Skip to main content

Effectiveness of systemic family therapy versus treatment as usual for young people after self-harm: a pragmatic, phase 3, multicentre, randomised controlled trial

Cottrell, David J., Wright-Hughes, Alexandra, Collinson, Michelle, Boston, Paula, Eisler, Ivan, Fortune, Sarah, Graham, Elizabeth H., Green, Jonathan, House, Allan O., Kerfoot, Michael, and others. (2018) Effectiveness of systemic family therapy versus treatment as usual for young people after self-harm: a pragmatic, phase 3, multicentre, randomised controlled trial. The Lancet Psychiatry, 5 (3). pp. 203-216. ISSN 2215-0366. E-ISSN 2215-0374. (doi:10.1016/S2215-0366(18)30058-0)

PDF - Publisher pdf

Creative Commons Licence
This work is licensed under a Creative Commons Attribution 4.0 International License.
Download (207kB) Download (207kB)
[img]
PDF - Author's Accepted Manuscript
Restricted to Repository staff only

Creative Commons Licence
This work is licensed under a Creative Commons Attribution 4.0 International License.
Contact us about this Publication
[img]
MS Office Open XML (OOXML) - Author's Accepted Manuscript
Restricted to Repository staff only
Contact us about this Publication
[img]
Official URL
https://dx.doi.org/10.1016/S2215-0366(18)30058-0

Abstract

Background: Self-harm in adolescents is common and repetition occurs in a high proportion of these cases. Scarce evidence exists for effectiveness of interventions to reduce self-harm.

Methods: This pragmatic, multicentre, randomised, controlled trial of family therapy versus treatment as usual was done at 40 UK Child and Adolescent Mental Health Services (CAMHS) centres. We recruited young people aged 11–17 years who had self-harmed at least twice and presented to CAMHS after self-harm. Participants were randomly assigned (1:1) to receive manualised family therapy delivered by trained and supervised family therapists or treatment as usual by local CAMHS. Participants and therapists were aware of treatment allocation; researchers were masked. The primary

(n=415) or treatment as usual (n=417). Primary outcome data were available for 795 (96%) participants. Numbers of hospital attendances for repeat self-harm events were not significantly different between the groups (118 [28%] in the family therapy group vs 103 [25%] in the treatment as usual group; hazard ratio 1·14 [95% CI 0·87–1·49] p=0·33). Similar numbers of adverse events occurred in both groups (787 in the family therapy group vs 847 in the treatment as usual group).

Interpretation: For adolescents referred to CAMHS after self-harm, having self-harmed at least once before, our family therapy intervention conferred no benefits over treatment as usual in

reducing subsequent hospital attendance for self-harm. Clinicians are therefore still unable to recommend a clear, evidence-based intervention to reduce repeated self-harm in adolescents.

Item Type: Article
DOI/Identification number: 10.1016/S2215-0366(18)30058-0
Uncontrolled keywords: self-harm, family therapy, treatment
Subjects: B Philosophy. Psychology. Religion > BF Psychology
Divisions: Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Personal Social Services Research Unit
Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Centre for Health Services Studies
Depositing User: Eirini Saloniki
Date Deposited: 01 Feb 2018 10:43 UTC
Last Modified: 06 Feb 2020 04:17 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/65837 (The current URI for this page, for reference purposes)
Saloniki, Eirini-Christina: https://orcid.org/0000-0002-5867-2702
  • Depositors only (login required):

Downloads

Downloads per month over past year