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

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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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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.
Psychiatric outpatients , Psychometric properties , Suicide attempters , Poisoning patients , Repetition , Behaviour , Parasuicide , Questionnaire , Intervention , Meta-analysis
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.
© 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