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More self-harm episodes in teens in group therapy.

HONOLULU -- Investigators in Australia have found that group psychotherapy significantly increases the chance that an adolescent who has engaged in deliberate self-harm will repeat that behavior, according to a randomized controlled trial of 72 individuals.

The result contradicts an earlier British study that appeared to show that this group-based intervention significantly decreased self-harm. The intervention, which is described in a detailed treatment manual, involves six sessions of cognitive-behavioral therapy (CBT), social skills training, interpersonal psychotherapy, and group psychotherapy (J. Am. Acad. Child Adolesc. Psychiatry 2001;40: 1246-53).

At the annual meeting of the American Academy of Child and Adolescent Psychiatry, Philip L. Hazell, Ph.D., of the University of Sydney, described his recent attempt at replicating that earlier study. Adolescents between the ages of 12 and 16 years with at least two reported episodes of self-harm within the past year were included in his study.

The teens were randomized in a single-blind fashion to either routine care or to the group therapy. Routine care typically involved individual counseling, family sessions, and medication assessment.

The group therapy was delivered by qualified psychologists, clinical psychologists, social workers, or nurses who were experienced in group therapy and CBT with adolescents (J. Am. Acad. Child Adolesc. Psychiatry 2009;48:662-70). Participants in the study averaged 14.6 years of age, and 90% were female.

Outcome data were available for 68 of the 72 participants. Six months after the intervention, 88% of the participants in the experimental group and 68% in the routine-care group had engaged in some form of self-harm. The earlier studies were included in a review by the Cochrane Collaboration (The Cochrane Library 2001; 2). Dr. Hazell said an update of the Cochrane review is under way.


Major Finding: At 12 months, 88% of participants in a group-based intervention had engaged in some form of self-harm, compared with 71% of participants in routine care.

Data Source: Randomized, single-blind trial of 72 teens with at least two episodes of self-harm in a year.

Disclosures: The study was supported by the American Foundation for Suicide Prevention. Dr. Hazell said he receives research funding from Celltech and Eli Lilly & Co.; serves as a consultant to Eli Lilly, Janssen-Cilag, Novartis, and Shire Pharmaceuticals; and participates in the speakers bureaus of Eli Lilly, Janssen-Cilag, and Pfizer Inc.
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Author:Finn, Robert
Publication:Clinical Psychiatry News
Date:Jan 1, 2010
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