Group therapy for adolescents with repeated self harm: randomised controlled trial with economic evaluation

Area of Science:

• Mental Health
• Adolescent Psychology
• Clinical Trials

Background:

• Self harm is a significant concern in adolescents.
• Effective interventions for repeated self harm in young people are needed.
• Existing treatments require evaluation for efficacy and cost-effectiveness.

Purpose of the Study:

• To evaluate the effectiveness of a manual-based developmental group therapy program for adolescents with a history of self harm.
• To assess the cost-effectiveness of this group therapy intervention compared to routine care alone.
• To analyze secondary outcomes including self harm severity, mood, suicidal ideation, and global functioning.

Main Methods:

• A randomized controlled trial (RCT) involving 366 adolescents aged 12-17 with at least two self harm episodes in the past year.
• Participants were allocated to either group therapy plus routine care or routine care alone.
• Outcomes, including frequency and severity of self harm, were assessed at 6 months and 1 year. Cost analysis included health, social care, education, and justice sectors.

Main Results:

• No statistically significant difference in the frequency or severity of self harm between the group therapy and routine care groups at 6 months or 1 year.
• Overall improvements in self harm outcomes were observed in the entire cohort from baseline to follow-up.
• Total 1-year costs were higher in the group therapy arm (£21,781) versus routine care (£15,372), but this difference was not statistically significant.

Conclusions:

• The addition of the targeted group therapy program did not improve self harm outcomes for adolescents with repeated self harm.
• There was no evidence of cost-effectiveness for the group therapy intervention.
• The study suggests that routine care alone may yield better outcomes than anticipated, warranting further investigation into effective adolescent self harm interventions.