Group problem-solving skills training for self-harm: randomised controlled trial
Open accessAbstract
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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Group psychotherapies reduced suicidal ideation in 5 of 10 studies and suicide in one study, but none reported reducing nonfatal suicide attempts.
“Group psychotherapies reduced suicidal ideation in 5/10 studies(100–109) and suicide in one,(100) but none reported reducing nonfatal suicide attempts (Table S3c).”
From Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review (2021) · cites this paper as [108]
The Results and the section ‘Outcome measures at baseline, post-assessment and follow-up’ report no significant difference in repeated self-harm between this trial’s group-therapy and usual-care arms. The paper does not establish the claim’s totals across ten studies or show that its intervention reduced suicidal ideation or suicide; those parts cannot be verified from this source. (LLM, conf=0.87)
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- Authors
- 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., & Arensman, E.
- Affiliations
- University College Cork (IE)
- Cork University Hospital (IE)
- National Suicide Research Foundation (IE)
- Health Service Executive (IE)
- Corresponding author
- McAuliffe, Carmel
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2014-05
- Volume
- 204
- Issue
- 5
- Pages
- 383-390
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2134401142
- Cited by
- 29
- References
- 43
- Citations by year
- 2026: 4 · 2025: 1 · 2024: 2 · 2023: 2 · 2021: 7 · 2020: 2 · 2019: 1 · 2018: 1 · 2017: 1 · 2016: 6 · 2015: 1 · 2014: 1
- FWCI
- 3.54
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Arrow@dit (Dublin Institute of Technology) (acceptedVersion)
- Cork Open Research Archive (University College Cork, Ireland) (submittedVersion)
- Lenus, The Irish Health Repository (Dr Steevens Hospital Library) (submittedVersion)
- Funders
- Health Research Board
- Health Service Executive
- University of Oxford
- Dormant Accounts Fund
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Health Professions › Speech and Hearing › Problem Solving Skills Development
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- self-harm, problem-solving training, group intervention, repeated self-harm, psychological functioning, social functioning, help-seeking, brief intervention, mental health services
- MeSH terms
- Adolescent, Adult, Female, Humans, Male, Mental Health Services, Middle Aged, Problem Solving, Psychotherapy, Group, Cognitive Behavioral Therapy, Self-Injurious Behavior, Treatment Outcome, Young Adult
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