An evaluation of the efficacy of promoting the use of problem focused coping skills in repetitive deliberately self-harming adolescents

Only rarely is it necessary to detain a troubled adolescent under the Mental Health Act (1983). Frequently the more disturbed adolescents will be placed in specialist adolescent secure inpatient facilities. Many of these young people present a primary risk to themselves in the form of serious self harm and potential suicide. The present research project seeks to investigate the therapeutic value of teaching problem focussed coping skills to deliberately self-harming adolescents.;The six individual participants included in the project show a mixed response to the intervention. Three participants demonstrate a good response to the intervention as measured by frequency of self harm. However, follow-up data on one of these participants suggests a relapse of self harm after the end of the intervention. Psychometric measures of symptomatology show very limited convergence with reduction in self harm. However, assessment of coping responses at pre and post intervention suggests that the observed reduction in frequency of self harm is associated with the development of more adaptive coping responses. Of the remaining three participants, two fail to demonstrate a response to the intervention, and the third failed to engage in the intervention.;The limitations of attempting to evaluate a specific and relatively discrete intervention in the case of complex and challenging patients are discussed. However, the results suggest that coping skills interventions are a necessary and vital component of an effective therapeutic programme for self harming adolescents and further refinement and integration with other therapeutic modalities may substantially improve the prognosis for some of our societies most damaged young people.