Randomised controlled trial of a brief theory-based online intervention to reduce self-harm

Chris Keyworth, Jessica Leather, Leah Quinlivan, Rory O'Connor, C J Armitage

Research output: Contribution to journalArticlepeer-review

Abstract

Background
Forming ‘if-then’ plans has been shown to reduce self-harm among people admitted to hospital following an episode of self-harm.

Aims
To explore whether the same intervention, delivered online, could prevent future self-harm among a large community sample who had previously self-harmed.

Method
UK adults were recruited to a randomised controlled trial and received either an intervention to reduce self-harm or one to reduce sedentariness (control group). Randomisation was stratified to ensure both groups were representative of the UK population. There were three primary outcomes: non-suicidal self-injury (NSSI), suicidal ideation and suicide attempts, assessed at baseline and 6 months post-intervention.

Results
Participants (1040) were randomised to the intervention (n = 520) or control (n = 520) group. The vast majority of people formed implementation intentions in both the experimental (n = 459 (88.3%)) and control (n = 520 (100%)) condition. Overall, the intervention did not significantly reduce the frequency of NSSI, suicidal ideation or suicide attempts. Among people who had self-harmed in the past week at follow-up, mixed analysis of covariance revealed a significant interaction between time and condition for reflective motivation, F(1,102) = 7.08, P < 0.01, pn2 = 0.07, such that significantly lower levels of reflective motivation were reported at follow-up in the control condition, t(57) = 2.42, P = 0.02.

Conclusions
This web-based intervention has limited utility for reducing self-reported self-harm or suicidal ideation in adults with a history of self-harm. Further work is needed to improve the effectiveness of brief interventions for self-harm aimed at adults living in the community and to understand the conditions under which the intervention may or may not be effective.
Original languageEnglish
JournalBJ Psych Open
Volume11
Issue number2
DOIs
Publication statusPublished - 19 Mar 2025

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