None listed
Conditions
Brief summary
This study aims to replicate, in an Australian context, on a larger scale and over a longer time period, the only intervention shown to be effective in reducing the repetition of self harm in adolescents. Adolescents attending clinical mental health services at three sites in Australia who report having engaged in two or more episodes of self harm in the past year will be invited to participate in a trial designed to establish the efficacy of a group psychotherapy program aimed specifically at the adolescent self harming population. Participants will be randomly allocated to receive treatment as usual or group psychotherapy in addition to usual care. The major outcomes assessed at baseline, 7, 26 and 52 weeks will be the repetition of self harm, suicidal ideation and level of depression. If benefits are replicated, this approach will represent the only intervention shown to be reliably effective in reducing the repetition of self harm in adolescents whilst demonstrating an efficient, economic and generalizable means of assisting an at risk and difficult to reach population.
Interventions
The group intervention is informed by the principles of cognitive behavior therapy, social skills training, interpersonal psychotherapy and group psychotherapy, and is explicitly described in a treatment manual developed by Drs Alison Wood and Gemma Trainor from Manchester, UK. It consists of an initial engagement phase provided over six sessions, and optional attendance at a long-term group. Groups are held for one hour per week and provided by clinicians from community-based adolescent mental
The group intervention is informed by the principles of cognitive behavior therapy, social skills training, interpersonal psychotherapy and group psychotherapy, and is explicitly described in a treatment manual developed by Drs Alison Wood and Gemma Trainor from Manchester, UK. It consists of an initial engagement phase provided over six sessions, and optional attendance at a long-term group. Groups are held for one hour per week and provided by clinicians from community-based adolescent mental health services. The group intervention aims to support young people at a difficult time by teaching them problem solving skills and cognitive strategies to deal with their problems. The intervention is delivered in a manner that may engage ‘hard to reach’ young people. The initial six sessions of the group are orientated around six themes of relevance to adolescents who self-harm: relationships, school and peer relationships, family problems, anger management, depression and self-harm, and hopelessness and feelings about the future. After completion of the initial six sessions, adolescents may transition to a longer term group. This places more emphasis on the group process, but continues to use strategies and techniques used in the initial phase. The long term group is available one hour per week and duration of treatment is open-ended. In practice most participants exit the group within 12 months. Further self-harming does not disqualify participants from attending the group. Concurrent with the group therapy participants also receive routine care as needed, which may include individual counseling (using a variety of therapeutic approaches), family sessions, medication assessment and review and other care coordination activities. Duration of routine treatment is open-ended and is determined by clinical need. Access to longer term group therapy and to routine care is available to participants beyond their 12 month period of enrolment in the trial.
Sponsors
University of Newcastle
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
12 Years to 16 Years
Healthy volunteers
No
Inclusion criteria
Participants were eligible if they were; (1) aged between 12 and16 years, (2) had been referred to a child and adolescent mental health service in Australian sites at Newcastle, Brisbane North or Logan, and (3) reported at least two episodes of self-harm in the past year, one of which had occurred in the past three months. Deliberate self-harm was defined as any intentional self-inflicted injury (including poisoning) irrespective of the apparent purpose of the behavior. Poisoning as a result of excessive use of recreational drugs was excluded from this definition.
Exclusion criteria
Participants were deemed ineligible if (1) they required continual monitoring due to suicidal ideation; (2) their current situation meant they could not attend groups; (3) they were experiencing acute psychosis, or (4) they exhibited difficulties or presenting issues that indicated that they would be unlikely to benefit from the group intervention (e.g. intellectual disability).
Outcome results
None listed