Feasibility of Emotion Regulation Group Therapy for Adolescent Self-Harm

Karolinska Institutet21 enrolled

Overview

Deliberate self-harm (DSH) is a prevalent behaviour among adolescents but there is no current recommendation for an efficacious treatment. Emotion regulation group therapy (ERGT) is a brief treatment for DSH with a well-documented utility and feasibility in the adult population, and an adapted version for adolescents may provide equal benefits for adolescents, provided adjustments to prevent or decrease social contagion are present. Adaptations to ERGT will result in a 12 session long treatment for adolescents Emotion regulation group therapy for Adolescents (ERGT-A). A parallel parent group focused on strengthening parental skills will be given alongside ERGT-A (5 sessions) Method: A quantitative feasibility open trial (N=20) with pre, post and 1 month follow-up assessments will examine the feasibility, acceptability and preliminary effect of ERGT for adolescents. Feasibility measures include recruitment rate, proportion beginning treatment, attrition, treatment credibility and satisfaction, negative effects, and alliance. Preliminary effects measures include DSH, emotion regulation ability, anxiety and depression. Method: A qualitative interview study. Using thematic analysis to explore participants' experience of ERGT-A and parent group

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Eligibility

Sex: ALLMin age: 13 YearsMax age: 17 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. 13-17 years of age; 2. having engaged in deliberate self-harm (DSH)-behaviours ≥ 5 times the last year; 3. having engaged in ≥1 DSH episode during the past month; 4. having ongoing psychiatric treatment in the community; 5. having at least one caregiver or other significant adult, committed to participate in the parent program; and 6. stability of psychotropic medications Exclusion Criteria: 1. a diagnosis of psychotic, bipolar I disorder or severe social anxiety disorder (SAD); 2. ongoing substance dependence; 3. the presence of co-occurring psychiatric disorders that require immediate treatment; 4. having an autism spectrum disorder together with borderline intellectual disability or having an intellectual disability; 5. insufficient understanding of the Swedish language

Outcomes

Primary Outcomes

Feasibility measure, recruitment rate

Recruitment rate

Time frame: through study completion, an average of 1 year

Feasibility measures, proportion included

Proportion of participants invited to participate who accepts and is included (higher = better, min 0%- max 100%)

Time frame: through study completion, an average of 1 year

Feasibility measures, compliance

Compliance, no of sessions attended (\>50%), (higher = better, min 0-max 10)

Time frame: Pre-treatment to post-treatment (End of treatment, EOT) (12 weeks)

Feasibility measures, attrition

Attrition, percent of included participants who drops out of treatment (lower = better, min 0%- max 100%)

Time frame: Pre-treatment to post-treatment EOT (12 weeks)

Feasibility measures, client satisfaction

Mean score on Client satisfaction questionnaire\> 25 (higher= better, min 8-max 32)

Time frame: at post-treatment EOT (12 weeks)

Feasibility measures, negative effects of treatment

Low rating on Negative effects Questionnaire (lower= better, min 0-max 20)

Time frame: at post-treatment EOT (12 weeks)

Secondary Outcomes

Preliminary effect, self harm frequency EOT

Mean Deliberate self-harm frequency at post-treatment (min 0-max 100, lower=better)

Time frame: Pre-treatment to post-treatment (EOT) (12 weeks)

Preliminary effect, self harm frequency 1MFU

Mean Deliberate self-harm frequency at post-treatment and 1MFU lower than at post-treatment (min 0-max 100, lower=better)

Time frame: Post-treatment (EOT) to follow-up (4 weeks)

Preliminary effect, emotion dysregulation EOT

Mean difficulty in emotion regulation rating (DERS-16) at post-treatment lower than at pre-treatment (min 16, max 80, lower=better)

Time frame: Pre-treatment to post-treatment (EOT) (12 weeks)

Preliminary effect, emotion dysregulation 1MFU

Mean difficulty in emotion regulation rating (DERS-16) at 1MFU lower than at post-treatment (min 16, max 80, lower=better)