Psychologist speaking with teenage woman
© Valerii Honcharuk / inventory.adobe.com
Adolescents visiting A&E departments with self-harm are extra more likely to repeat self-harm and try suicide than matched controls. Many of those adolescents don’t obtain efficient follow-up care, regardless of this being a vital time of elevated threat for suicide. The Supporting Adolescents with Self-Hurt (SASH) examine responds to this hole by providing a rapid-response transient psychological intervention aiming to enhance outcomes for younger individuals in disaster.
How are we doing it?
We’re conducting a realistic randomized managed trial evaluating the clinical- and cost-effectiveness of the intervention in lowering repeat self-harm in comparison with therapy as ordinary (TAU). The trial is recruiting 144 adolescents who current to A&Es with self-harm or suicidal ideation with latest self-harm (inside 1 month).
Now we have recruited 33 psychological well being practitioners from CAMHS Pressing Care Groups to participate within the examine. Half of the recruited practitioners have been skilled within the new SASH Intervention, while the opposite half are persevering with to ship TAU. The practitioners ship the intervention or TAU to sufferers throughout recruitment who meet the eligibility standards and consent to participate within the trial.
The SASH Intervention
The SASH Intervention is three to 6 follow-up periods involving Therapeutic Evaluation, Enhanced Security Planning, and Resolution Targeted strategies:
- Dennis Ougrin’s Therapeutic Evaluation (2009) is a collaborative and person-centered method that engages younger individuals within the analysis of their psychological well being and self-harm difficulties. It prioritizes establishing a supportive alliance, exploring their narrative, and formulating a shared understanding of their self-harm.
- Enhanced Security Planning entails an in depth dialogue across the younger particular person’s strengths and sources, their most well-liked coping methods, potential obstacles to utilizing these coping methods, and collaboratively planning easy methods to overcome these obstacles ought to they come up.
- The Resolution Targeted method entails exploring the younger particular person’s hopes for the long run, imagining that desired state of affairs intimately, after which figuring out the attainable sources and strengths already current in reaching or working in the direction of these hopes. Specializing in the younger particular person’s strengths and options relatively than issues could assist refocus them on the positives relatively than negatives in life and thus could also be much less more likely to contemplate the trail of suicide.
In a non-randomized examine, Therapeutic Evaluation and fast scientific follow-up designed for adolescents presenting with self-harm have proven promising ends in lowering self-harm. Therapeutic Evaluation dramatically will increase engagement with follow-up care which is a key mechanism for lowering future self-harm: 83% attended the primary follow-up session. That is in keeping with a latest systematic evaluation in adults, whereby interventions which included therapeutic evaluation, security planning and fast follow-ups had been efficient in lowering self-harm habits in adults presenting with self-harm to the ED.
The first end result will likely be variety of self-harm episodes within the final month, measured 6 months after beginning the intervention, based mostly on the younger particular person’s self-report. We’re additionally measuring socio-demographics; melancholy, anxiousness and well-being scores; college attendance; experiences of care in A&E; and the therapeutic relationship as rated by the younger particular person.
We skilled the Intervention Practitioners in January 2023. Participant recruitment opened in Might 2023, at present we’ve got 16 members recruited.
The SASH examine is funded by the Kavli Belief.
The challenge will likely be led by Metropolis College of London.
- Principal Investigator: Professor Rose McCabe
- Co-Investigators: Dr Sally O’Keeffe, Dr Dennis Ougrin, Professor Stefan Priebe, Dr Peter Martin, Dr Yan Feng
- Analysis Fellow: Maria Lengthy
- Analysis Assistants: Josh Lee & Katherine Tallent