Fife, S; Blumenfeld, F; Williams, C; Wood, L; (2019) A feasibility study highlighting challenges in evaluating a structured, psychological treatment for self-harm in adult psychiatric inpatient settings. Psychiatry Research , 282 , Article 112609. 10.1016/j.psychres.2019.112609.

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Abstract

BACKGROUND: Despite being the most common reason for admission to psychiatric inpatient services, no evidence-based treatment currently exists for self-harm in this setting. Dialectical Behavioural Therapy (DBT) trials have found promising results in treating self-harm in outpatient settings; however findings for inpatient settings are still limited. METHOD: A single-arm feasibility trial was conducted examining a DBT-informed 'Coping with Crisis' (CwC) group protocol, which focused on self-harm and crisis management strategies. Twenty-four participants were recruited from an inpatient ward in a National Health Service (NHS) Trust in the UK. The Inventory of Statements about Self-Injury and Distress Tolerance Scale were administered at baseline and post-therapy. Data was collected on the rates of recruitment, retention, session attendance, outcome measure completion, adverse events and participant feedback, in order to inform the design of a main study. RESULTS: Findings indicated that it was feasible to run the CWC group and research study on an inpatient ward. However, there were several challenges in recruiting to target (80% achieved) and retaining participants (38% of consented participants completed). A number of implementation issues were identified and recommendations have been made to inform future group and study designs.

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