Group problem-solving skills training for self-harm: randomised controlled trial

Carmel McAuliffe , Breda C. McLeavey , Tony Fitzgerald , Paul Corcoran , Bernie Carroll , Louise Ryan , Brian O’Keeffe , Eva Fitzgerald , Portia Hickey , Mary O’Regan , Jillian Mulqueen , Ella Arensman
  • Declaration of interest

    None.

Abstract

Background

Rates of self-harm are high and have recently increased. This trend and the repetitive nature of self-harm pose a significant challenge to mental health services.

Aims

To determine the efficacy of a structured group problem-solving skills training (PST) programme as an intervention approach for self-harm in addition to treatment as usual (TAU) as offered by mental health services.

Method

A total of 433 participants (aged 18-64 years) were randomly assigned to TAU plus PST or TAU alone. Assessments were carried out at baseline and at 6-week and 6-month follow-up and repeated hospital-treated self-harm was ascertained at 12-month follow-up.

Results

The treatment groups did not differ in rates of repeated self-harm at 6-week, 6-month and 12-month follow-up. Both treatment groups showed significant improvements in psychological and social functioning at follow-up. Only one measure (needing and receiving practical help from those closest to them) showed a positive treatment effect at 6-week (P = 0.004) and 6-month (P = 0.01) follow-up. Repetition was not associated with waiting time in the PST group.

Conclusions

This brief intervention for self-harm is no more effective than treatment as usual. Further work is required to establish whether a modified, more intensive programme delivered sooner after the index episode would be effective.

Footnotes

  • Funding

    This work was supported by funding from the Health Service Executive (HSE) South, HSE Mid-West, the HSE National Office for Suicide Prevention, the Health Research Board and Pobal-Dormant Accounts Fund in Ireland.

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