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Transcript of Social Problem Solving Therapy. Aim of the day ► To produce an action plan aimed at consolidating...
Social Problem Social Problem Solving TherapySolving Therapy
Aim of the dayAim of the day
►To produce an action plan aimed at To produce an action plan aimed at consolidating social problem solving consolidating social problem solving therapy as one of the Trust’s core therapy as one of the Trust’s core therapies, with the view to achieving a therapies, with the view to achieving a sound base of practical skills that will sound base of practical skills that will permit research into the effectiveness permit research into the effectiveness of social problem solving therapyof social problem solving therapy
►Principles relate to other therapies, not Principles relate to other therapies, not only social problem solving therapyonly social problem solving therapy
ProgrammeProgrammeSocial problem solving – Past, present and futureSocial problem solving – Past, present and futureProfessor Mary McMurranProfessor Mary McMurranDivision of Psychiatry, University of NottinghamDivision of Psychiatry, University of Nottingham
New roles and new ways of working in mental health: The challenge for educationNew roles and new ways of working in mental health: The challenge for educationProfessor Ian BaguleyProfessor Ian BaguleyDirector, Centre for Clinical and Academic Workforce Innovation, University of Director, Centre for Clinical and Academic Workforce Innovation, University of
LincolnLincoln
To accredit or not to accredit? That is the questionTo accredit or not to accredit? That is the questionMr Lawrence WhyteMr Lawrence WhyteWorkforce Development Dept, Nottinghamshire Healthcare NHS TrustWorkforce Development Dept, Nottinghamshire Healthcare NHS Trust
Supporting applied clinical research in NHS therapies: Towards practice based Supporting applied clinical research in NHS therapies: Towards practice based evidenceevidence
Professor Chris EvansProfessor Chris EvansResearch Programmes Director, Nottinghamshire Healthcare NHS TrustResearch Programmes Director, Nottinghamshire Healthcare NHS Trust
Looking backwards in order to move forwardsLooking backwards in order to move forwardsProfessor Conor DugganProfessor Conor DugganChair of the Personality Disorder Institute, Division of Psychiatry & Chair of the Personality Disorder Institute, Division of Psychiatry &
Nottinghamshire Healthcare NHS TrustNottinghamshire Healthcare NHS Trust
Social problem Social problem solving:solving:
Past, present and Past, present and futurefuture
Mary McMurran Mary McMurran
University of Nottingham University of Nottingham
PlanPlan
►Developments of social problem Developments of social problem solving theory and therapy in East solving theory and therapy in East Midlands since mid 1990sMidlands since mid 1990s
►A collaboration between A collaboration between Nottinghamshire Healthcare NHS Trust Nottinghamshire Healthcare NHS Trust and University of Nottinghamand University of Nottingham
►How research and practice need to How research and practice need to develop in partnershipdevelop in partnership
ESRC Research Seminar ESRC Research Seminar GroupGroup
► Seminar Groups Seminar Groups multi-institutional multi-institutional academic researchersacademic researchers postgraduate students postgraduate students non-academic users non-academic users
► Meet regularly to exchange Meet regularly to exchange information and ideas with the aim information and ideas with the aim of advancing research within their of advancing research within their fieldsfields
Social problem solving and Social problem solving and personality disorderpersonality disorder
► 2004 -20062004 -2006► Award = £11,974 Award = £11,974
Meeting costsMeeting costs Speakers’ costsSpeakers’ costs Organisers’ costsOrganisers’ costs
► EventsEvents Research meetingsResearch meetings ConferenceConference Training eventTraining event Today’s eventToday’s event
Seminar GroupsSeminar Groups
► AcademicsAcademics►Psychology, Psychiatry, SociologyPsychology, Psychiatry, Sociology►Cardiff University, University of Nottingham, Cardiff University, University of Nottingham,
University of Wales Institute Cardiff, University University of Wales Institute Cardiff, University of Sheffield, University of Liverpool, Drexel of Sheffield, University of Liverpool, Drexel University PhiladelphiaUniversity Philadelphia
► PractitionersPractitioners ►Psychologists, Psychiatrists, Nurses, OTs, Social Psychologists, Psychiatrists, Nurses, OTs, Social
Workers, Probation OfficersWorkers, Probation Officers►Public and Private SectorsPublic and Private Sectors►Leicestershire, Lincolnshire, NottinghamshireLeicestershire, Lincolnshire, Nottinghamshire
► Qualified, trainees, post-graduatesQualified, trainees, post-graduates► Service UserService User
Past to PresentPast to Present
►Seminars built on a body of local Seminars built on a body of local knowledge and experienceknowledge and experience
►Maintained and developed an interest Maintained and developed an interest in the areain the area
►What was that body of local What was that body of local knowledge?knowledge?
►What is social problem solving What is social problem solving therapy?therapy?
Social problem solvingSocial problem solving
►The self-directed cognitive-behavioural The self-directed cognitive-behavioural process by which a person attempts to process by which a person attempts to identify or discover effective or identify or discover effective or adaptive solutions for specific adaptive solutions for specific problems encountered in everyday problems encountered in everyday livingliving
D’Zurilla & NezuD’Zurilla & Nezu
Social problem solvingSocial problem solving
►The self-directed cognitive-The self-directed cognitive-behaviouralbehavioural-affective-affective process processeses by by which a person attempts to identify or which a person attempts to identify or discover effective or adaptive solutions discover effective or adaptive solutions for specific problems encountered in for specific problems encountered in everyday livingeveryday living
D’Zurilla & Nezu D’Zurilla & Nezu & & McMurranMcMurran
Social problem solving skillsSocial problem solving skills
►Ability to recognise emotional cuesAbility to recognise emotional cues► Identify and define a problemIdentify and define a problem►Specify goal for changeSpecify goal for change►Generate options to attain goalGenerate options to attain goal►Consequential thinking Consequential thinking ►Selection of effective strategiesSelection of effective strategies►Means-end action planningMeans-end action planning
Social problem solving and Social problem solving and social adjustmentsocial adjustment
►Social problem solving deficits evident Social problem solving deficits evident in in Aggressive childrenAggressive children Suicidal prisonersSuicidal prisoners Depressed peopleDepressed people Personality disordered offendersPersonality disordered offenders Child sex offendersChild sex offenders
►Social problem solving therapy Social problem solving therapy reduces problems in these groups reduces problems in these groups
Social problem solving Social problem solving therapytherapy
► Teach skills of social problem solvingTeach skills of social problem solving Problem recognitionProblem recognition Problem definitionProblem definition Goal settingGoal setting Option generationOption generation Consequential thinkingConsequential thinking Means-end action planningMeans-end action planning Solution implementationSolution implementation Outcome evaluationOutcome evaluation
Arnold Lodge, 1995 - 1999Arnold Lodge, 1995 - 1999
Pilot studyPilot study
► Trainee psychologist looking for Trainee psychologist looking for experience in delivering therapiesexperience in delivering therapies
► Small scale social problem solving Small scale social problem solving interventionintervention
► Detained mentally disordered offendersDetained mentally disordered offenders 6 mentally ill + 3 personality disordered 6 mentally ill + 3 personality disordered
► Showed pre- to post-intervention Showed pre- to post-intervention improvements on the Social Problem improvements on the Social Problem Solving Inventory – Revised (SPSI-R)Solving Inventory – Revised (SPSI-R)
Pilot studyPilot study
►SPSI-RSPSI-R Positive Problem Orientation (PPO)Positive Problem Orientation (PPO) Negative Problem Orientation (NPO) Negative Problem Orientation (NPO) Rational Problem Solving (RPO)Rational Problem Solving (RPO) Impulsive/careless style (ICS)Impulsive/careless style (ICS) Avoidant style (AS)Avoidant style (AS) Social problem solving index (SPS)Social problem solving index (SPS)
DevelopmentsDevelopments
►Began to use SPSI-R as part of general Began to use SPSI-R as part of general assessment of Arnold Lodge patients – assessment of Arnold Lodge patients – database on MDOsdatabase on MDOs
►Personality Disorder Unit (PDU) Personality Disorder Unit (PDU) opened and adopted Social Problem opened and adopted Social Problem Solving Therapy, Solving Therapy, Stop & Think!, Stop & Think!, as a as a core part of treatmentcore part of treatment
Arnold Lodge & Cardiff Arnold Lodge & Cardiff University, University, 2000-20052000-2005
Finding #1Finding #1
►Personality disordered offenders are Personality disordered offenders are poorer at social problem solving, as poorer at social problem solving, as measured by the SPSI-R, than measured by the SPSI-R, than prisoners and mature students.prisoners and mature students.
Population comparisonsPopulation comparisons
PPO
NPO
RPS
ICS
AS
SPS
PD (N=42) Prisoners (N=39) Mature students (N=70)▼
▼
▼
▼▼
▼ ▼
Finding #2Finding #2
►Personality traits are associated with Personality traits are associated with social problem solving skillssocial problem solving skills
TraitsTraits
►Mentally disordered offenders Mentally disordered offenders ►N=52; 38 MI and 14 PDN=52; 38 MI and 14 PD►Big FiveBig Five
NeuroticismNeuroticism ExtraversionExtraversion OpennessOpenness AgreeablenessAgreeableness ConscientiousnessConscientiousness
TraitsTraits
►High N associated with poor social High N associated with poor social problem solving in MDOsproblem solving in MDOs Less positiveLess positive More negativeMore negative Less rationalLess rational More impulsive/careless More impulsive/careless More avoidantMore avoidant
ImpulsivityImpulsivity
►Studies with studentsStudies with students Impulsiveness (BIS)Impulsiveness (BIS) Social Problem Solving (SPSI-R)Social Problem Solving (SPSI-R) Aggression (AQ)Aggression (AQ)
ImpulsivityImpulsivity
Impulsivity Aggression
ImpulsivityImpulsivity
Impulsivity Social problem-solving
Aggression
Finding #3Finding #3
►Social problem solving therapy Social problem solving therapy improves social problem solving, as improves social problem solving, as measured by SPSI-R scoresmeasured by SPSI-R scores
Social Problem Solving Social Problem Solving TherapyTherapy
►PD Offenders PD Offenders
SPSSPS
scorescore
Baseline 9m Baseline 9m 15m 15m 21m 21m
(N=42) (N=26) (N=15) (N=11)(N=42) (N=26) (N=15) (N=11)
15
14
13
12
11
10
SPS Conference, Nottingham SPS Conference, Nottingham 20012001
► James McGuire, University of LiverpoolJames McGuire, University of Liverpool► Liisa Keltikangas-JLiisa Keltikangas-Järvinen, University of Helsinkiärvinen, University of Helsinki► Steve Fyffe, Arnold Lodge PDUSteve Fyffe, Arnold Lodge PDU► Linda Blud & Rosie Travers, HM Prison ServiceLinda Blud & Rosie Travers, HM Prison Service► Debbie Fleck, Hutton Centre RSUDebbie Fleck, Hutton Centre RSU► Fiona Biggam, Glasgow Caledonian UniversityFiona Biggam, Glasgow Caledonian University
► Special issue of Special issue of Criminal Behaviour & Mental Criminal Behaviour & Mental Health, 2001, Vol. 11, No. 4 .Health, 2001, Vol. 11, No. 4 .
BookBook
► McMurran, M. & McMurran, M. & McGuire, J. (Eds) McGuire, J. (Eds) (2005). (2005). Social Social problem solving and problem solving and offending: Evidence, offending: Evidence, evaluation and evaluation and evolution.evolution. Chichester: Wiley.Chichester: Wiley.
ContributorsContributors
Fiona BiggamConor DugganVince EganTheresa GannonJames McGuireKevin Power
ContributorsContributors
Liisa Keltikangas-Järvinen
Walter Matthys
Friedrich LöselAndreas Beelmann
ContributorsContributors
Robin Harvey
Tony WardDevon Polaschek
ContributorsContributors
Dan AntonowiczShelley BrownRobert RossRalph Serin
Laura DreerTom D’ZurillaTim ElliottWarren JacksonJohn LochmanChristine Maguth NezuArthur M Nezu
Nottingham, 2006Nottingham, 2006
Landscaped projectLandscaped project
►Nick Huband et al. (2006) B J Nick Huband et al. (2006) B J PsychiatryPsychiatry
►Randomised controlled treatment trial Randomised controlled treatment trial ►Stop & Think! + psychoeducation Stop & Think! + psychoeducation ►Community adults with PDCommunity adults with PD► Improved social problem solving (SPSI-Improved social problem solving (SPSI-
R)R)► Improved social functioning (SFQ)Improved social functioning (SFQ)
Personality disorders & SPSI-Personality disorders & SPSI-RR
SPSI-R predictorsCluster A
Paranoid NoneSchizoid NoneSchizotypal None
Cluster BAntisocial NoneBorderline ↑ Impulsive ↓ AvoidantHistrionic ↑ ImpulsiveNarcissistic ↑ Impulsive ↑ Positive
Cluster CAvoidant ↓ Impulsive ↑ Negative Dependent ↑ NegativeObsess/Comp None
Problem solving model of Problem solving model of personality disorderpersonality disorder
Traitse.g., High N;impulsivity
Poor socialproblem solving
Dysfunction, e.g.,Poor interpersonal skills; poor coping
Problem solving model of Problem solving model of personality disorderpersonality disorder
Traitse.g., High N;impulsivity
Poor socialproblem solving
Dysfunction, e.g.,Poor interpersonal skills; poor coping
Information processing
biases
Problem solving model of Problem solving model of personality disorderpersonality disorder
Traitse.g., High N;impulsivity
Poor socialproblem solving
Dysfunction, e.g.,Poor interpersonal skills; poor coping
MaladaptiveschemasInformation
processing biases
Problem solving model of Problem solving model of personality disorderpersonality disorder
Traitse.g., High N;impulsivity
Poor socialproblem solving
Dysfunction, e.g.,Poor interpersonal skills; poor coping
Substance use
Distress
MaladaptiveschemasInformation
processing biases
A testable modelA testable model
► Testable by whom?Testable by whom?► A glimpse of the A glimpse of the
futurefuture
SPS Conference, Nottingham SPS Conference, Nottingham 20062006
Chris Nezu, USA
Art Nezu, USAJames McGuire, UK
FutureFuture
University of Nottingham
Drexel University, USAUniversity of Liverpool
FutureFuture
University of Nottingham
Nottinghamshire Healthcare NHS Trust
Drexel University, USAUniversity of Liverpool
FutureFuture
University of Nottingham
Nottinghamshire Healthcare NHS Trust
Drexel University, USAUniversity of Liverpool
Personality Disorder Institute
Nottingham Institute of Mental Health
AcknowledgementsAcknowledgements
► Research colleaguesResearch colleagues Professor Conor DugganProfessor Conor Duggan Dr Nick HubandDr Nick Huband Professor Vince EganProfessor Vince Egan Dr Jo SellenDr Jo Sellen Dr Lucy McCarthyDr Lucy McCarthy Dr Shahla AhmadiDr Shahla Ahmadi Dr Cathryn RichardsonDr Cathryn Richardson
Dr Marie BlairDr Marie Blair Dr Gary ChristopherDr Gary Christopher
► Practitioner colleaguesPractitioner colleagues Cathy WrayCathy Wray Steve FyffeSteve Fyffe Andy LathamAndy Latham Claudia GeraldClaudia Gerald
► FundersFunders NHS National Programme NHS National Programme
on Forensic Mental on Forensic Mental Health R&DHealth R&D
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