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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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“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]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“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
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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]
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“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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“Comprehensive meta-analytic [22, 23] and systematic review [24, 25, 26] studies published in the past decade high-light existing interventions for youth with suicidal ideation or behavior that vary in treatment modality, targets, as well as evidence base supporting their effectiveness.”
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“The formalised risk reduction approach is what is mainly explored in the literature (Edwards et al., 2024; Glenn et al., 2015), but we need more contextualised, in depth, clinically informed ideas, given that adolescent mental health has become a top policy priority in the UK and internationally…”
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“6,7 Unlike many risk factors for adolescent suicide (e.g. past history of trauma, temperament, biological sex 8,9 ), which are difficult or impossible to modify, parenting behaviours are amenable to change.”
Étude qualitative de l’expérience des parents après la tentative de suicide de leur adolescent
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Pilot Study: Cut the Cut—A Treatment Program for Adolescent Inpatients with Nonsuicidal Self-Injury
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“Also it will teach the adolescents to focus on affect stabilization and alternative strategies to NSSI, while regression into negative affective states on the inpatient unit will reduce [21].”
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Suicide and Suicide Attempts During Adolescence
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Metadata
- 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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