scholarly journals A qualitative study of a blended therapy using problem solving therapy with a customised smartphone app in men who present to hospital with intentional self-harm

2017 ◽  
Vol 20 (4) ◽  
pp. 118-122 ◽  
Author(s):  
Craig Mackie ◽  
Nicole Dunn ◽  
Sarah MacLean ◽  
Valerie Testa ◽  
Marnin Heisel ◽  
...  
Keyword(s):  
Problem Solving ◽  
Qualitative Study ◽  
Smartphone App ◽  
Problem Solving Therapy ◽  
Self Harm

Developing interventions for prevention of self-harm for British South Asian women: A qualitative study

2016 ◽  
Vol 33 (S1) ◽  
pp. S600-S600
Author(s):  
N. Husain ◽  
F. Lunat ◽  
N. Gire ◽  
S. Bin Bilal Hafi ◽  
M.I. Husain ◽  
...  
Keyword(s):  
Problem Solving ◽  
Qualitative Study ◽  
South Asian ◽  
Health Professionals ◽  
Asian Women ◽  
Service Improvement ◽  
South Asian Women ◽  
Problem Solving Therapy ◽  
Culturally Adapted ◽  
Self Harm

IntroductionIt has been estimated that the global burden of suicide is a million deaths per year (WHO, 2014). Rates of self-harm in British South Asian (BSA) women are higher compared to their white counterparts. Limited evidence is available on effective preventative strategies and culturally sensitive interventions for these patients.ObjectiveTo understand common perceptions about self-harm, identify any barriers to accessing services and service improvement recommendations including appropriate interventions for BSA women.AimTo examine the views of health professionals on the culturally adapted problem solving therapy (C-MAP) in BSA women.MethodsThe design was a qualitative study using focus group discussion. This is part of a larger exploratory trial, to test a culturally adapted problem solving therapy (C-MAP) in British South Asian women who have a history of self-harm (Husain et al., 2011). Three focus groups were held with Asian lay members of the community, health professionals and service users. The data was analysed using a manual content analysis and indexing technique.ResultsResults showed lack of identification of self-harm by health professionals. Common self-harm methods reported were serious overdoses, use of household chemicals, burning and cutting. Lack of trust in GP s was one common reason for non-disclosure of self-harm behaviour. Need for increased awareness, working along with local Imams, better cultural sensitivity among health professionals and non-judgmental support were some solutions offered to address these barriers.ConclusionThe results of this study have provided insight into developing strategies to prevent and manage self-harm in British South Asian women.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Problem-solving therapy for people who present to hospital with self-harm: Zelen randomised controlled trial

2011 ◽  
Vol 199 (4) ◽  
pp. 310-316 ◽  
Author(s):  
Simon Hatcher ◽  
Cynthia Sharon ◽  
Varsha Parag ◽  
Nicola Collins
Keyword(s):  
Problem Solving ◽  
Randomised Controlled Trial ◽  
Usual Care ◽  
Controlled Trial ◽  
Effective Intervention ◽  
Number Needed To Treat ◽  
Problem Solving Therapy ◽  
Significant Difference ◽  
Self Harm ◽  
Randomised Controlled

BackgroundPresentations to hospital with self-harm are common, associated with suicide and have an increased mortality, yet there is no accepted effective intervention.AimsTo investigate whether problem-solving therapy would improve outcomes in adults presenting to hospital with self-harm, compared with usual care.MethodA Zelen randomised controlled trial was conducted in four district health boards in New Zealand. A second hospital presentation with self-harm at 1 year for all episodes, plus separate comparisons of first-time and repeat presentations at the index episode, were the a priori primary outcomes. The trial registration number was ACTRN12605000337673.ResultsIn an intention-to-treat analysis of all randomised patients (n = 1094) there was no significant difference at 12 months in the proportion of people who had presented again with self-harm when comparing all episodes (intervention 13.4%, usual care 14.1%; relative risk reduction RR = 0.05, 95% CI −0.28 to 0.30, P = 0.79) or where the index episode was the first episode (intervention 13.4%, usual care 9.4%, RR =–0.42, 95% CI −1.17 to 0.08, P = 0.37). Where the index episode was repeated self-harm, those who received therapy were less likely to present again with self-harm (intervention 13.5%, usual care 22.1%, RR = 0.39, 95% CI 0.07 to 0.60, number needed to treat 12, P = 0.03).ConclusionsProblem-solving therapy is not recommended for everyone who presents to hospital with self-harm. Among adults with a history of self-harm it may be an effective intervention.

scholarly journals The BEACON study: protocol for a cohort study as part of an evaluation of the effectiveness of smartphone-assisted problem-solving therapy in men who present with intentional self-harm to emergency departments in Ontario

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Simon Hatcher ◽  
Marnin Heisel ◽  
Oyedeji Ayonrinde ◽  
Julie K. Campbell ◽  
Ian Colman ◽  
...  
Keyword(s):  
Cohort Study ◽  
Problem Solving ◽  
Alcohol Use ◽  
Meaning In Life ◽  
Short Form ◽  
Randomised Trial ◽  
Cluster Randomised Trial ◽  
Problem Solving Therapy ◽  
Cluster Randomised ◽  
Self Harm

Abstract Background Patients who present to emergency departments after intentional self-harm are at an increased risk of dying by suicide. This applies particularly to men, who represent nearly two-thirds of those who die by suicide in Ontario. One way of potentially addressing this gap is to offer a course of blended problem-solving therapy, comprised of a brief course of evidence-based psychotherapy for individuals at risk for suicide, facilitated by the use of a patient-facing smartphone application and a clinician-facing “dashboard.” This approach has the potential to combine the benefits of face-to-face therapy and technology to create a novel intervention. Methods This is a cohort study nested within a larger pragmatic multicentre pre- and post-design cluster randomised trial. Suicidal ideation assessed by the Beck Scale for Suicide Ideation is the primary outcome variable. Secondary outcome measures include depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder 7-item scale), post-traumatic stress disorder (Primary Care PTSD Screen), health-related quality of life (EuroQol 5-dimension 5-level questionnaire), meaning in life (Experienced Meaning in Life Scale), perceived social supports (Multidimensional Scale of Perceived Social Support), alcohol use (Alcohol Use Disorders Identification Test), drug use (Drug Abuse Screening Test Short Form 10), problem-solving skills (Social Problem-Solving Inventory–Revised Short Form), and self-reported healthcare costs, as well as health service use measured using Ontario administrative health data. A process evaluation will also be conducted following study completion. Discussion The cohort study will test whether better adherence to the intervention results in better outcomes. The value of the cohort study design is that we can examine in more detail certain subgroups or other variables that are not available in the larger cluster randomised trial. This trial will aim to improve standards by informing best practice in management of men who self-harm and present to hospitals in Ontario. Trial registration ClinicalTrials.gov, NCT03473535. Registered on March 22, 2018.

scholarly journals The BEACON Study: Protocol for a cluster randomized controlled trial of a service to deliver smartphone-assisted problem-solving therapy compared to usual care in men who present with intentional self-harm to Emergency Departments in Ontario

2020 ◽  
Author(s):  
Simon Hatcher ◽  
Marnin Heisel ◽  
Oyedeji Ayonrinde ◽  
Julie Kathleen Campbell ◽  
Ian Colman ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Problem Solving ◽  
Health System ◽  
Usual Care ◽  
Emergency Departments ◽  
Controlled Trial ◽  
Problem Solving Therapy ◽  
Randomized Controlled ◽  
Self Harm ◽  
Cluster Randomized

Abstract Background Patients who present to Emergency Departments (ED) after intentional self-harm receive variable levels care in Ontario. Many are not assessed by a mental health professional following discharge from ED and do not receive psychological services available in the community as many of these services are not covered by the provincial health insurance. Patients who present with intentional self-harm to hospital are more likely to die by suicide and premature death by other means compared to the general population. This risk is elevated in men, who represent two-thirds of those who die by suicide in Ontario. One way of potentially addressing this gap is to offer problem-solving therapy (PST) designed specifically for men, facilitated by the use of a patient facing smartphone application and a clinician facing dashboard. This attempts to blend the use of face to face therapy and technology to create an effective intervention after self-harm.Methods This is a pragmatic, multicentre pre- and post-design cluster randomized controlled trial (cRCT) comparing the provision of a suicide prevention intervention to usual care, in men who present to the ED with self-harm. The study intervention is composed of: 1) staff education; 2) resource materials for men who present to the ED with self-harm; and, 3) the option to refer patients to a blended PST service for the treatment of self-harm. The primary outcome to be assessed is a composite of the incidence of suicides and/or re-presentations to any ED in Ontario for self-harm in the year after presentation with self-harm. Secondary outcome measures include: total number of suicides; re-presentations to any ED in Ontario for the repetition of self-harm; re-presentations to any ED in Ontario for any reason; other health system use including use of primary care and hospital outpatient appointments; mortality not related to suicide; and, health system costs over one year. All outcomes will be measured from provincial health administrative databases available at the Institute for Clinical and Evaluative Sciences (IC/ES).

scholarly journals The efficacy of problem-solving treatments after deliberate self-harm: meta-analysis of randomized controlled trials with respect to depression, hopelessness and improvement in problems

2001 ◽  
Vol 31 (6) ◽  
pp. 979-988 ◽  
Author(s):  
E. TOWNSEND ◽  
K. HAWTON ◽  
D. G. ALTMAN ◽  
E. ARENSMAN ◽  
D. GUNNELL ◽  
...  
Keyword(s):  
Problem Solving ◽  
Randomized Controlled Trials ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Control Treatment ◽  
Controlled Trials ◽  
Problem Solving Therapy ◽  
Deliberate Self Harm ◽  
Randomized Controlled ◽  
Self Harm

Background. Brief problem-solving therapy is regarded as a pragmatic treatment for deliberate self-harm (DSH) patients. A recent meta-analysis of randomized controlled trials (RCTs) evaluating this approach indicated a trend towards reduced repetition of DSH but the pooled odds ratio was not statistically significant. We have now examined other important outcomes using this procedure, namely depression, hopelessness and improvement in problems.Method. Six trials in which problem-solving therapy was compared with control treatment were identified from an extensive literature review of RCTs of treatments for DSH patients. Data concerning depression, hopelessness and improvement in problems were extracted. Where relevant statistical data (e.g. standard deviations) were missing these were imputed using various statistical methods. Results were pooled using meta-analytical procedures.Results. At follow-up, patients who were offered problem-solving therapy had significantly greater improvement in scores for depression (standardized mean difference =−0·36; 95% CI −0·61 to −0·11) and hopelessness (weighted mean difference =−3·2; 95% CI −4·0 to −2·41), and significantly more reported improvement in their problems (odds ratio = 2·31; 95% CI 1·29 to 4·13), than patients who were in the control treatment groups.Conclusions. Problem-solving therapy for DSH patients appears to produce better results than control treatment with regard to improvement in depression, hopelessness and problems. It is desirable that this finding is confirmed in a large trial, which will also allow adequate testing of the impact of this treatment on repetition of DSH.

Sign in / Sign up

Export Citation Format

Share Document