Manual-Assisted Cognitive-Behaviour Therapy (MACT): a Randomized Controlled Trial of a Brief Intervention With Bibliotherapy in the Treatment of Recurrent Deliberate Self-Harm

34 patients, aged between 16 & 50, seen after an episode of deliberate self-harm, with personality disturbance within the flamboyant cluster & a previous parasuicide episode, within the past 12 months, were randomly assigned to treatment with manual-assisted cognitive-behaviour therapy (MACT) (n=18) or treatment as usual (n=16). Assessment of clinical symptoms & social function were made at baseline & at 6 months. 32 patients were seen at follow-up & 10 patients in each group had a suicidal act during the 6 months. The rate of suicide acts per month was lower with MACT & self-rated depressive symptoms also improved. The treatment involved a mean of 2.7 sessions & the observed average cost of care was 46% less with MACT. (24 refs.)