Evidence-Based Psychosocial Treatments for Self-Injurious Thoughts and Behaviors in Youth
Open accessAbstract
The purpose of this study was to review the current evidence base of psychosocial treatments for suicidal and nonsuicidal self-injurious thoughts and behaviors (SITBs) in youth. We reviewed major scientific databases (HealthSTAR, MEDLine, PsycINFO, PubMed) for relevant studies published prior to June 2013. The search identified 29 studies examining interventions for suicidal or nonsuicidal SITBs in children or adolescents. No interventions currently meet the Journal of Clinical Child and Adolescent Psychology standards for Level 1: well-established treatments. Six treatment categories were classified as Level 2: probably efficacious or Level 3: possibly efficacious for reducing SITBs in youth. These treatments came from a variety of theoretical orientations, including cognitive-behavioral, family, interpersonal, and psychodynamic theories. Common elements across efficacious treatments included family skills training (e.g., family communication and problem solving), parent education and training (e.g., monitoring and contingency management), and individual skills training (e.g., emotion regulation and problem solving). Several treatments have shown potential promise for reducing SITBs in children and adolescents. However, the probably/possibly efficacious treatments identified each have evidence from only a single randomized controlled trial. Future research should focus on replicating studies of promising treatments, identifying active treatment ingredients, examining mediators and moderators of treatment effects, and developing brief interventions for high-risk periods (e.g., following hospital discharge).
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A systematic review of 29 treatment studies found that no intervention met the standard to be classified as a 'well-established intervention', and only six interventions could be classified as 'probably efficacious'.
“Similarly, a systematic review of 29 treatment studies (including 18 RCTs) for suicidal and nonsuicidal self-injurious thoughts and behaviours (SITBs) in youth found that no intervention met the standard to be classified as a ‘well-established intervention’, and only six interventions could be classified as ‘probably efficacious’ [21].”
From Does treatment method matter? A meta-analysis of the past 20 years of research on therapeutic interventions for self-harm and suicidal ideation in adolescents (2020) · cites this paper as [21]
The Review of Interventions reports 29 studies, including 18 RCTs, and the Abstract’s Results state that none met the Level 1 well-established standard. The Summary of Evidence-Based Treatments identifies five interventions as Level 2 (probably efficacious) and a sixth as Level 3 (possibly efficacious), not six as probably efficacious. Page numbers are unavailable in our copy. (LLM, conf=0.93)
Experimental — accuracy not yet measuredA previous meta-analysis focused exclusively on a small number (k = 3) of RCTs, and a systematic review of CCTs and pre-post evaluations only included studies published prior to July 2013 (k = 5, no RCTs).
“However, previous meta-analysis focused exclusively on a small number (k = 3) of randomized controlled trials (RCTs; Kothgassner et al., 2020), and the systematic review of controlled clinical trials (CCTs, trials including a control group, but which lack randomization) and pre-post evaluations only included studies published prior to July 2013 (k = 5, no RCTs; Glenn et al., 2015).”
From Efficacy of dialectical behavior therapy for adolescent self-harm and suicidal ideation: a systematic review and meta-analysis (2021) · cites this paper as Glenn et al., 2015
The Dialectical behavior therapy (DBT) section reports five youth DBT studies using non-randomized controlled or pilot designs and says no published RCTs had examined DBT in youth. But those five studies are a subset of the review, which reports 29 intervention studies, including 18 RCTs. The July 2013 cutoff is also not established: the Review Parameters section says articles were searched through before September 2013, while the Abstract says before June 2013; page numbers are unavailable in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredStandard treatment of suicidality consisting of cognitive behavioral therapy, dialectical behavioral therapy, and/or medication has shown limited effects on suicidality.
“Until recently, standard treatment of suicidality consisted of cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), and/or medication, but all showed limited effects on suicidality [11, 13, 14].”
From The effectiveness and cost-effectiveness of attachment-based family therapy for young adults with high suicidal ideation: protocol of a randomized controlled trial (2024) · cites this paper as [13]
The CBT and DBT review sections report limited evidence of superiority over comparison treatments for several interventions in youth, and the Concluding Comments state that no treatment for self-injurious thoughts and behaviors in youth was yet well established. The CBT section also reports a trial with no difference in suicide events between CBT, medication, and their combination, but it describes another CBT intervention that reduced suicide attempts relative to usual care. The paper does not establish that these three approaches were the historical standard treatment or that all had limited effects on suicidality generally; its conclusions concern youth. (LLM, conf=0.86)
Experimental — accuracy not yet measuredTwo previous reviews evaluating psychosocial treatments for reducing adolescent self-harm and suicidal ideation highlighted DBT-A as a promising treatment.
“To date, two reviews evaluating the efficacy of psychosocial treatments for reducing adolescent self-harm and suicidal ideation have highlighted DBT-A as a promising treatment (Glenn, Franklin, & Nock, 2015; Kothgassner, Robinson, Goreis, Ougrin, & Plener, 2020).”
From Efficacy of dialectical behavior therapy for adolescent self-harm and suicidal ideation: a systematic review and meta-analysis (2021) · cites this paper as Glenn, Franklin, & Nock, 2015
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“…thoughts and behaviors (which will be referred to collectively as SITBs for the remainder of the manuscript) usually begin between the ages of 12 and 14 (Nock, 2009) and millions of adolescents engage in SITBs each year, treatments designed specifically for youth are especially important.”
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“It may be surprising that DBT was not classified as an efficacious treatment, given its utility for reducing SITBs in adults (e.g., Linehan, Heard, & Armstrong, 1993; Linehan et al., 2006).”
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“However, it is important to note that this is not true for all risk factors: interventions that reduce depression do not decrease SITBs in youth (Asarnow et al., 2011b; Gibbons, Brown, Hur, Davis, & Mann, 2012; Wilkinson et al., 2011).”
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“However, it is important to note that this is not true for all risk factors: interventions that reduce depression do not decrease SITBs in youth (Asarnow et al., 2011b; Gibbons, Brown, Hur, Davis, & Mann, 2012; Wilkinson et al., 2011).”
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“However, given that adolescents (and adults) are at greatest risk for attempting suicide in the six months following hospital discharge (Brent et al., 1993; Goldston et al., 1999; Prinstein et al., 2008), long-term interventions may be inadequate for helping adolescents during these high-risk periods.”
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“The TASA trial compared Cognitive Behavior Therapy for Suicide Prevention (CBT-SP: see Stanley et al., 2009), a medication algorithm, and the combination of CBT-SP and medication.”
MethodAttachment-Based Family Therapy for Depressed Adolescents: A Treatment Development Study
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“Diamond et al. (2010) examined Attachment-Based Family Therapy (ABFT: Diamond et al., 2002), which aims to reduce SITBs by improving family relationships, and especially the parent-adolescent relationship.”
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“And finally, attrition is a major problem in treatment research with youth (Kazdin, 1996), and the studies in our review were no exception.”
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“In a more acute setting, Katz et al. (2004) compared a brief (2-week) DBT package (individual sessions, skills group, and DBT milieu) to psychodynamic psychotherapy (TAU) for 62 adolescents receiving inpatient treatment.”
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Huey, S. J., Henggeler, S. W., Rowland, M. D., Halliday‐Boykins, C. A., Cunningham, P. B., Pickrel, S. G., & Edwards, J. E. (2004) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200402000-00014 · Cited by 316 · cited 9× · see citing works
“A few studies included children as young as age 10 (e.g., Asarnow et al., 2011a; Harrington et al., 1998; Huey et al., 2004) and one study focused on children ages 8 to 11 (Perepletchikova et al., 2011).”
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“However, it is important to note that this is not true for all risk factors: interventions that reduce depression do not decrease SITBs in youth (Asarnow et al., 2011b; Gibbons, Brown, Hur, Davis, & Mann, 2012; Wilkinson et al., 2011).”
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“Further support for parent training as a mechanism of change comes from a classroom-based prevention trial indicating that behavior management strategies in childhood may reduce SI over adolescence and young adulthood (Wilcox et al., 2008).”
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“…these studies from our review: prevention programs generally aim to screen and identify high-risk youth, whereas our review was focused on interventions for youth that are already determined to be at high-risk (for reviews of prevention programs: see Katz et al., 2013; Robinson et al., 2013).”
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“FBT-Problem-focused— Harrington et al. (1998) examined a family-based intervention that used behavioral (e.g., modeling, behavioral rehearsal) and family therapy techniques (e.g., psychoeducation, communication training) to target family problems hypothesized to contribute to adolescents' DSH…”
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“This is the first study to examine IPT for NSSI (Jacobson & Mufson, 2012); however, it appears that only five adolescents completed the treatment and results of the trial have not yet been published.”
BackgroundInfluentialRandomized trial of group therapy for repeated deliberate self-harm in adolescents
WOOD, A., TRAINOR, G., ROTHWELL, J., MOORE, A., & HARRINGTON, R. (2001) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200111000-00003 · Cited by 264 · cited 4× · see citing works
“For instance, although Wood et al. (2001) initially reported promising results of DGT, attempts to replicate these findings by other research groups were unsuccessful (Green et al., 2011; Hazell et al., 2009).”
BackgroundResultInfluentialSilverman, W. K., & Hinshaw, S. P. (2008) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374410701817725 · Cited by 263 · cited 1× · see citing works
“…12 Task Force on the Promotion and Dissemination of Psychological Procedures to determine intervention potency, which were later revised and expanded to cover a wider range of treatment studies (e.g., pilot studies) (see Chambless et al., 1998; Chambless & Hollon, 1998; Silverman & Hinshaw, 2008).”
BackgroundMehlum, L. I., Ramberg, M., Tørmoen, A. J., Haga, E., Diep, L. M., Stanley, B., Miller, A. L., Sund, A. M., & Grøholt, B. (2016) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2016.01.005 · Cited by 263 · see citing works
Brent, D. A., Greenhill, L. L., Compton, S., Emslie, G., Wells, K., Walkup, J. T., Vitiello, B., Bukstein, O., Stanley, B., Posner, K., et al. (2009) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/chi.0b013e3181b5dbe4 · Cited by 262 · cited 3× · see citing works
“A CBT-individual and family intervention was also examined in the large ( n = 124) Treatment of Adolescent Suicide Attempters (TASA) study – an open trial designed to examine intensive and tailored treatments for adolescent suicide attempters with major depression (Brent et al., 2009).”
BackgroundInfluentialSoutham‐Gerow, M. A., & Prinstein, M. J. (2013) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2013.855128 · Cited by 256 · see citing works
Treatment of co-occurring substance abuse and suicidality among adolescents: A randomized trial.
Esposito-Smythers, C., Spirito, A., Kahler, C. W., Hunt, J., & Monti, P. (2011) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0026074 · Cited by 254 · cited 8× · see citing works
“For instance, Esposito-Smythers et al. (2011) found that parent training enhanced their CBT package.”
BackgroundInfluentialAsarnow, J. R., Baraff, L. J., Berk, M., Grob, C. S., Devich-Navarro, M., Suddath, R., Piacentini, J. C., Rotheram-Borus, M. J., Cohen, D., & Tang, L. (2011) · Psychiatric Services · doi:10.1176/ps.62.11.pss6211_1303 · Cited by 251 · cited 3× · see citing works
“However, it is important to note that this is not true for all risk factors: interventions that reduce depression do not decrease SITBs in youth (Asarnow et al., 2011b; Gibbons, Brown, Hur, Davis, & Mann, 2012; Wilkinson et al., 2011).”
A SYSTEMATIC REVIEW OF SCHOOL-BASED SUICIDE PREVENTION PROGRAMS
Katz, C., Bolton, J. M., Katz, L. Y., Isaak, C. A., Tilston-Jones, T., Sareen, J., & Swampy Cree Suicide Prevention Team (2013) · Depression and Anxiety · doi:10.1002/da.22114 · Cited by 242 · see citing works
Prinstein, M. J., Heilbron, N., Guerry, J. D., Franklin, J. C., Rancourt, D., Simon, V., & Spirito, A. (2010) · Journal of Abnormal Child Psychology · doi:10.1007/s10802-010-9423-0 · Cited by 234 · cited 1× · see citing works
“Given the mixed results of this group therapy and the potential for contagion of SITBs among groups of adolescents (Prinstein et al., 2010; Walsh & Rosen, 1985), group therapy alone may be contraindicated for this population.”
ResultSelf-citationInterpersonal Psychotherapy for Depressed Adolescents
Moreau, D., & Mufson, L. H. (1997) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/s1056-4993(18)30322-5 · Cited by 231 · see citing works
Development of a Computerized Adaptive Test for Depression
Gibbons, R. D., Weiss, D. J., Pilkonis, P. A., Frank, E., Moore, T., Kim, J. B., & Kupfer, D. J. (2012) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2012.14 · Cited by 230 · see citing works
Protecting Adolescents From Self-Harm: A Critical Review of Intervention Studies
Brent, D. A., McMakin, D. L., Kennard, B. D., Goldstein, T. R., Mayes, T. L., & Douaihy, A. B. (2013) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2013.09.009 · Cited by 223 · cited 1× · see citing works
“Because no single theoretical orientation is superior, treatment efficacy is likely due to common elements across these interventions (also see review: Brent et al., 2013).”
Backgroundde Bruin, E. J., Bögels, S. M., Oort, F. J., & Meijer, A. M. (2015) · SLEEP · doi:10.5665/sleep.5240 · Cited by 214 · see citing works
GOLDSTON, D. B., DANIEL, S. S., REBOUSSIN, D. M., REBOUSSIN, B. A., FRAZIER, P. H., & KELLEY, A. E. (1999) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199906000-00012 · Cited by 214 · cited 4× · see citing works
“…the treatment groups in SEs at six-month follow-up, but the authors noted that SE rates generally, and SA rates specifically, were lower in the TASA trial compared to those reported in naturalistic studies of high-risk adolescent samples following hospital discharge (e.g., Goldston et al., 1999).”
BackgroundResultInfluentialThe 18-month impact of an emergency room intervention for adolescent female suicide attempters.
Rotheram‐Borus, M. J., Piacentini, J. C., Cantwell, C., Belin, T. R., & Song, J. (2000) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.68.6.1081 · Cited by 201 · cited 2× · see citing works
“, 1996), these differences did not hold at any of the follow-up assessments over the subsequent 3 to 18 months (Rotheram-Borus et al., 2000).”
BackgroundGlenn, C. R., Lanzillo, E. C., Esposito, E. C., Santee, A. C., Nock, M. K., & Auerbach, R. P. (2017) · Journal of Abnormal Child Psychology · doi:10.1007/s10802-016-0214-0 · Cited by 197 · see citing works
Self-citationROTHERAM-BORUS, M. J., PIACENTINI, J., VAN ROSSEM, R., GRAAE, F., CANTWELL, C., CASTRO-BLANCO, D., MILLER, S., & FELDMAN, J. (1996) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199605000-00021 · Cited by 196 · cited 2× · see citing works
“Although the initial study reported reduced SI following the specialized ED intervention (Rotheram-Borus et al., 1996), these differences did not hold at any of the follow-up assessments over the subsequent 3-18 months (Rotheram-Borus et al.”
BackgroundO'Connor, E., Gaynes, B. N., Burda, B. U., Soh, C., & Whitlock, E. P. (2013) · Annals of Internal Medicine · doi:10.7326/0003-4819-158-10-201305210-00642 · Cited by 193 · see citing works
Adolescent Psychiatric Inpatients' Risk of Suicide Attempt at 6-Month Follow-up
BRENT, D. A., KOLKO, D. J., WARTELLA, M. E., BOYLAN, M. B., MORITZ, G., BAUGHER, M., & ZELENAK, J. P. (1993) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199301000-00015 · Cited by 183 · cited 2× · see citing works
“However, given that adolescents (and adults) are at greatest risk for attempting suicide in the six months following hospital discharge (Brent et al., 1993; Goldston et al., 1999; Prinstein et al., 2008), long-term interventions may be inadequate for helping adolescents during these high-risk periods.”
BackgroundEffectiveness of an outpatient intervention targeting suicidal young adults: Preliminary results.
Rudd, M. D., Rajab, M. H., Orman, D. T., Stulman, D. A., Joiner, T., & Dixon, W. A. (1996) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.64.1.179 · Cited by 182 · cited 1× · see citing works
“We included two studies that examined adolescents and young adults, ages 15-24 (Robinson et al., 2012; Rudd et al., 1996), because young adults are relatively close in age to older adolescents.”
Pineda, J., & Dadds, M. R. (2013) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2013.05.015 · Cited by 174 · cited 4× · see citing works
“Pineda and Dadds (2013) reported promising findings for a brief (4-session) parent education program for reducing adolescent suicide risk – Resourceful Adolescent Parent Program (RAP-P).”
BackgroundInfluentialYouth-Nominated Support Team for suicidal adolescents (Version 1): A randomized controlled trial.
King, C. A., Kramer, A., Preuss, L. J., Kerr, D., Weisse, L., & Venkataraman, S. (2006) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.74.1.199 · Cited by 171 · cited 1× · see citing works
“Although there was not a main effect of treatment, the YST-I was more efficacious than TAU for reducing SI in girls (King et al., 2006).”
BackgroundAdolescent Substance Use and Suicidal Behavior: A Review With Implications for Treatment Research
Esposito-Smythers, C. L., & Spirito, A. (2004) · Alcoholism Clinical and Experimental Research · doi:10.1097/01.alc.0000127417.99752.87 · Cited by 169 · cited 1× · see citing works
“Given that substance use increases risk for suicidal behavior among adolescents (Esposito-Smythers & Spirito, 2004), reductions in alcohol and drug use in the I-CBT group may have been important for treatment efficacy.”
BackgroundSPIRITO, A., BOERGERS, J., DONALDSON, D., BISHOP, D., & LEWANDER, W. (2002) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200204000-00016 · Cited by 163 · cited 3× · see citing works
“We excluded the following types of studies if they did not include a specific SITB outcome: treatment adherence studies (e.g., Spirito et al., 2002a) and studies including measures of broad suicide risk factors, such as psychiatric symptoms (e.g., Orbach & Bar-Joseph, 1993).”
BackgroundResultKing, C. A., Klaus, N. M., Kramer, A., Venkataraman, S., QUINLAN, P. E., & Gillespie, B. W. (2009) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0016552 · Cited by 157 · cited 5× · see citing works
“King and colleagues (King et al., 2006; King et al., 2009) examined a support-based intervention for adolescents following hospitalization—Youth-nominated Support Team (YST).”
InfluentialFamily Factors in Youth Suicidal Behaviors
Wagner, B. M., Silverman, M. A. C., & Martin, C. E. (2003) · American Behavioral Scientist · doi:10.1177/0002764202250661 · Cited by 153 · see citing works
Treatment for adolescents following a suicide attempt: results of a pilot trial
Donaldson, D., Spirito, A., & Esposito-Smythers, C. (2005) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200502000-00003 · Cited by 151 · cited 6× · see citing works
“CBT-Individual + CBT-Family + Parent Training— Building on earlier versions of their CBT packages (Donaldson et al., 2005; Esposito-Smythers et al., 2006), Esposito-Smythers et al. (2011) added a parent training component to create integrated CBT (I-CBT), which includes a variety of individual CBT…”
BackgroundMethodInfluentialSuicide Prevention for High‐Risk Persons Who Refuse Treatment <sup>*</sup>
Motto, J. A. (1976) · Suicide and Life-Threatening Behavior · doi:10.1111/j.1943-278x.1976.tb00880.x · Cited by 150 · cited 2× · see citing works
“It is important to note that the original Motto (1976) study examined the postcard intervention in a sample of over 3,000 adults.”
BackgroundTang, T., Jou, S., Ko, C., Huang, S., & Yen, C. (2009) · Psychiatry and Clinical Neurosciences · doi:10.1111/j.1440-1819.2009.01991.x · Cited by 148 · cited 2× · see citing works
“(2002b), TAU in the current review varied from supportive counseling (Tang et al., 2009) to inpatient hospitalization (Huey et al.”
BackgroundResultDBT Skills Manual for Adolescents
Miller, A. L., & Rathus, J. H. (2014) · Cited by 148 · see citing works
Asarnow, J. R., Berk, M., Hughes, J. L., & Anderson, N. L. (2015) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2014.940624 · Cited by 147 · see citing works
Regression to the mean: treatment effect without the intervention
Morton, V., & Torgerson, D. J. (2005) · Journal of Evaluation in Clinical Practice · doi:10.1111/j.1365-2753.2004.00505.x · Cited by 147 · see citing works
Secondary prevention of attempted suicide in adolescence
Cotgrove, A., Zirinsky, L., Black, D., & Weston, D. (1995) · Journal of Adolescence · doi:10.1006/jado.1995.1039 · Cited by 143 · cited 3× · see citing works
“Cotgrove et al. (1995) examined a relatively simple intervention that provided adolescents with immediate access to hospital care (via a green card).”
BackgroundInfluentialDevelopmental Approach to Prevent Adolescent Suicides
Wyman, P. A. (2014) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2014.05.039 · Cited by 141 · see citing works
Evidence base update for psychosocial treatments for pediatric obsessive-compulsive disorder
Freeman, J., Garcia, A., Frank, H., Benito, K., Conelea, C., Walther, M., & Edmunds, J. (2014) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2013.804386 · Cited by 139 · cited 1× · see citing works
“This classification is consistent with other EBT Updates in this series (e.g., Freeman et al., 2014).”
ResultGreen, J. M., Wood, A. J., Kerfoot, M. J., Trainor, G., Roberts, C., Rothwell, J., Woodham, A., Ayodeji, E., Barrett, B., Byford, S., et al. (2011) · BMJ · doi:10.1136/bmj.d682 · Cited by 137 · cited 4× · see citing works
“(2001) initially reported promising results of DGT, attempts to replicate these findings by other research groups were unsuccessful (Green et al., 2011; Hazell et al., 2009).”
ResultInfluentialHazell, P. L., Martin, G., Mcgill, K., Kay, T., Wood, A., Trainor, G., & Harrington, R. (2009) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/chi.0b013e3181aoacec · Cited by 132 · cited 5× · see citing works
“However, these initially promising treatment findings have failed to replicate in other samples of adolescents (Green et al., 2011; Hazell et al., 2009).”
BackgroundResultInfluentialOverlooked and Underserved: “Action Signs” for Identifying Children With Unmet Mental Health Needs
Jensen, P. S., Goldman, E. E., Offord, D., Costello, E. J., Friedman, R., Huff, B. P., Crowe, M., Amsel, L., BENNETT, K. J., Bird, H., et al. (2011) · PEDIATRICS · doi:10.1542/peds.2009-0367 · Cited by 124 · see citing works
James, A. C., Taylor, A., Winmill, L., & Alfoadari, K. (2008) · Child and Adolescent Mental Health · doi:10.1111/j.1475-3588.2007.00470.x · Cited by 114 · cited 2× · see citing works
“The three small pilot studies (sample sizes ranged from 12 to 25 adolescents) examining DBT reported significant reductions in DSH (James et al., 2008; 2011) and NSSI (Fleischhaker et al., 2011) over the course of treatment.”
BackgroundEvaluation of out-patient counselling compared with general practitioner care following overdoses
Hawton, K. E., McKeown, S., Day, A., Martin, P., O'Connor, M. E., & Yule, J. (1987) · Psychological Medicine · doi:10.1017/s0033291700025988 · Cited by 108 · cited 2× · see citing works
“A number of studies were excluded because they examined interventions across adolescence and adulthood but did not examine treatment effects separately in adolescent participants (e.g., Bateman & Fonagy, 1999; Hawton et al., 1981; Hawton et al., 1987).”
BackgroundRobinson, J., Hetrick, S., Cox, G., Bendall, S., Yuen, H. P., Yung, A., & Pirkis, J. (2016) · Early Intervention in Psychiatry · doi:10.1111/eip.12137 · Cited by 108 · see citing works
Ougrin, D., Zundel, T., Ng, A., Banarsee, R., Bottle, A., & Taylor, E. (2011) · Archives of Disease in Childhood · doi:10.1136/adc.2010.188755 · Cited by 106 · cited 1× · see citing works
“Finally, Ougrin and colleagues (Ougrin, Boege, Stahl, Banarsee, & Taylor, 2013; Ougrin et al., 2011) examined the utility of a one-session family-based ED intervention (i.”
BackgroundHsu, L. (1989) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.57.1.131 · Cited by 104 · see citing works
Firearms Availability and Suicide
Brent, D. A., & Bridge, J. A. (2003) · American Behavioral Scientist · doi:10.1177/0002764202250662 · Cited by 101 · see citing works
Orbach, I., & Bar‐Joseph, H. (1993) · Suicide and Life-Threatening Behavior · doi:10.1111/j.1943-278x.1993.tb00376.x · Cited by 95 · cited 1× · see citing works
“We excluded the following types of studies if they did not include a specific SITB outcome: treatment adherence studies (e.g., Spirito et al., 2002a) and studies including measures of broad suicide risk factors, such as psychiatric symptoms (e.g., Orbach & Bar-Joseph, 1993).”
Self-mutilation and contagion: an empirical test
Walsh, B. W., & Rosen, P. (1985) · American Journal of Psychiatry · doi:10.1176/ajp.142.1.119 · Cited by 95 · see citing works
Taylor, L. M. W., Oldershaw, A., Richards, C., Davidson, K. M., Schmidt, U. H., & Simic, M. (2011) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465811000075 · Cited by 90 · see citing works
Domiciliary and out-patient treatment of self-poisoning patients by medical and non-medical staff
Hawton, K. E., Bancroft, J., Catalan, J. M., Kingston, B., Stedeford, A., & Welch, N. (1981) · Psychological Medicine · doi:10.1017/s0033291700053381 · Cited by 90 · cited 1× · see citing works
“A number of studies were excluded because they examined interventions across adolescence and adulthood, but did not examine treatment effects separately in adolescent participants (e.g., Bateman & Fonagy, 1999; Hawton et al., 1981; 1987).”
BackgroundPerepletchikova, F., Axelrod, S. R., Kaufman, J., Rounsaville, B. J., Douglas-Palumberi, H., & Miller, A. L. (2010) · Child and Adolescent Mental Health · doi:10.1111/j.1475-3588.2010.00583.x · Cited by 89 · cited 2× · see citing works
“, 2004) and one study focused on children ages 8 to 11 (Perepletchikova et al., 2011).”
BackgroundMorthorst, B. R., Krogh, J., Erlangsen, A., Alberdi, F., & Nordentoft, M. (2012) · BMJ · doi:10.1136/bmj.e4972 · Cited by 84 · see citing works
Ougrin, D., Boege, I., Stahl, D., Banarsee, R., & Taylor, E. (2013) · Archives of Disease in Childhood · doi:10.1136/archdischild-2012-303200 · Cited by 84 · see citing works
Asarnow, J. R., Baraff, L. J., Berk, M. S., Grob, C. S., Devich-Navarro, M., Suddath, R., Piacentini, J. C., Rotheram‐Borus, M. J., Cohen, D., & Tang, L. (2011) · Psychiatric Services · doi:10.1176/appi.ps.62.11.1303 · Cited by 77 · see citing works
King, C. A., Gipson, P. Y., Horwitz, A. G., & Opperman, K. J. (2015) · Psychiatric Services · doi:10.1176/appi.ps.201300347 · Cited by 73 · see citing works
Robinson, J., Hetrick, S., Cox, G., Bendall, S., Yung, A., & Pirkis, J. (2015) · Early Intervention in Psychiatry · doi:10.1111/eip.12136 · Cited by 71 · see citing works
Adolescent suicidal and self-destructive behavior
Deykin, E. Y., Hsieh, C.-C., Joshi, N., & Mcnamarra, J. J. (1986) · Journal of Adolescent Health Care · doi:10.1016/s0197-0070(86)80002-x · Cited by 71 · cited 1× · see citing works
“Deykin et al. (1986) examined an intervention package aimed at increasing treatment compliance among disadvantaged (e.g., Medicaid-eligible) youth.”
BackgroundRobinson, J., Yuen, H. P., Gook, S., Hughes, A., Cosgrave, E., Killackey, E. J., Baker, K., Jorm, A. F., McGorry, P. D., & Yung, A. R. (2012) · Early Intervention in Psychiatry · doi:10.1111/j.1751-7893.2011.00334.x · Cited by 69 · cited 1× · see citing works
“We included two studies that examined adolescents and young adults, ages 15-24 (Robinson et al., 2012; Rudd et al., 1996), because young adults are relatively close in age to older adolescents.”
MethodKennard, B. D., Biernesser, C. L., Wolfe, K. L., Foxwell, A. A., Lee, S. J. C., Rial, K. V., Patel, S., Cheng, C., Goldstein, T. R., McMakin, D. L., et al. (2015) · Journal of Technology in Human Services · doi:10.1080/15228835.2015.1106384 · Cited by 67 · see citing works
Alavi, A., Sharifi, B., Ghanizadeh, A. J., & Dehbozorgi, G. (2013) · Europe PMC (PubMed Central) · Cited by 66 · see citing works
Interpersonal Psychotherapy for Depressed Adolescents ☆
Young, J. F., & Mufson, L. H. (2017) · Elsevier eBooks · doi:10.1016/b978-0-12-809324-5.06093-4 · Cited by 61 · see citing works
Suicide; Assessment and Intervention
Hatton, C. L., Valente, S. M., & Rink, A. (1978) · AJN American Journal of Nursing · doi:10.1097/00000446-197803000-00049 · Cited by 57 · see citing works
Spirito, A., Stanton, C. A., Donaldson, D. L., & Boergers, J. (2002) · Journal of Clinical Child & Adolescent Psychology · doi:10.1207/s15374424jccp3101_06 · Cited by 55 · cited 7× · see citing works
“In a sample of 63 adolescents receiving TAU, Spirito, Stanton, Donaldson, and Boergers (2002b) found that treatments varied widely in theoretical orientation (cognitive, behavioral, psychodynamic) and frequency of sessions (Range: 0-22).”
BackgroundResultInfluentialJames, A. C., Winmill, L., Anderson, C., & Alfoadari, K. (2010) · Child and Adolescent Mental Health · doi:10.1111/j.1475-3588.2010.00571.x · Cited by 54 · cited 2× · see citing works
“The three small pilot studies (sample sizes ranged from 12 to 25 adolescents) examining DBT reported significant reductions in DSH (James et al., 2008; 2011) and NSSI (Fleischhaker et al., 2011) over the course of treatment.”
BackgroundBarriers to Outpatient Mental Health Treatment for Children and Adolescents: Parental Perspectives
Smith, T., Linnemeyer, R. M., Scalise, D., & Hamilton, J. (2013) · International Journal of Systemic Therapy · doi:10.1080/08975353.2013.792203 · Cited by 49 · see citing works
Physical Exercise as a Treatment for Non-Suicidal Self-Injury: Evidence From a Single-Case Study
Wallenstein, M. B., & Nock, M. K. (2007) · American Journal of Psychiatry · doi:10.1176/appi.ajp.164.2.350-a · Cited by 46 · cited 1× · see citing works
“In contrast to RCTs that examine treatment effects on target outcomes between individuals, SCEDs examine the impact of treatment on targets within individuals (e.g., Wallenstein & Nock, 2007).”
ResultSelf-citationWright-Hughes, A. M., Graham, L., Farrin, A. J., Collinson, M., Boston, P., Eisler, I., Fortune, S. A., Green, J., House, A. O., Owens, D., et al. (2015) · Trials · doi:10.1186/s13063-015-1007-4 · Cited by 43 · see citing works
A Sociable God: A Brief Introduction to a Transcendental Sociology
WALSH, R. N. (1985) · American Journal of Psychiatry · doi:10.1176/ajp.142.2.259 · Cited by 40 · see citing works
Brief home-based intervention with young suicide attempters and their families
Kerfoot, M., Harrington, R., & Dyer, E. J. (1995) · Journal of Adolescence · doi:10.1006/jado.1995.1038 · Cited by 39 · cited 1× · see citing works
“…et al. (1998) examined a family-based intervention that used behavioral (e.g., modeling, behavioral rehearsal) and family therapy techniques (e.g., psychoeducation, communication training) to target family problems hypothesized to contribute to adolescents' DSH (Kerfoot, Harrington, & Dyer, 1995).”
BackgroundSpirito, A., Wolff, J. C., Seaboyer, L. M., Hunt, J., Esposito-Smythers, C. L., Nugent, N. R., Zlotnick, C., & Miller, I. (2014) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/cap.2013.0130 · Cited by 39 · see citing works
Esposito-Smythers, C., Spirito, A., Uth, R., & Lachance, H. R. (2006) · American Journal on Addictions · doi:10.1080/10550490601006188 · Cited by 32 · cited 4× · see citing works
“CBT-Individual + CBT-Family + Parent Training— Building on earlier versions of their CBT packages (Donaldson et al., 2005; Esposito-Smythers et al., 2006), Esposito-Smythers et al. (2011) added a parent training component to create integrated CBT (I-CBT), which includes a variety of individual CBT…”
BackgroundInfluentialJacobson, C. M., & Mufson, L. (2012) · American Journal of Psychotherapy · doi:10.1176/appi.psychotherapy.2012.66.4.349 · Cited by 30 · cited 7× · see citing works
“This is the first study to examine IPT for NSSI (Jacobson & Mufson, 2012); however, it appears that only five adolescents completed the treatment and results of the trial have not yet been published.”
BackgroundInfluentialRobinson, J., Hetrick, S. E., Cox, G., Bendall, S., Yung, A. R., Yuen, H. P., Templer, K., & Pirkis, J. (2014) · BMC Psychiatry · doi:10.1186/1471-244x-14-155 · Cited by 30 · see citing works
Tumilty, T. N. (1982) · doi:10.5040/9798216982968.ch-003 · Cited by 22 · see citing works
We’ve Come a Long Way, Baby!: Evolution and Revolution in CBT with Youth
Friedberg, R. D., Hoyman, L. C., Behar, S., Tabbarah, S., Pacholec, N. M., Keller, M., & Thordarson, M. A. (2014) · Journal of Rational-Emotive & Cognitive-Behavior Therapy · doi:10.1007/s10942-014-0178-3 · Cited by 19 · see citing works
Casarin, A., McAuley, D. F., Alce, T. M., Zhao, X., Ely, E. W., Jackson, J. C., McDowell, C., Agus, A. M., Murphy, L., & Page, V. J. (2015) · Trials · doi:10.1186/s13063-015-0731-0 · Cited by 17 · see citing works
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Risk factors for suicidal thoughts and behaviors: A meta-analysis of 50 years of research
Franklin, J. C., Ribeiro, J. D., Fox, K. R., Bentley, K. H., Kleiman, E. M., Huang, X., Musacchio, K. M., Jaroszewski, A. C., Chang, B. P., & Nock, M. K. (2017) · Psychological Bulletin · doi:10.1037/bul0000084 · Cited by 3,784 · see citing works
Self-citationTurecki, G., Brent, D. A., Gunnell, D., O’Connor, R. C., Oquendo, M. A., Pirkis, J., & Stanley, B. H. (2019) · Nature Reviews Disease Primers · doi:10.1038/s41572-019-0121-0 · Cited by 1,074 · see citing works
Annual Research Review: Suicide among youth – epidemiology, (potential) etiology, and treatment
Cha, C. B., Franz, P. J., M. Guzmán, E., Glenn, C. R., Kleiman, E. M., & Nock, M. K. (2018) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12831 · Cited by 602 · see citing works
Self-citationMeta-analysis of risk factors for nonsuicidal self-injury
Fox, K. R., Franklin, J. C., Ribeiro, J. D., Kleiman, E. M., Bentley, K. H., & Nock, M. K. (2015) · Clinical Psychology Review · doi:10.1016/j.cpr.2015.09.002 · Cited by 548 · see citing works
Self-citationMcCauley, E., Berk, M. S., Asarnow, J. R., Adrian, M., Cohen, J., Korslund, K., Avina, C., Hughes, J., Harned, M., Gallop, R., et al. (2018) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2018.1109 · Cited by 531 · see citing works
Why Do People Hurt Themselves? A New Conceptual Model of Nonsuicidal Self-Injury
Hooley, J., & Franklin, J. (2018) · Clinical Psychological Science · doi:10.1177/2167702617745641 · Cited by 357 · see citing works
Self-citationKothgassner, O. D., Goreis, A., Robinson, K., Huscsava, M. M., Schmahl, C., & Plener, P. L. (2021) · Psychological Medicine · doi:10.1017/s0033291721001355 · Cited by 288 · see citing works
“…controlled trials (RCTs; Kothgassner et al., 2020), and the systematic review of controlled clinical trials (CCTs, trials including a control group, but which lack randomization) and pre-post evaluations only included studies published prior to July 2013 ( k = 5, no RCTs; Glenn et al., 2015).”
Interventions for self-harm in children and adolescents
Hawton, K., Witt, K. G., Taylor Salisbury, T. L., Arensman, E., Gunnell, D., Townsend, E., van Heeringen, K., & Hazell, P. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012013 · Cited by 261 · see citing works
Evidence Base Update of Psychosocial Treatments for Self-Injurious Thoughts and Behaviors in Youth
Glenn, C. R., Esposito, E. C., Porter, A. C., & Robinson, D. J. (2019) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2019.1591281 · Cited by 219 · see citing works
“Second, and consistent with the 2015 review (Glenn et al., 2015), we elected to include only interventions specifically designed to treat SITBs in at-risk youth.”
BackgroundSelf-citationFranklin, J. C., Fox, K. R., Franklin, C. R., Kleiman, E. M., Ribeiro, J. D., Jaroszewski, A. C., Hooley, J. M., & Nock, M. K. (2016) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000093 · Cited by 217 · see citing works
Self-citationCucchi, A., Ryan, D., Konstantakopoulos, G., Stroumpa, S., Kacar, A. S., Renshaw, S., Landau, S., & Kravariti, E. (2016) · Psychological Medicine · doi:10.1017/s0033291716000027 · Cited by 162 · see citing works
“Future research should focus on replicating studies of promising treatments, examining mediators and moderators of treatment effects, and developing brief interventions for high-risk periods (e.g. following hospital discharge) (Turner et al. 2014; Glenn et al. 2015).”
BackgroundA systematic review of psychosocial suicide prevention interventions for youth
Calear, A. L., Christensen, H. M., Freeman, A., Fenton, K., Grant, J. B., van Spijker, B. A. J., & Donker, T. (2015) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-015-0783-4 · Cited by 215 · see citing works
Suicidal Thoughts and Behaviors Among LGBTQ Youth: Meta-Analyses and a Systematic Review
Hatchel, T., Polanin, J. R., & Espelage, D. L. (2021) · Archives of Suicide Research · doi:10.1080/13811118.2019.1663329 · Cited by 172 · see citing works
Kothgassner, O. D., Robinson, K., Goreis, A., Ougrin, D., & Plener, P. L. (2020) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/s40479-020-00123-9 · Cited by 163 · see citing works
“More recently, an update to the systematic review of treatment interventions for SITBs in youth [21] focused exclusively on RCTs, including the 9 new trials available since 2015 [20].”
BackgroundResultDiamond, G. S., Kobak, R. R., Krauthamer Ewing, E. S., Levy, S. A., Herres, J. L., Russon, J. M., & Gallop, R. J. (2019) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2018.10.006 · Cited by 147 · see citing works
“Using broad selection criteria, a recent review found 18 randomized control trials (RCTs) that examined psychosocial (with or without medication) treatments for adolescents with suicide ideation or behaviors.(2) Only 6 of these treatments met criteria for being probably or possibly efficacious.”
BackgroundInterventions for self-harm in children and adolescents
Witt, K. G., Hetrick, S. E., Rajaram, G., Hazell, P., Taylor Salisbury, T. L., Townsend, E., & Hawton, K. (2021) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd013667.pub2 · Cited by 149 · see citing works
Mackin, D. M., Perlman, G., Davila, J., Kotov, R., & Klein, D. N. (2017) · Psychological Medicine · doi:10.1017/s0033291716003275 · Cited by 127 · see citing works
“However, evidence regarding effective prevention and interventions for adolescents with suicidal thoughts or behaviors is extremely limited (Robinson et al. 2011; Glenn et al. 2015).”
BackgroundKearns, J. C., Coppersmith, D. D. L., Santee, A. C., Insel, C., Pigeon, W. R., & Glenn, C. R. (2020) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2018.09.011 · Cited by 115 · see citing works
Self-citationGlenn, C. R., Cha, C. B., Kleiman, E. M., & Nock, M. K. (2017) · Clinical Psychological Science · doi:10.1177/2167702616686854 · Cited by 113 · see citing works
Self-citationArbuthnott, A. E., & Lewis, S. P. (2015) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-015-0066-3 · Cited by 107 · see citing works
“Studies assessing cognitive behaviour therapies (CBT) for youth NSSI have involved parents through family CBT in addition to individual CBT for the youth [88], or through a parent psycho-education component [89]; the inclusion of family problem solving sessions or parent training in CBT has not yet been assessed in re…”
BackgroundInfluentialCzyz, E. K., King, C. A., & Biermann, B. J. (2019) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2018.1496442 · Cited by 105 · see citing works
“, 2015) and several reviews (Brent et al., 2013; Glenn et al., 2015) of interventions for suicidal adolescents concluded that family involvement plays a key role in positive intervention effects.”
BackgroundAsarnow, J. R., & Mehlum, L. (2019) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13130 · Cited by 100 · see citing works
Bjureberg, J., Sahlin, H., Hedman-Lagerlöf, E., Gratz, K. L., Tull, M. T., Jokinen, J., Hellner, C., & Ljótsson, B. (2018) · BMC Psychiatry · doi:10.1186/s12888-018-1885-6 · Cited by 96 · see citing works
King, C. A., Arango, A., Kramer, A., Busby, D. R., Czyz, E. K., Foster, C. E., Gillespie, B. W., & for the YST Study Team (2019) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2018.4358 · Cited by 96 · see citing works
Effectiveness of Psychotherapy on Suicidal Risk: A Systematic Review of Observational Studies
Méndez-Bustos, P., Calati, R., Rubio-Ramírez, F., Olié, É., Courtet, P., & López‐Castromán, J. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.00277 · Cited by 95 · see citing works
“Some interventions need to be tested in independent and larger samples to verify their utility before translation into common clinical practice could be considered (Glenn et al., 2015).”
BackgroundNonsuicidal self-injury disorder: The path to diagnostic validity and final obstacles
Selby, E. A., Kranzler, A., Fehling, K. B., & Panza, E. A. (2015) · Clinical Psychology Review · doi:10.1016/j.cpr.2015.03.003 · Cited by 89 · see citing works
Recent advances in understanding and managing self-harm in adolescents
Clarke, S., Allerhand, L. A., & Berk, M. S. (2019) · F1000Research · doi:10.12688/f1000research.19868.1 · Cited by 87 · see citing works
Advancing Research in Child Suicide: A Call to Action
Ayer, L. A., Colpe, L. J., Pearson, J. L., Rooney, M. E., & Murphy, E. R. (2020) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2020.02.010 · Cited by 84 · see citing works
Bjureberg, J., Sahlin, H., Hellner, C., Hedman-Lagerlöf, E., Gratz, K. L., Bjärehed, J., Jokinen, J., Tull, M. T., & Ljótsson, B. (2017) · BMC Psychiatry · doi:10.1186/s12888-017-1527-4 · Cited by 84 · see citing works
Self-injury recovery: A person-centered framework.
Lewis, S. P., & Hasking, P. A. (2020) · Journal of Clinical Psychology · doi:10.1002/jclp.23094 · Cited by 67 · see citing works
Family factors associated with adolescent self‐harm: a narrative review
Fortune, S. A., Cottrell, D. J., & Fife, S. (2016) · Journal of Family Therapy · doi:10.1111/1467-6427.12119 · Cited by 79 · see citing works
Interventions to reduce self-harm on in-patient wards: systematic review
Nawaz, R. F., Reen, G., Bloodworth, N., Maughan, D. L., & Vincent, C. A. (2021) · BJPsych Open · doi:10.1192/bjo.2021.41 · Cited by 77 · see citing works
Dobias, M., Schleider, J. L., Jans, L. K., & Fox, K. R. (2021) · Behaviour Research and Therapy · doi:10.1016/j.brat.2021.103983 · Cited by 74 · see citing works
Emerging Trends in Adolescent Suicide Prevention Research
King, C., Arango, A., & Foster, C. E. (2017) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2017.08.037 · Cited by 61 · see citing works
Adrian, M., McCauley, E., Berk, M. S., Asarnow, J. R., Korslund, K., Avina, C., Gallop, R., & Linehan, M. M. (2019) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13099 · Cited by 68 · see citing works
Bentley, K. H., Nock, M., Sauer-Zavala, S., Gorman, B., & Barlow, D. (2017) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000205 · Cited by 65 · see citing works
Self-citationCaring for Young People Who Self-Harm: A Review of Perspectives from Families and Young People
Curtis, S., Thorn, P., McRoberts, A., Hetrick, S. E., Rice, S., & Robinson, J. (2018) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph15050950 · Cited by 72 · see citing works
“Notably, efficacious psychosocial treatments for self-harm thoughts and behaviors for young people focus on treating the family, as well as the young person [35].”
BackgroundFamily processes: risk, protective and treatment factors for youth at risk for suicide.
Diamond, G., Kodish, T., Ewing, E. S. K., Hunt, Q. A., & Russon, J. M. (2022) · Aggression and Violent Behavior · doi:10.1016/j.avb.2021.101586 · Cited by 70 · see citing works
“these interventions has been well reviewed in several other papers (Brent et al., 2013; Glenn et al., 2015; Ougrin et al., 2015).”
BackgroundPrevention of internalizing disorders and suicide via adolescent sleep interventions
Blake, M. J., & Allen, N. B. (2019) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2019.08.027 · Cited by 66 · see citing works
Treating nonsuicidal self-injury (NSSI) in adolescents: consensus based German guidelines
Plener, P. L., Brunner, R. M., Fegert, J. M., Groschwitz, R. C., In‐Albon, T., Kaess, M., Kapusta, N. D., Resch, F., & Becker, K. (2016) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-016-0134-3 · Cited by 64 · see citing works
“Although the number of controlled studies on psychotherapeutic interventions in NSSI is still limited, evidence on the efficacy of psychotherapy in the treatment of NSSI accumulates [34, 35].”
BackgroundKelada, L., Hasking, P. A., & Melvin, G. A. (2016) · Youth & Society · doi:10.1177/0044118x16653153 · Cited by 63 · see citing works
“In support of this, in their review of psychosocial treatments for NSSI, Glenn et al. (2014) noted that familybased treatments such as attachment-based family therapy, combined individual and family therapy, and parent training were promising, but further research is required.”
BackgroundParents’ Experiences of Nonsuicidal Self-Injury Among Adolescents and Young Adults
Kelada, L., Whitlock, J. L., Hasking, P. A., & Melvin, G. A. (2016) · Journal of Child and Family Studies · doi:10.1007/s10826-016-0496-4 · Cited by 62 · see citing works
Parental validation and invalidation predict adolescent self-harm.
Adrian, M. C., Berk, M. S., Korslund, K. E., Whitlock, K. B., McCauley, E., & Linehan, M. M. (2018) · Professional Psychology Research and Practice · doi:10.1037/pro0000200 · Cited by 62 · see citing works
Evidence-Based Interventions for Youth Suicide Risk
Busby, D. R., Hatkevich, C., McGuire, T. C., & King, C. A. (2020) · Current Psychiatry Reports · doi:10.1007/s11920-020-1129-6 · Cited by 59 · see citing works
Dysregulation and Suicide in Children and Adolescents
Benton, T. D., Muhrer, E. J., Jones, J. D., & Lewis, J. (2021) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2020.10.008 · Cited by 66 · see citing works
Bahji, A., Pierce, M., Wong, J., Roberge, J. N., Ortega, I., & Patten, S. (2021) · JAMA Network Open · doi:10.1001/jamanetworkopen.2021.6614 · Cited by 60 · see citing works
Berk, M. S., Starace, N. K., Black, V. P., & Avina, C. (2020) · Archives of Suicide Research · doi:10.1080/13811118.2018.1509750 · Cited by 57 · see citing works
Bjureberg, J., Ojala, O., Hesser, H., Häbel, H., Sahlin, H., Gratz, K. L., Tull, M. T., Claesdotter Knutsson, E., Hedman-Lagerlöf, E., Ljótsson, B., et al. (2023) · JAMA Network Open · doi:10.1001/jamanetworkopen.2023.22069 · Cited by 59 · see citing works
Rojas‐Velasquez, D., Pluhar, E., Burns, P., & Burton, E. T. (2020) · Prevention Science · doi:10.1007/s11121-020-01147-x · Cited by 57 · see citing works
Kelada, L., Hasking, P. A., Melvin, G., Whitlock, J., & Baetens, I. (2018) · Journal of Adolescent Research · doi:10.1177/0743558416684954 · Cited by 54 · see citing works
Czyz, E. K., Glenn, C. R., Busby, D. R., & King, C. A. (2019) · Psychiatry Research · doi:10.1016/j.psychres.2019.112588 · Cited by 56 · see citing works
Self-citationGlenn, C. R., Kleiman, E. M., Coppersmith, D. D. L., Santee, A. C., Esposito, E. C., Cha, C. B., Nock, M. K., & Auerbach, R. P. (2017) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12769 · Cited by 54 · see citing works
Self-citationNovel online daily diary interventions for nonsuicidal self-injury: a randomized controlled trial
Hooley, J. M., Fox, K. R., Wang, S. B., & Kwashie, A. N. D. (2018) · BMC Psychiatry · doi:10.1186/s12888-018-1840-6 · Cited by 54 · see citing works
Czyz, E. K., King, C. A., Prouty, D., Micol, V. J., Walton, M., & Nahum‐Shani, I. (2021) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13383 · Cited by 54 · see citing works
Oppenheimer, C. W., Glenn, C. R., & Miller, A. B. (2022) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2022.2051526 · Cited by 58 · see citing works
Self-citationKelada, L., Hasking, P. A., & Melvin, G. A. (2016) · Journal of Marital and Family Therapy · doi:10.1111/jmft.12150 · Cited by 52 · see citing works
Waraan, L., Siqveland, J., Hanssen‐Bauer, K., Czjakowski, N. O., Axelsdottir, B., Mehlum, L. I., & Aalberg, M. (2022) · Clinical Child Psychology and Psychiatry · doi:10.1177/13591045221125005 · Cited by 56 · see citing works
Esposito, C., Dragone, M., Affuso, G., Amodeo, A. L., & Bacchini, D. (2022) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-022-02083-7 · Cited by 51 · see citing works
Fox, K., Ribeiro, J. D., Kleiman, E. M., Hooley, J., Nock, M., & Franklin, J. (2018) · Psychiatry Research · doi:10.1016/j.psychres.2017.11.083 · Cited by 40 · see citing works
Self-citationXiao, Y., & Lindsey, M. A. (2021) · Psychological Medicine · doi:10.1017/s0033291721000465 · Cited by 50 · see citing works
“For example, by improving family support and psychoeducation, the Youth-Nominated Support Team-Version II intervention was found to be more cost-effective and efficient than traditional intervention (Glenn et al., 2015).”
MethodUnderstanding and treating suicidal risk in young children.
Ridge-Anderson, A., Keyes, G. M., & Jobes, D. A. (2016) · Practice Innovations · doi:10.1037/pri0000018 · Cited by 49 · see citing works
“As Glenn, Franklin, and Nock (2015) have remarked, “there are currently no wellestablished treatments for suicidal or nonsuicidal self-injurious behaviors in youth.””
BackgroundLüdtke, J., In‐Albon, T., Michel, C., & Schmid, M. (2016) · Psychiatry Research · doi:10.1016/j.psychres.2016.02.026 · Cited by 48 · see citing works
“A recent review on psychosocial treatment for selfinjurious thoughts and behavior by Glenn et al. (2015) concluded that an essential part of effective treatment is the training of skills to regulate emotion.”
BackgroundInfluentialEfficacy of interventions for suicide and self-injury in children and adolescents: a meta-analysis
Harris, L. M., Huang, X., Funsch, K. M., Fox, K. R., & Ribeiro, J. D. (2022) · Scientific Reports · doi:10.1038/s41598-022-16567-8 · Cited by 47 · see citing works
Bentley, K. H., Sauer-Zavala, S. E., Cassiello-Robbins, C. F., Conklin, L. R., Vento, S. A., & Homer, D. (2017) · Behavior Modification · doi:10.1177/0145445516689661 · Cited by 44 · see citing works
Czyz, E. K., Horwitz, A. G., Yegüez, C. E., Foster, C. E., & King, C. A. (2017) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2017.1342546 · Cited by 44 · see citing works
“Moreover, parent involvement has been identified as a key factor of efficacious interventions for suicidal adolescents (Brent et al., 2013; Glenn et al., 2015) and has been integrated into promising interventions for high-risk teens during or following an ED visit (e.g., Asarnow et al., 2011, 2017;…”
BackgroundPosition paper for guiding response to non-suicidal self-injury in schools
Hasking, P. A., Heath, N., Kaess, M., Lewis, S. P., Plener, P., Walsh, B., Whitlock, J., & Wilson, M. S. (2016) · School Psychology International · doi:10.1177/0143034316678656 · Cited by 34 · see citing works
“in emotion regulation), motivation for treatment, and a focus on improving family and other interpersonal relationships (Glenn et al., 2015; Turner et al., 2014).”
BackgroundMehlum, L., Schmahl, C., Berens, A., Doering, S., Hutsebaut, J., Kaera, A., Kramer, U., Moran, P. A., Renneberg, B., Ribaudi, J. S., et al. (2020) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/s40479-020-00131-9 · Cited by 42 · see citing works
Meza, J. I., Patel, K., & Bath, E. P. J. (2022) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/appi.focus.20210034 · Cited by 42 · see citing works
Cottrell, D. J., Wright-Hughes, A. M., Collinson, M., Boston, P., Eisler, I., Fortune, S. A., Graham, L., Green, J., House, A. O., Kerfoot, M., et al. (2018) · Health Technology Assessment · doi:10.3310/hta22120 · Cited by 42 · see citing works
Weinstein, S. M., Cruz, R. A., Isaia, A., Peters, A. T., & West, A. E. (2017) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12416 · Cited by 41 · see citing works
“Across the youth suicide intervention literature, treatments that have shown promise for decreasing suicidal thoughts and behaviors in adolescents share several common elements, including improving family and other relationships, parenting skills, and individual coping skills (Glenn et al., 2015).”
InfluentialN -Acetylcysteine for Nonsuicidal Self-Injurious Behavior in Adolescents: An Open-Label Pilot Study
Cullen, K. R., Klimes‐Dougan, B., Schreiner, M. W., Carstedt, P. A., Marka, N. A., Nelson, K. J., Miller, M. J., Reigstad, K. M., Westervelt, A., Gunlicks‐Stoessel, M., et al. (2017) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/cap.2017.0032 · Cited by 40 · see citing works
“…therapy (CBT), mentalization-based therapy (MBT), and some specific family-based interventions are psychotherapeutic approaches that have some preliminary support for treating self-injurious behavior (pooling both suicidal and NSSI together) in adolescents (Glenn et al. 2015; Ougrin et al. 2015).”
BackgroundAnti-Suicide Function of Nonsuicidal Self-Injury in Female Inpatient Adolescents
Kraus, L., Schmid, M., & In‐Albon, T. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.00490 · Cited by 38 · see citing works
“A review has shown that all efficacious NSSI treatments include individual skills training as a common element, such as emotion regulation or problem-solving strategies (47).”
BackgroundReyes, A. D. L. (2017) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2016.1266649 · Cited by 38 · see citing works
“After 3 years, updates such as those by Smith and Iadarola (2015) on treatments for autism spectrum disorder and by Glenn, Franklin, and Nock (2015) on treatments for self-injurious thoughts and behaviors are among the most highly cited articles in JCCAP.”
BackgroundBrausch, A. M., O’Connor, S. S., Powers, J. T., McClay, M. M., Gregory, J. A., & Jobes, D. A. (2019) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12587 · Cited by 37 · see citing works
Parent–teen communication predicts treatment benefit for depressed and suicidal adolescents.
Zisk, A., Abbott, C. H., Bounoua, N., Diamond, G. S., & Kobak, R. (2019) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000457 · Cited by 37 · see citing works
“, 2014) is a 16week manualized treatment that has demonstrated efficacy in treating suicidal and depressed adolescents (Glenn et al., 2015).”
BackgroundBeidas, R. S., Ahmedani, B. K., Linn, K. A., Marcus, S. C., Johnson, C., Maye, M. P., Westphal, J. A., Wright, L., Beck, A. L., Buttenheim, A. M., et al. (2021) · Implementation Science · doi:10.1186/s13012-021-01154-8 · Cited by 38 · see citing works
“promising yet underused suicide prevention strategy [28].”
Lee, J., Chun, J., Kim, J., Lee, J.-E., & Lee, S. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph182010623 · Cited by 40 · see citing works
“Moreover, some prior studies indicate that there are currently no wellestablished treatments shown to prevent or reduce suicidal ideation and behavior in youth [68,69].”
BackgroundDigital self‐harm and suicidality among adolescents
Patchin, J. W., Hinduja, S., & Meldrum, R. C. (2022) · Child and Adolescent Mental Health · doi:10.1111/camh.12574 · Cited by 42 · see citing works
Simes, D., Shochet, I. M., Murray, K. E., & Sands, I. G. (2021) · Adolescent Research Review · doi:10.1007/s40894-021-00164-3 · Cited by 36 · see citing works
Baker, A. C., Wallander, J. L., Elliott, M. N., & Schuster, M. A. (2022) · Child Psychiatry & Human Development · doi:10.1007/s10578-022-01319-6 · Cited by 39 · see citing works
“Reviews of interventions for self-harm behaviors including NSSI have found that the most efficacious interventions focused on improving adolescents’ relationships with parents and family [66, 67].”
BackgroundNon-suicidal Self-injurious Thoughts and Behaviors Among Adolescent Inpatients
Millon, E. M., Alqueza, K. L., Kamath, R. A., Marsh, R., Pagliaccio, D., Blumberg, H. P., Stewart, J. G., & Auerbach, R. P. (2022) · Child Psychiatry & Human Development · doi:10.1007/s10578-022-01380-1 · Cited by 36 · see citing works
Thoughts, images, and appraisals associated with acting and not acting on the urge to self-injure.
McEvoy, P. M., Hayes, S., Hasking, P. A., & Rees, C. S. (2017) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2017.05.010 · Cited by 34 · see citing works
“A recent systematic review suggests cognitive-behavioural treatments are “probably efficacious” in treating NSSI (Glenn et al., 2015; also; Muehlenkamp, 2006), but they are typically not aimed at selfinjury (Klonsky, 2007; Washburn et al., 2012).”
BackgroundAdolescent Admissions to Emergency Departments for Self-Injurious Thoughts and Behaviors
Zanus, C., Battistutta, S., Aliverti, R., Montico, M., Cremaschi, S., Ronfani, L., Monasta, L., & Carrozzi, M. (2017) · PLoS ONE · doi:10.1371/journal.pone.0170979 · Cited by 29 · see citing works
Acceptability and Use of Evidence-Based Practices for Firearm Storage in Pediatric Primary Care
Beidas, R. S., Jager‐Hyman, S., Becker‐Haimes, E. M., Wolk, C. B., Ahmedani, B. K., Zeber, J. E., Fein, J. A., Brown, G. K., Gregor, C. A., Lieberman, A., et al. (2018) · Academic Pediatrics · doi:10.1016/j.acap.2018.11.007 · Cited by 34 · see citing works
What suicide interventions should target
Franklin, J. C., Huang, X., Fox, K. R., & Ribeiro, J. D. (2017) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2017.08.002 · Cited by 34 · see citing works
Self-citationDevelopment and efficacy of a family-focused treatment for depression in childhood
Tompson, M. C., Langer, D. A., & Asarnow, J. R. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.06.057 · Cited by 36 · see citing works
Czyz, E. K., Arango, A., Healy, N. A., King, C. A., & Walton, M. A. (2020) · JMIR Mental Health · doi:10.2196/17345 · Cited by 34 · see citing works
Pan, C.-H., Lee, M., Wu, C., Liao, S., Chan, C., & Chen, C.-Y. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.12.139 · Cited by 34 · see citing works
Itzhaky, L., Davaasambuu, S., Ellis, S. P., Cisneros-Trujillo, S., Hannett, K., Scolaro, K., Stanley, B. H., Mann, J. J., Wainberg, M. L., Oquendo, M. A., et al. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.12.094 · Cited by 33 · see citing works
Risk Assessment and Crisis Intervention for Youth in a Time of Telehealth
Holland, M. L., Hawks, J. L., Morelli, L. C., & Khan, Z. S. (2021) · Contemporary School Psychology · doi:10.1007/s40688-020-00341-6 · Cited by 32 · see citing works
Hasking, P. A. (2017) · Prevention Science · doi:10.1007/s11121-017-0755-7 · Cited by 32 · see citing works
“Evidencebased interventions that specifically target NSSI are rare (see Andover et al. 2015; Gratz et al. 2015 for notable exceptions).”
BackgroundReview of family‐based treatments from 2010 to 2019 for suicidal ideation and behavior
Frey, L. M., Hunt, Q. A., Russon, J. M., & Diamond, G. (2022) · Journal of Marital and Family Therapy · doi:10.1111/jmft.12568 · Cited by 32 · see citing works
Scopetti, M., Morena, D., Padovano, M., Manetti, F., Fazio, N. D., Delogu, G., Ferracuti, S., Frati, P., & Fineschi, V. (2023) · Healthcare · doi:10.3390/healthcare11101470 · Cited by 33 · see citing works
Esposito-Smythers, C. L., Hadley, W. S., Curby, T. W., & Brown, L. K. (2016) · Behaviour Research and Therapy · doi:10.1016/j.brat.2016.11.005 · Cited by 30 · see citing works
“Given that rates of suicide attempts were very low, and suicidal and non-suicidal self-injury were significantly correlated over follow-ups (r = .38-.44, p=.001 to .004), these forms of DSH were collapsed into one item as is common in suicide treatment research (Glenn et al., 2015).”
BackgroundTreatments for Self-Injurious Thoughts and Behaviors in Youth: Progress and Challenges
Bettis, A. H., Liu, R. T., Walsh, B., & Klonsky, E. (2020) · Evidence-Based Practice in Child and Adolescent Mental Health · doi:10.1080/23794925.2020.1806759 · Cited by 20 · see citing works
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“Factors that have been identified to date remain poorly understood (12, 14), and results have been inconsistent (2, 15).”
ResultPredicting Patterns of Treatment Response and Outcome for Adolescents Who Are Suicidal and Depressed
Abbott, C. H., Zisk, A., Bounoua, N., Diamond, G. S., & Kobak, R. (2019) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2018.12.013 · Cited by 30 · see citing works
Tschan, T., Lüdtke, J., Schmid, M., & In‐Albon, T. (2019) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-019-0275-2 · Cited by 30 · see citing works
Simonsson, O., Engberg, H., Bjureberg, J., Ljótsson, B., Stensils, J., Sahlin, H., & Hellner, C. (2020) · JMIR Formative Research · doi:10.2196/17910 · Cited by 20 · see citing works
“The availability of frequent and flexible online and telephonic contact was important for the participants, in line with previous findings [25,27].”
BackgroundResultRees, C. S., Hasking, P. A., Breen, L. J., Lipp, O. V., & Mamotte, C. D. S. (2015) · BMC Psychiatry · doi:10.1186/s12888-015-0527-5 · Cited by 29 · see citing works
- Authors
- Glenn, C. R., Franklin, J. C., & Nock, M. K.
- Affiliations
- Harvard University (US)
- Corresponding author
- Glenn, Catherine R.
- Venue
- Journal of Clinical Child & Adolescent Psychology
- Publisher
- Informa UK Limited
- Published
- 2014-09-25
- Volume
- 44
- Issue
- 1
- Pages
- 1-29
- ISSN
- 1537-4416 (ISSN-L)
- 1537-4424
- PMC
- PMC4557625
- OpenAlex
- W2081568229
- Cited by
- 288
- References
- 133
- Citations by year
- 2026: 11 · 2025: 11 · 2024: 29 · 2023: 26 · 2022: 24 · 2021: 56 · 2020: 32 · 2019: 25 · 2018: 29 · 2017: 23 · 2016: 16 · 2015: 6
- FWCI
- 17.70
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Clinical Child & Adolescent Psychology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- Funders
- The research was supported, in part, by a grant from the National Institute of Mental Health (F32 MH097354) awarded to Catherine R. Glenn and a MacArthur Fellowship awarded to Matthew K. Nock. We thank Daniel Coppersmith, Sima Shabaneh, and Suzanne Shdo for their assistance reviewing the relevant literature for this manuscript.
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- self-injurious thoughts and behaviors, suicidal ideation, non-suicidal self-injury, youth, psychosocial interventions, treatment efficacy, family skills training, parent training, contingency management, emotion regulation, problem solving, children and adolescents
- MeSH terms
- Adolescent, Behavior Therapy, Child, Humans, Randomized Controlled Trials as Topic, Self-Injurious Behavior, Treatment Outcome, Evidence-Based Medicine, Suicidal Ideation
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