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Psychological therapy reduces self-harm in adolescents

Posted on 04/03/2015
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Psychological therapy reduces self-harm in adolescents, according to a study led by the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London and published in the Journal of the American Academy of Child & Adolescent Psychiatry.

Suicide is the second leading cause of death in adolescents in the UK and self-harm represents the strongest predictor of suicide. In addition, the number of adolescents who present to A&E departments with self-harm is increasing. 

Despite advances in our understanding of self-harm and links between self-harm and suicide, progress in reducing suicide death rates has been elusive, with no substantive reduction in suicide death rates over the past 60 years. 

Most studies of psychological therapy have been unable to demonstrate its effectiveness in reducing self-harm in adolescents, often due to a lack of participants. This study, funded by the South London and Maudsley NHS Foundation Trust, is the first to demonstrate a reduction in self-harm, drawing on a sample of 19 studies with more than 2,000 adolescent participants.

Researchers found that psychological therapies led to a 5 per cent reduction in the risk of self-harm. The most effective of these included cognitive-behavioural therapy (CBT), dialectical behaviour therapy (DBT) and mentalisation-based therapy. 

There is currently not enough evidence to determine if any medicine is effective in reducing self-harm in adolescents.

Cognitive behavioural therapy and dialectical behaviour therapy are talking therapies that focus on how thoughts, beliefs and attitudes affect feelings and behaviour. They teach coping skills for dealing with different problems. DBT has been adapted to meet the particular needs of people who experience emotions very intensely. 

Mentalisation based therapy is a treatment which aims to improve mentalisation (the ability to understand behaviour in terms of mental states such as intentions) by focusing on the nature of the relationship between the therapist and the patient. 

Dr Dennis Ougrin, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), said: ‘Our findings indicate that psychological therapy should be made more available for adolescents with self-harm and more professionals should receive training and supervision in delivering this form of psychological therapy. 

‘Family involvement is crucial in achieving the positive effect of psychological treatment, so we urge that the whole family should be involved in treatment.’ 

Dr Ougrin added that future research should be aimed at identifying specific interventions that demonstrate similar effectiveness in reducing self-harm.

Notes to editors

For further media information please contact Jack Stonebridge, Press Officer, Institute of  Psychiatry, Psychology & Neuroscience, King’s College London on jack.stonebridge@kcl.ac.uk or 020 7848 5377. 

Paper reference: ‘Therapeutic Interventions for Suicide Attempts and Self-Harm in Adolescents: Systematic Review and Meta-Analysis.’ Dennis Ougrin, Troy Tranah, Daniel Stahl, Paul Moran, Joan Rosenbaum Asarnow. Published in the Journal of the American Academy of Child & Adolescent Psychiatry. International DOI: http://dx.doi.org/10.1016/j.jaac.2014.10.009

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