There are No Proven Psychosocial Therapies that Reduce Self-harming in Teens

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There are no psychosocial treatments or psychotherapeutic methods that are proven to effectively reduce thoughts and behaviors of self-harm in youth, according to a review of the scientific literature by a team of Harvard University psychologists publishing in the Journal of Clinical Child & Adolescent Psychology.

The researchers identified 29 studies published before June of 2013 that examined treatment interventions for suicidal or self-injurious thoughts and behaviors in children or adolescents. They then evaluated the studies using the evidence-based treatment evaluation criteria of the Journal of Clinical Child and Adolescent Psychology. They found that not a single intervention met the Level 1 standard for “well-established treatments.”

However, six types of treatment were found to be “probably efficacious” or “possibly efficacious” for reducing self-injurious thoughts and behaviors. “These treatments came from a variety of theoretical orientations,” noted the researchers, “including cognitive-behavioral, family, interpersonal, and psychodynamic theories.”

Since none of these methods were better than the others, the researchers speculated that the relative efficacy they did have was likely due to common elements among them. For example, most of the different therapeutic strategies involved skills training such as problem solving and emotional regulation, targeted interpersonal relationship dynamics, and included families in the therapy sessions. The strategies also tended to be relatively “intensive,” in that they involved multiple meetings per week with therapists.

Glenn, Catherine R., Joseph C. Franklin, and Matthew K. Nock. “Evidence-Based Psychosocial Treatments for Self-Injurious Thoughts and Behaviors in Youth.” Journal of Clinical Child & Adolescent Psychology 44, no. 1 (January 2, 2015): 1–29. doi:10.1080/15374416.2014.945211. (Abstract)

3 COMMENTS

  1. yes ‘evidence’ based, what does that mean? From how I see it only conversations with society, families and cutters helps…keep conversing,
    let people know you are vulnerable, how else can we all heal without opening up to one another. Do we really need another and another and another…study?

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  2. Kind of a misleading title, considering that some of the approaches did appear to have some effect.

    I’d also love to see the question of whether any pharmocological approach actually reduces this behavior (other than drugging the person to the point they are unable to act). What I know of the literature suggests the answer is “no.”

    —- Steve

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    • Especially that there’s no “placebo” for psychotherapy. They are all looking at some statistical noise and I’d not be surprised if there’s another study showing opposite results. The fact is that “therapy” only helps if the people involved actually get into some kind of normal human relationship (which is in essence forbidden for psychotherapists to do). Nothing to do with any fancy three-letter acronym of an even more fancy technique.
      “whether any pharmocological approach actually reduces this behavior”
      My guess is they enhance them. My guess is that any psychiatric intervention is likely to increase these behaviours as for most people it is a phase anyway – it’s called growing up and happens when people grow up in shitty circumstances. How about helping them with real problems?

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