title: Group problem-solving skills training for self-harm: randomised controlled trial.
abstract: BACKGROUND
  Rates of self-harm are high and have recently increased. This trend and the repetitive nature of self-harm pose a significant challenge to mental health services.
  
  
  OBJECTIVE
  To determine the efficacy of a structured group problem-solving skills training (PST) programme as an intervention approach for self-harm in addition to treatment as usual (TAU) as offered by mental health services.
  
  
  METHODS
  A total of 433 participants (aged 18-64 years) were randomly assigned to TAU plus PST or TAU alone. Assessments were carried out at baseline and at 6-week and 6-month follow-up and repeated hospital-treated self-harm was ascertained at 12-month follow-up.
  
  
  RESULTS
  The treatment groups did not differ in rates of repeated self-harm at 6-week, 6-month and 12-month follow-up. Both treatment groups showed significant improvements in psychological and social functioning at follow-up. Only one measure (needing and receiving practical help from those closest to them) showed a positive treatment effect at 6-week (P = 0.004) and 6-month (P = 0.01) follow-up. Repetition was not associated with waiting time in the PST group.
  
  
  CONCLUSIONS
  This brief intervention for self-harm is no more effective than treatment as usual. Further work is required to establish whether a modified, more intensive programme delivered sooner after the index episode would be effective.
authors.affiliation: Carmel McAuliffe, BA, HDip, MPhil, MA, PhD, Health Service Executive South/National Suicide Research Foundation, Cork, and Department of Epidemiology & Public Health, University College Cork, Ireland; Breda C. McLeavey, BSc, MA, PhD, Health Service Executive South, Department of Psychiatry, Cork University Hospital, Ireland; Tony Fitzgerald, BSc, MSc, MS, ScD, Department of Epidemiology and Public Health, University College Cork, Ireland; Paul Corcoran, BSc, MSc, PhD, National Suicide Research Foundation, Cork, Ireland; Bernie Carroll, BSc, Louise Ryan, BSc, Health Service Executive West, St Joseph's Hospital, Limerick, Ireland; Brian O'Keeffe, BA, DipClinPsychol, Health Service Executive West, Tevere Day Hospital, Limerick, Ireland; Eva Fitzgerald, BA, HDipPsychol, Portia Hickey, BSc, Mary O'Regan, BA, MPhil, National Suicide Research Foundation, Cork, Ireland; Jillian Mulqueen, BA, Health Service Executive West, St Joseph's Hospital, Limerick, Ireland; Ella Arensman, MSc, PhD, National Suicide Research Foundation, and Department of Epidemiology & Public Health, University College Cork, Ireland.
authors.forename: Carmel
authors.initials: C
authors.lastname: McAuliffe
authors.forename: Breda C
authors.initials: BC
authors.lastname: McLeavey
authors.forename: Tony
authors.initials: T
authors.lastname: Fitzgerald
authors.forename: Paul
authors.initials: P
authors.lastname: Corcoran
authors.forename: Bernie
authors.initials: B
authors.lastname: Carroll
authors.forename: Louise
authors.initials: L
authors.lastname: Ryan
authors.forename: Brian
authors.initials: B
authors.lastname: O'Keeffe
authors.forename: Eva
authors.initials: E
authors.lastname: Fitzgerald
authors.forename: Portia
authors.initials: P
authors.lastname: Hickey
authors.forename: Mary
authors.initials: M
authors.lastname: O'Regan
authors.forename: Jillian
authors.initials: J
authors.lastname: Mulqueen
authors.forename: Ella
authors.initials: E
authors.lastname: Arensman
mesh_terms: D000293:Adolescent; D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services; D008875:Middle Aged; D011340:Problem Solving; D011615:Psychotherapy, Group / Q000379:methods*; D016728:Self-Injurious Behavior / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult