Abstract
Background: Suicide is the leading cause of death in adolescents. Furthermore, up to one quarter of adolescents who self-harm will repeat self-harm within one year, highlighting the need for evidence-based prevention and treatment services. Mentalization Based Therapy (MBT) has yielded promising outcomes for individuals who self-harm, however to date only one study has examined MBT in adolescents, wherein the treatment protocol consisted of individual and family therapy. Currently, there has been no development or examination of MBT-A in a group format for adolescents.
 Methods/Design: The present study is a randomised controlled single blind feasibility trial that aims to (1) adapt the original explicit MBT introductory group manual for an adolescent population (MBT-Ai) and to (2) assess the feasibility of MBT-Ai through examination of consent rates, attendance, attrition and self-harm. Participants are adolescents presenting to Child and Adolescent Mental Health Services (CAMHS) with self-harming behaviors within the last 6 months. Young people will be randomised to a 12-week MBT-Ai group plus treatment as usual (TAU) or TAU alone. Participants will be assessed at baseline and at 12-, 24- and 36-weeks post-baseline.
 Discussion: This paper describes the development of a treatment manual and the protocol of a randomised controlled feasibility trial of MBT-Ai aimed at treating adolescents who self-harm. Further investigation of a full-scale trial will be necessary to instill benefits if pilot results suggest efficacy.
 Trial registration: NCT02771691
Highlights
Suicide is the leading cause of death in adolescents
In this paper we describe the development of a novel group-based Mentalization Based Therapy (MBT)-Ai programme and the methodology of the present study, a pilot randomised controlled trials (RCTs) comparing MBT-Ai plus treatment as usual (TAU) to TAU alone
Does receipt of Mentalization Based Treatment for Adolescents delivered as group therapy plus treatment as usual lead to reduced self-harm and crisis presentations compared to treatment as usual alone? 4
Summary
As we know that clinical CAMH services are stretched for resources, comparatively brief, group-based MBT-Ai could potentially increase access to treatment for young people who self-harm, translating into feasible practice. Adolescent Mentalization-Based Integrative Treatment Borderline Personality Disorder Borderline Personality Features Scale for Children Child and Adolescent Mental Health Services Child and Adolescent Mental Health Client Service Receipt Inventory Difficulties in Emotion Regulation Scale Experiences in Close Relationships Scale–Revised Child version Interpersonal Sensitivity Measure Mentalization Based Therapy Mentalization Based Treatment for Adolescents Mentalization Based Treatment for Adolescents – Group format Mentalization Based Treatment – Family Therapy Mentalization Based Treatment – Introductory National Health Service Research Assistant Revised Child Anxiety and Depression Scale Randomized Controlled Trial Reflective Functioning Questionnaire for Youths Risk-Taking and Self-Harm Inventory Standard Protocol Items: Recommendations for Interventional Trials Treatment as Usual.
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