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Introduction
Self-harm is defined as self-injury or self-poisoning, irrespective of the presence of suicidal intent. It includes both non-suicidal self-injury and attempted suicide. The lifetime prevalence of self-harm is approximately 20% in young people. The initial assessment for self-harm should contain an evaluation of risk, a safety plan and a therapeutic element, which should be focused on understanding the nature of self-harm, instilling hope and linking young people with follow-up treatment. Dialectical Behaviour Therapy should be offered to young people with severe self-harm. School-based interventions, such as the Youth Aware of Mental Health programme could prevent self-harm in young people.
The event will be equivalent to 2.3/4hrs of CPD.
Content
This Workshop aims to: 1) review current views and evidence around the aetiology and epidemiology of teen suicide attempts and nonsuicidal self-injury (NSSI); 2) consider the issue of engaging teenagers in treatment; 3) teach the concepts of therapeutic assessment (TA) for teenagers presenting with suicide attempts and NSSI; 4) teach participants how to construct a TA diagram in practice, which forms the basis of TA, from which a range of possible “exits” derive; and 5) introduce how exits are created together with the adolescent using a range of evidence-based psychological interventions.
These objectives will be achieved through: 1) a theoretical teaching to introduce the concepts of TA; 2) films of TA in practice to demonstrate its use; 3) example scenarios from which participants develop and practice skills in constructing TA diagrams; and 4) individual practice to focus on specific “exit” strategies, such as CBT, motivational interviewing techniques, mentalization-based therapy, and others.
This Workshop teaches participants a new, manualized approach to the assessment of teenagers presenting with suicide attempts or NSSI. TA has been shown to improve attendance at follow-up in a multicentre randomized, controlled trial. The improved engagement was recently shown to continue after 2 years in a 2-year follow-up study.
Learning Objectives
By the end of the Workshop, participants will be competent in constructing TA diagrams and will understand how to derive exits from the diagrammatic cycle of maladaptive behaviours.
Training Modalities
Presentation, videos, individual self-practice.
Key References
OUGRIN, D., NG, A. V. & LOW, J. (2008). Therapeutic assessment based on cognitive-analytic therapy for young people presenting with self-harm: pilot study. Psychiatric Bulletin, 32, 423-426.
OUGRIN, D., TRANAH, T., LEIGH, E., TAYLOR, L. & ASARNOW, J. R. (2012a). Practitioner Review: Self-harm in adolescents. Journal of Child Psychology and Psychiatry, 53, 337-350.
OUGRIN, D., TRANAH, T., STAHL, D., MORAN, P. & ASARNOW, J. R. (2015). Therapeutic Interventions for Suicide Attempts and Self-Harm in Adolescents: Systematic Review and Meta-Analysis. Journal of the American Academy of Child & Adolescent Psychiatry, 54, 97-107.e102.
OUGRIN, D., ZUNDEL, T., KYRIAKOPOULOS, M., BANARSEE, R., STAHL, D. & TAYLOR, E. (2012b). Adolescents with suicidal and nonsuicidal self-harm: clinical characteristics and response to therapeutic assessment. Psychol Assess, 24, 11-20.
About the presenter
Dennis Ougrin is Professor of Child and Adolescent Psychiatry and Global Mental Health at Queen Mary University of London. He is a visiting professor at KCL.
Professor Ougrin graduated from a medical school in Ukraine in 1998 and came to England to undertake his post-graduate training. He completed his higher training in child and adolescent psychiatry at Guy's and Maudsley and is currently an honorary consultant child and adolescent psychiatrist at the Enhanced Treatment Service at South London and Maudsley NHS Foundation Trust. Professor Ougrin leads a programme of information exchange between the UK and Ukraine.
His main professional interests include prevention of Borderline Personality Disorder and effective interventions for self-harm in young people.
Professor Ougrin is the author of Therapeutic Assessment, a novel model of assessment for young people with self-harm. He also developed and tested an Intensive Community Care Service model for young people with severe psychiatric disorders called Supported Discharge Service. The model was evaluated in the first randomised controlled trial of any intensive community care service for young people in the UK. The results of the trial informed the development of intensive community care services in the UK and internationally. Professor Ougrin has expertise in conducting randomised controlled trials in the fields of psychological therapy and mental health service models.
Professor Ougrin also works on developing a modular psychotherapeutic intervention for self-harm and on understanding the pathophysiology of self-harm in young people. .
Who should attend
Clinicians who undertake self-harm assessments.