Recommendation ID
Clinical and cost effectiveness of psychological therapy:- with problem-solving elements for people who self-harm:- For people who have self-harmed, does the provision of a psychological therapy with problemsolving elements, compared with treatment as usual, improve outcomes? What is the differential effect for people with a past history of self-harm, compared with people who self-harm for the first time? This question should be answered using a well-conducted randomised controlled trial. Consider six sessions of psychological therapy with problem-solving elements, delivered immediately after discharge for the index episode of self-harm. The therapist should be trained and experienced in working with people who self-harm. Participants' history of previous self-harm, methods used and psychiatric history should be noted. Primary outcomes should include both hospital-reported and self-reported repetitions of self-harm. Other important outcomes, such as quality of life, depressive symptoms, service users' experience and adverse events (for example, distress or exacerbation of symptoms associated with therapy) should be included. The study design should take into account the complex motives that underpin self-harm. Studies need to be large enough to determine the intervention's costs and cost effectiveness.
Any explanatory notes
(if applicable)
Why this is important:- Although review of the research evidence suggests that psychological therapy with problem solving elements offers promise, it is not clear which components are the active ingredients of any such intervention, or whether such an intervention is effective for people with a past history of self-harm compared with those who have self-harmed for the first time. Further, only a few studies have looked at a broad range of outcomes for different populations who self-harm.

Source guidance details

Comes from guidance
Self-harm in over 8s: long-term management
Date issued
November 2011

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No