Specific psychological treatment versus treatment as usual in adolescents with self-harm: Systematic review and meta-analysis

Background: Despite recent advances in the understanding and treatment of self-harm, poor engagement with therapy remains a serious problem. Aims: To investigate whether offering specific psychological treatment (SPT) leads to better engagement than offering treatment as usual (TAU) in adolescents who have self-harmed. Methods: Data sources were identified by searching Medline, PsychINFO, EMBASE, and PubMed for randomized controlled trials comparing SPT versus TAU in adolescents presenting with self-harm. Results: Seven studies met inclusion criteria, and six were entered into the meta-analysis. There was no statistically significant difference between the number of subjects not completing four or more sessions of an SPT (27.7%, 70/253) than TAU (43.3%, 106/245), RR = 0.71 (95% CI: 0.49-1.05). Conclusions: Engaging adolescents with psychological treatment is necessary although not sufficient to achieve treatment goals. Further research is needed to develop tools for maximizing engagement.