'Stop & Think!': Social problem-solving therapy with personality-disordered offenders
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Background: In this paper, the authors describe 'Stop & Think!', a social problem-solving intervention implemented with personality-disordered males resident on a dedicated personality disorder unit (PDU) within Arnold Lodge, a secure forensic psychiatric unit in Leicester, UK, as part of an integrated, multidisciplinary treatment programme. The problem-solving approach consists of seven steps: (1) orientation, (2) problem definition, (3) goal setting, (4) generation of alternatives, (5) decision making, (6) action, and (7) evaluation. Efforts to integrate the 'Stop & Think!' problem-solving process with individual and other therapies are described. Results: Using the Social Problem-Solving Inventory-Revised with 14 PDU patients at three and nine months after the commencement of 'Stop & Think!', significant improvements were recorded on all scales and subscales apart from Positive Problem Orientation. Change was maintained at 15 months for eight patients, with no significant further improvement. Recommendations for developments in assessment and treatment are made.