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

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Date
2014-05-01
Authors
McAuliffe, Carmel
McLeavey, Breda C.
Fitzgerald, Anthony P.
Corcoran, Paul
Carroll, Bernie
Ryan, Louise
Fitzgerald, Eva
O'Regan, Mary
Mulqueen, Jillian
Arensman, Ella
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Royal College of Psychiatrists
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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.
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Keywords
Psychiatric outpatients , Psychometric properties , Suicide attempters , Poisoning patients , Repetition , Behaviour , Parasuicide , Questionnaire , Intervention , Meta-analysis
Citation
McAuliffe, C., McLeavey, B. C., Fitzgerald, T., Corcoran, P., Carroll, B., Ryan, L., O'Keeffe, B., Fitzgerald, E., Hickey, P., O'Regan, M., Mulqueen, J. and Arensman, E. (2014) 'Group problem-solving skills training for self-harm: randomised controlled trial', British Journal of Psychiatry, 204(5), pp. 383-390. http://dx.doi.org/10.1192/bjp.bp.111.101816
Copyright
© 2014, Royal College of Psychiatrists. This is an author-produced electronic version of an article accepted for publication in the British Journal of Psychiatry. The definitive publisher-authenticated version is available online at http://bjp.rcpsych.org.