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Social Problem Solving Therapy

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Social Problem Solving Therapy Aim of the day To produce an action plan aimed at consolidating social problem solving therapy as one of the Trust s core therapies ... – PowerPoint PPT presentation

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Title: Social Problem Solving Therapy


1
Social Problem Solving Therapy
2
Aim of the day
  • To produce an action plan aimed at consolidating
    social problem solving therapy as one of the
    Trusts 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

3
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

4
Social problem solvingPast, present and future
  • Mary McMurran
  • University of Nottingham

5
Plan
  • 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

6
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

7
Social problem solving and personality disorder
  • 2004 -2006
  • Award 11,974
  • Meeting costs
  • Speakers costs
  • Organisers costs
  • Events
  • Research meetings
  • Conference
  • Training event
  • Todays event

8
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

9
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?

10
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
  • DZurilla Nezu

11
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
  • DZurilla Nezu McMurran

12
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

13
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

14
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

15
Arnold Lodge, 1995 - 1999
16
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)

17
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)

18
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

19
Arnold Lodge Cardiff University, 2000-2005
20
Finding 1
  • Personality disordered offenders are poorer at
    social problem solving, as measured by the
    SPSI-R, than prisoners and mature students.

21
Population comparisons
PD (N42) Prisoners (N39) Mature students
(N70)
PPO NPO RPS ICS AS SPS
?
?
?
?
?
?
?
22
Finding 2
  • Personality traits are associated with social
    problem solving skills

23
Traits
  • Mentally disordered offenders
  • N52 38 MI and 14 PD
  • Big Five
  • Neuroticism
  • Extraversion
  • Openness
  • Agreeableness
  • Conscientiousness

24
Traits
  • High N associated with poor social problem
    solving in MDOs
  • Less positive
  • More negative
  • Less rational
  • More impulsive/careless
  • More avoidant

25
Impulsivity
  • Studies with students
  • Impulsiveness (BIS)
  • Social Problem Solving (SPSI-R)
  • Aggression (AQ)

26
Impulsivity
Impulsivity
Aggression
27
Impulsivity
Social problem- solving
Impulsivity
Aggression
28
Finding 3
  • Social problem solving therapy improves social
    problem solving, as measured by SPSI-R scores

29
Social Problem Solving Therapy
  • PD Offenders
  • SPS
  • score
  • Baseline 9m 15m
    21m
  • (N42) (N26) (N15)
    (N11)

15 14 13 12 11 10
30
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 .

31
Book
  • McMurran, M. McGuire, J. (Eds) (2005). Social
    problem solving and offending Evidence,
    evaluation and evolution. Chichester Wiley.

32
Contributors
Fiona Biggam Conor Duggan Vince Egan Theresa
Gannon James McGuire Kevin Power
33
Contributors
Liisa Keltikangas-Järvinen
Walter Matthys
Friedrich Lösel Andreas Beelmann
34
Contributors
Robin Harvey Tony Ward Devon Polaschek
35
Contributors
Dan Antonowicz Shelley Brown Robert Ross Ralph
Serin Laura Dreer Tom DZurilla Tim
Elliott Warren Jackson John Lochman Christine
Maguth Nezu Arthur M Nezu
36
Nottingham, 2006
37
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)

38
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
39
Problem solving model of personality disorder
Traits e.g., High N impulsivity
Dysfunction, e.g., Poor interpersonal skills
poor coping
Poor social problem solving
40
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
41
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
42
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
43
A testable model
  • Testable by whom?
  • A glimpse of the future

44
SPS Conference, Nottingham 2006
Art Nezu, USA
James McGuire, UK
Chris Nezu, USA
45
Future
University of Liverpool
Drexel University, USA
University of Nottingham
46
Future
University of Liverpool
Drexel University, USA
University of Nottingham
Nottinghamshire Healthcare NHS Trust
47
Future
University of Liverpool
Drexel University, USA
University of Nottingham
Nottinghamshire Healthcare NHS Trust
Personality Disorder Institute
Nottingham Institute of Mental Health
48
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
    RD
  • Home Office
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