Pooja Saini, Anna Hunt, Caroline Clements, Mark Gabbay, Catherine Mills, Kari Kvamme-Mitchell, Naheed Tahir, Helen Mulholland, Cecil Kullu, Mark Hann, Rui Duarte, Andrea Murphy, Else Guthrie, Peter Taylor
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引用次数: 0
Abstract
Background: Self-harm is widespread and often occurs in the community without resulting in hospital presentation. Individuals with depressive symptoms are at elevated risk. There are limited self-harm interventions designed for community and primary care settings. The Community Outpatient Psychological Engagement Service for Self-harm (COPESS) is a brief talking therapy intervention for self-harm based in community settings.
Aims: To assess the feasibility of evaluating the COPESS intervention in a community setting in relation to participant recruitment, retention, data collection and the acceptability of the intervention.
Method: We used a mixed-method approach and a single-blind randomised controlled trial design with 1:1 allocation to either COPESS plus treatment as usual or treatment as usual alone. Adults with depressive symptoms and self-harm in the past 6 months were recruited from general practices. Secondary outcome measures were assessed at baseline and 1 month, 2 months and 3 months after randomisation. The trial was pre-registered on clinicaltrials.gov (NCT04191122) on 9 December 2019.
Results: Fifty-five people were randomised (of an initial target of 60). Retention rates at follow-up assessments were high (>75%), as was attendance by all participants for all therapy sessions (93%). At 3 months, there were trends towards lower levels of self-harm urges, depressive symptoms and distress in the COPESS group compared with controls. Fidelity to the manualised COPESS therapy was moderate to high.
Conclusions: All progression criteria were met, supporting further evaluation of the intervention in a full-scale efficacy and/or cost-effectiveness trial. These findings add to the growing evidence base supporting the utility of brief psychological interventions for self-harm. COPESS has potential as a brief primary-care-based intervention for those struggling with self-harm.
期刊介绍：
Announcing the launch of BJPsych Open, an exciting new open access online journal for the publication of all methodologically sound research in all fields of psychiatry and disciplines related to mental health. BJPsych Open will maintain the highest scientific, peer review, and ethical standards of the BJPsych, ensure rapid publication for authors whilst sharing research with no cost to the reader in the spirit of maximising dissemination and public engagement. Cascade submission from BJPsych to BJPsych Open is a new option for authors whose first priority is rapid online publication with the prestigious BJPsych brand. Authors will also retain copyright to their works under a creative commons license.
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