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Randomized Controlled Trial
. 2020 Jun;29(6):881-891.
doi: 10.1007/s00787-019-01399-1. Epub 2019 Sep 11.

Effectiveness of a brief psychotherapeutic intervention compared with treatment as usual for adolescent nonsuicidal self-injury: a single-centre, randomised controlled trial

Michael Kaess  1   2 , Alexandra Edinger  3 , Gloria Fischer-Waldschmidt  4 , Peter Parzer  4 , Romuald Brunner  5 , Franz Resch  4
Affiliations
Randomized Controlled Trial

Effectiveness of a brief psychotherapeutic intervention compared with treatment as usual for adolescent nonsuicidal self-injury: a single-centre, randomised controlled trial

Michael Kaess et al. Eur Child Adolesc Psychiatry. 2020 Jun.

Abstract

Although nonsuicidal self-injury (NSSI) is a clinically significant behavior, evidence-based, specific, time-, and cost-effective treatment approaches are lacking. The aim of this study was to compare the efficacies of a brief cognitive-behavioral psychotherapy manual, the Cutting Down Programme (CDP), and treatment as usual (TAU) in the treatment of adolescent NSSI. We conducted a single-centre randomised controlled trial (RCT). Eligible participants were aged 12-17 years engaging in repetitive NSSI (at least 5 times within the past 6 months). We randomly allocated 74 participants to CDP (n = 37) or TAU (n = 37; in a 1:1 ratio). Outcome measures were administered before treatment (T0), directly after CDP or 4 months after baseline evaluation in the TAU group (T1), and another 6 months later (T2; primary endpoint). Primary outcome was a 50% reduction in NSSI frequency within the past 6 months at 10-month follow-up (T2). Regarding the primary outcome, there were no significant differences between the CDP (n = 26; 70.3%) and TAU group [n = 27; 73.0%; χ2(1) = 0.07; p = 0.797]; NSSI frequency within the past 6 months was significantly reduced at T2 [χ2(1) = 12.45; p < 0.001] with no between-group difference [χ2(1) = 0.14; p = 0.704]. However, we found a significant group x point of measurement interaction [χ2(2) = 7.78; p = 0.021] regarding NSSI within the last month indicating at T1. CDP was equally effective and achieved faster recovery compared to a significantly more intensive TAU in treating adolescent NSSI. The CDP could provide a brief and pragmatic first treatment within a stepped-care model for NSSI in routine clinical care.Clinical Trial Registration The trial was prospectively registered in the German Registry of Clinical Trials (https://www.drks.de; DRKS00003605) and is now complete.

Keywords: Adolescents; Nonsuicidal self-injury; Psychotherapy; Randomised controlled trial.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

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Study design
Fig. 2
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Trial profile
Fig. 3
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Secondary outcomes: change of NSSI frequencies within the last month, suicide attempts, quality of life, and depression
See this image and copyright information in PMC

References

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