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Psychosocial interventions for people who self-harm: Methodological issues involved in trials to evaluate effectiveness

Witt, Katrina; Townsend, Ellen; Arensman, Ella; Gunnell, David; Hazell, Philip; Salisbury, Tatiana Taylor; Van Heeringen, Kees; Hawton, Keith


Katrina Witt

Ella Arensman

David Gunnell

Philip Hazell

Tatiana Taylor Salisbury

Kees Van Heeringen

Keith Hawton


We have assessed the methodological quality of randomized controlled trials (RCTs) of interventions to prevent self-harm repetition and suicide. Trials were identified in two systematic reviews of RCTs of psychosocial treatments following a recent (within six months) episode of self-harm indexed in any of five electronic databases (CCDANCTR-Studies and References, CENTRAL, Medline, Embase, and PsycINFO) between 1 January, 1998 and 29 April, 2015. A total of 66 trials were included, 55 in adults and 11 in children and adolescents. While evidence for efficacy of some approaches has grown, there were few trials from low-to-middle income countries, little information on interventions for males, information on the control condition was often limited, data on suicides were often not reported, and, while trials have increased in size in recent years, most have included too few participants to detect clinically significant results. There are major limitations in many trials of interventions for individuals who self-harm. Improved methodology, especially with regard to study size, provision of details of control therapy, and evaluation of key outcomes, would enhance the evidence base for clinicians and service users.


Witt, K., Townsend, E., Arensman, E., Gunnell, D., Hazell, P., Salisbury, T. T., …Hawton, K. (2020). Psychosocial interventions for people who self-harm: Methodological issues involved in trials to evaluate effectiveness. Archives of Suicide Research, 24(sup2), S32-S93.

Journal Article Type Article
Acceptance Date Mar 6, 2019
Online Publication Date Apr 7, 2019
Publication Date 2020
Deposit Date Mar 28, 2019
Publicly Available Date Apr 8, 2020
Journal Archives of Suicide Research
Print ISSN 1381-1118
Electronic ISSN 1543-6136
Publisher Routledge
Peer Reviewed Peer Reviewed
Volume 24
Issue sup2
Pages S32-S93
Keywords Clinical Psychology; Psychiatry and Mental health
Public URL
Publisher URL
Additional Information This is an Accepted Manuscript of an article published by Taylor & Francis in Archives of Suicide Research on 7 April 2019, available online:


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