Specific psychological treatment versus treatment as usual in adolescents with self-harm: systematic review and meta-analysis

Crisis. 2011;32(2):74-80. doi: 10.1027/0227-5910/a000060.


Background: Despite recent advances in the understanding and treatment of self-harm, poor engagement with therapy remains a serious problem.

Aims: To investigate whether offering specific psychological treatment (SPT) leads to better engagement than offering treatment as usual (TAU) in adolescents who have self-harmed.

Methods: Data sources were identified by searching Medline, PsychINFO, EMBASE, and PubMed for randomized controlled trials comparing SPT versus TAU in adolescents presenting with self-harm.

Results: Seven studies met inclusion criteria, and six were entered into the meta-analysis. There was no statistically significant difference between the number of subjects not completing four or more sessions of an SPT (27.7%, 70/253) than TAU (43.3%, 106/245), RR = 0.71 (95% CI: 0.49-1.05).

Conclusions: Engaging adolescents with psychological treatment is necessary although not sufficient to achieve treatment goals. Further research is needed to develop tools for maximizing engagement.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adolescent
  • Cause of Death
  • Cross-Sectional Studies
  • Family Therapy / methods
  • Female
  • Goals
  • House Calls
  • Humans
  • Male
  • Motivation*
  • Patient Dropouts / psychology
  • Professional-Patient Relations
  • Psychotherapy / methods*
  • Randomized Controlled Trials as Topic
  • Self-Injurious Behavior / epidemiology
  • Self-Injurious Behavior / prevention & control*
  • Self-Injurious Behavior / psychology*
  • Suicidal Ideation
  • Suicide / prevention & control*
  • Suicide / psychology*
  • Suicide / statistics & numerical data