Abstract
BackgroundPeople who self-harm are at high risk for future suicide and often suffer considerable emotional distress. Depression is common among people who self-harm and may be an underlying driver of self-harm behaviour. Self-harm is often repeated, and risk of repetition is highest immediately after an act of self-harm. Readily accessible brief talking therapies show promise in helping people who self-harm, but further evaluation of these approaches is needed. A brief talking therapy intervention for depression and self-harm has been designed for use in a community setting. This mixed methods feasibility study with repeated measures will examine the feasibility and acceptability of the Community Outpatient Psychological Engagement Service for Self-Harm (COPESS) for people with self-harm and depression in the community, compared to routine care.MethodsSixty participants with a history of self-harm within the last six months, who are also currently depressed, will be recruited to take part in a feasibility single-blind randomised controlled trial (RCT). Participants will be randomised 1:1 to receive COPESS plus treatment as usual (TAU) or TAU alone. Recruitment will be via General Practitioners (GP) and self-referral. Assessment of feasibility and acceptability will be assessed via quantitative and qualitative methods including measures of recruitment and retention to the feasibility trial, participants’ experience of therapy, completion/completeness of outcome measures at relevant time-points and completion of a service use questionnaire.DiscussionThe results will indicate whether it is feasible to conduct a definitive full trial to determine whether COPESS is a clinically and cost effective intervention for people who self-harm in the community. Qualitative and quantitative data will in addition help identify potential strengths and/or challenges of implementing brief community-based interventions for people who self-harm.Trial registrationNCT04191122 registered 9th December 2019.
Highlights
People who self-harm are at high risk for future suicide and often suffer considerable emotional distress
Talking therapies that target the psychological processes underlying self-harm have been shown to reduce repetition of self-harm [25,26,27] and depressive symptoms [27, 28], and there is some evidence that cognitive behavioural therapy (CBT) and psychodynamic interpersonal therapy (PIT) were effective in reducing some selfharm behaviours in the short-term [28]
The aim of this study is to examine the feasibility and acceptability of delivering the Community Outpatient Psychological Engagement Service for Self-Harm (COPESS) intervention in a community setting, as well as to assess the feasibility and acceptability of the trial procedures themselves, with a view to future implementation in a full-scale efficacy trial
Summary
Sixty participants with a history of self-harm within the last six months, who are currently depressed, will be recruited to take part in a feasibility single-blind randomised controlled trial (RCT). Participants will be randomised 1:1 to receive COPESS plus treatment as usual (TAU) or TAU alone. Recruitment will be via General Practitioners (GP) and self-referral. Assessment of feasibility and acceptability will be assessed via quantitative and qualitative methods including measures of recruitment and retention to the feasibility trial, participants’ experience of therapy, completion/completeness of outcome measures at relevant time-points and completion of a service use questionnaire
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