Social problem-solving plus psychoeducation for adults with personality disorder - Pragmatic randomised controlled trial

Background Social problem-solving therapy may be relevant in the treatment of personality disorder, although assessments of its effectiveness are uncommon. Aims To determine the effectiveness of a problem-solving intervention for adults with personality disorder in the community under conditions resembling routine clinical practice. Method Participants were randomly allocated to brief psychoeducation plus 16 problem-solving group sessions (n=87) or to waiting-list control (n=89). Primary outcome was comparison of scores on the Social Problem Solving Inventory and the Social Functioning Questionnaire between intervention and control arms at the conclusion of treatment, on average at 24 weeks after randomisation. Results In intention-to-treat analysis, those allocated to intervention showed significantly better problem-solving skills (P<0.001), higher overall social functioning (P=0.031) and lower anger expression (P=0.039) compared with controls. No significant differences were found on use of services during the intervention period. Conclusions Problem-solving plus psychoeducation has potential as a preliminary intervention for adults with personality disorder.