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

Published online by Cambridge University Press:  02 January 2018

Carmel McAuliffe ,
Breda C. McLeavey ,
Tony Fitzgerald ,
Paul Corcoran ,
Bernie Carroll ,
Louise Ryan ,
Brian O'Keeffe ,
Eva Fitzgerald ,
Portia Hickey  and
Mary O'Regan
...Show all authors
Carmel McAuliffe*
Affiliation:
Health Service Executive South/National Suicide Research Foundation, Cork, and Department of Epidemiology & Public Health, University College Cork, Ireland
Breda C. McLeavey
Affiliation:
Health Service Executive South, Department of Psychiatry, Cork University Hospital, Ireland
Tony Fitzgerald
Affiliation:
Department of Epidemiology and Public Health, University College Cork, Ireland
Paul Corcoran
Affiliation:
National Suicide Research Foundation, Cork, Ireland
Bernie Carroll
Affiliation:
Health Service Executive West, St Joseph's Hospital, Limerick, Ireland
Louise Ryan
Affiliation:
Health Service Executive West, St Joseph's Hospital, Limerick, Ireland
Brian O'Keeffe
Affiliation:
Health Service Executive West, Tevere Day Hospital, Limerick, Ireland
Eva Fitzgerald
Affiliation:
National Suicide Research Foundation, Cork, Ireland
Portia Hickey
Affiliation:
National Suicide Research Foundation, Cork, Ireland
Mary O'Regan
Affiliation:
National Suicide Research Foundation, Cork, Ireland
Jillian Mulqueen
Affiliation:
Health Service Executive West, St Joseph's Hospital, Limerick, Ireland
Ella Arensman
Affiliation:
National Suicide Research Foundation, and Department of Epidemiology & Public Health, University College Cork, Ireland
*
Carmel M. McAuliffe, National Suicide Research Foundation, Western Gateway Building, Western Road, Cork, Ireland. Email: [email protected]
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Abstract

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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.

Type
Papers
Information
The British Journal of Psychiatry , Volume 204 , Issue 5 , May 2014 , pp. 383 - 390
Copyright
Copyright © Royal College of Psychiatrists, 2014 

Footnotes

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.

Declaration of interest

None.

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