Cognitive-behavioural therapy for deliberate self-harm

Slee, N. (2008)

Doctoral Thesis

This thesis describes the outcomes of a randomized controlled trial of a Cognitive Behavioural Therapy (CBT) intervention for patients who engage in Deliberate Self-Harm (DSH). The CBT intervention was designed to supplement usual care following an episode of DSH. The study involved 90 people (95% females), aged 15–35 years, who were randomly assigned to CBT in addition to treatment as usual (TAU) or to treatment as usual only. The main study hypothesis, that CBT in addition to TAU would be more effective in reducing repetition of DSH than TAU only, was supported. Furthermore, those who received CBT in addition to TAU were shown to have significantly greater reductions in depression, anxiety and suicidal cognitions, and significantly greater improvements in self-esteem and problem solving ability. It is reasonable to assume that these positive findings are attributable to the effect of the CBT, given the random assignment as well as the absence of between group differences with respect to demographics, DSH, history of DSH, psychopathology and use of health care services. It is encouraging that these results are found for people with recurrent and chronic DSH, with high risk of repetition, and with high levels of psychiatric co-morbidity.

• Deliberate self-harm
• Cognitive-behavioural therapy
• Randomized controlled trial
• Treatment outcome
• Mediation
• Emotion regulation
• Suicide cognitions
• Childhood abuse

• All authors: Slee, N.
• Supervisor: Spinhoven, P.; Garnefski, N.; Arensman, E.
• Qualification: Doctor (dr.)
• Awarding Institution: Faculty of Social and Behavioural Sciences, Leiden University
• Date: 2008-04-24
• Court: LEI Universiteit Leiden
• Sponsorship: Support for the study was provided by The Netherlands Organisation for Health Research and Development (ZonMw) (contract grant number: 2100.0068).