thinking
    • Means-end action planning
    • Solution implementation
    • Outcome evaluation
pilot study
Pilot study
  • 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
  • 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
  • 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
finding 1
Finding #1
  • Personality disordered offenders are poorer at social problem solving, as measured by the SPSI-R, than prisoners and mature students.
population comparisons
Population comparisons

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

PPO

NPO

RPS

ICS

AS

SPS

finding 2
Finding #2
  • Personality traits are associated with social problem solving skills
traits
Traits
  • Mentally disordered offenders
  • N=52; 38 MI and 14 PD
  • Big Five
    • Neuroticism
    • Extraversion
    • Openness
    • Agreeableness
    • Conscientiousness
traits1
Traits
  • High N associated with poor social problem solving in MDOs
    • Less positive
    • More negative
    • Less rational
    • More impulsive/careless
    • More avoidant
impulsivity
Impulsivity
  • Studies with students
    • Impulsiveness (BIS)
    • Social Problem Solving (SPSI-R)
    • Aggression (AQ)
impulsivity1
Impulsivity

Impulsivity

Aggression

impulsivity2
Impulsivity

Social problem-

solving

Impulsivity

Aggression

finding 3
Finding #3
  • Social problem solving therapy improves social problem solving, as measured by SPSI-R scores
social problem solving therapy2
Social Problem Solving Therapy
  • 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
  • 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 .
slide31
Book
  • McMurran, M. & McGuire, J. (Eds) (2005). Social problem solving and offending: Evidence, evaluation and evolution. Chichester: Wiley.
contributors
Contributors

Fiona Biggam

Conor Duggan

Vince Egan

Theresa Gannon

James McGuire

Kevin Power

contributors1
Contributors

Liisa Keltikangas-Järvinen

Walter Matthys

Friedrich Lösel

Andreas Beelmann

contributors2
Contributors

Robin Harvey

Tony Ward

Devon Polaschek

contributors3
Contributors

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

landscaped project
Landscaped project
  • 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

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

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

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

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

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
  • Testable by whom?
  • A glimpse of the future
sps conference nottingham 2006
SPS Conference, Nottingham 2006

Art Nezu, USA

James McGuire, UK

Chris Nezu, USA

future
Future

University of

Liverpool

Drexel University, USA

University of Nottingham

future1
Future

University of

Liverpool

Drexel University, USA

University of Nottingham

Nottinghamshire Healthcare NHS Trust

future2
Future

University of

Liverpool

Drexel University, USA

University of Nottingham

Nottinghamshire Healthcare NHS Trust

Personality Disorder

Institute

Nottingham Institute

of Mental Health

acknowledgements
Research colleagues

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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