Randomized trial of group therapy for repeated deliberate self-harm in adolescents

Objective: To compare group therapy with routine care in adolescents who ha d deliberately harmed themselves on at least two occasions within a year. M ethod: Single-blind pilot study with two randomized parallel groups that to ok place in Manchester, England. Sixty-three adolescents aged 12 through 16 years were randomly assigned to group therapy and routine care or routine care alone. Outcome data on suicide attempts were obtained without knowledg e of treatment allocation on all randomized cases (62/63 by direct intervie w) on average 29 weeks later, The primary outcomes were depression and suic idal behavior. Results: In intention-to-treat analyses, adolescents who had group therapy were less likely to be "repeaters" at the end of the study ( i.e., to have repeated deliberate self-harm on two or more further occasion s) than adolescents who had routine care (2/32 versus 10/31; odds ratio 6.3 ), but the confidence intervals for this ratio were wide (95% confidence in terval 1.4 to 28.7). They were also less likely to use routine care, had be tter school attendance, and had a lower rate of behavioral disorder than ad olescents given routine care alone. The interventions did not differ, howev er, in their effects on depression or global outcome. Conclusions: Group th erapy shows promise as a treatment for adolescents who repeatedly harm them selves, but larger studies are required to assess more accurately the effic acy of this intervention.