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Preliminary evaluation of an intensive integrated individual and family therapy model for self-harming adolescents

Wijana, Moa Bråthén ; Enebrink, Pia ; Liljedahl, Sophie I. LU and Ghaderi, Ata (2018) In BMC Psychiatry 18(1).
Abstract

BACKGROUND: To investigate the outcome of an integrated individual and family therapy (Intensive Contextual Treatment: ICT) in terms of reducing suffering and increasing functional adjustment among self-harming and/or suicidal adolescents with high symptom loads and their families. METHODS: Forty-nine self-harming and/or suicidal adolescents, Mage = 14.6, of predominantly Swedish origin and female gender (85.7%) participated with their parents. The study had a within group design with repeated measures at pre- and post-treatment, as well as six- and twelve-months follow-ups. Self-reports were used for the main outcomes; self-harm rates, suicide attempts, parent-reported days of inpatient/institutional care, internalized and externalized... (More)

BACKGROUND: To investigate the outcome of an integrated individual and family therapy (Intensive Contextual Treatment: ICT) in terms of reducing suffering and increasing functional adjustment among self-harming and/or suicidal adolescents with high symptom loads and their families. METHODS: Forty-nine self-harming and/or suicidal adolescents, Mage = 14.6, of predominantly Swedish origin and female gender (85.7%) participated with their parents. The study had a within group design with repeated measures at pre- and post-treatment, as well as six- and twelve-months follow-ups. Self-reports were used for the main outcomes; self-harm rates, suicide attempts, parent-reported days of inpatient/institutional care, internalized and externalized symptoms, perceived stress, emotion regulation, school hours and adjustment. Secondary outcomes were levels of reported expressed emotions within family dyads, as well as parental anxiety, depression and stress. RESULTS: From pre- to post-assessment, the adolescents reported significant reductions of self-harm (p = .001, d = 0.54) and suicide attempts (p < .0001, d = 1.38). Parent-reported days of inpatient/institutional care were reduced, as well as parent- and adolescent-reported internalizing and externalizing symptoms. Furthermore, school attendance and adjustment were improved, and the adolescents reported experiencing less criticism while parents reported less emotional over-involvement. The results were maintained at follow-ups. CONCLUSIONS: The adolescents and the parents reported improvements for the main outcomes. This treatment appears promising in keeping the families in treatment and out of hospital, suggesting that an integrative approach may be beneficial and feasible for this group. TRIAL REGISTRATION: This study has been approved 19/12 2011, by the regional review board in Stockholm (Dnr 2011/1593-31/5).

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Adolescents, Family therapy, Intervention, Self-harm, Suicide
in
BMC Psychiatry
volume
18
issue
1
article number
371
publisher
BioMed Central (BMC)
external identifiers
  • pmid:30477463
  • scopus:85057258302
ISSN
1471-244X
DOI
10.1186/s12888-018-1947-9
language
English
LU publication?
yes
id
bde6e4d6-a65c-45e7-8152-7542dc730608
date added to LUP
2018-12-03 13:41:35
date last changed
2020-01-13 01:14:43
@article{bde6e4d6-a65c-45e7-8152-7542dc730608,
  abstract     = {<p>BACKGROUND: To investigate the outcome of an integrated individual and family therapy (Intensive Contextual Treatment: ICT) in terms of reducing suffering and increasing functional adjustment among self-harming and/or suicidal adolescents with high symptom loads and their families. METHODS: Forty-nine self-harming and/or suicidal adolescents, Mage = 14.6, of predominantly Swedish origin and female gender (85.7%) participated with their parents. The study had a within group design with repeated measures at pre- and post-treatment, as well as six- and twelve-months follow-ups. Self-reports were used for the main outcomes; self-harm rates, suicide attempts, parent-reported days of inpatient/institutional care, internalized and externalized symptoms, perceived stress, emotion regulation, school hours and adjustment. Secondary outcomes were levels of reported expressed emotions within family dyads, as well as parental anxiety, depression and stress. RESULTS: From pre- to post-assessment, the adolescents reported significant reductions of self-harm (p = .001, d = 0.54) and suicide attempts (p &lt; .0001, d = 1.38). Parent-reported days of inpatient/institutional care were reduced, as well as parent- and adolescent-reported internalizing and externalizing symptoms. Furthermore, school attendance and adjustment were improved, and the adolescents reported experiencing less criticism while parents reported less emotional over-involvement. The results were maintained at follow-ups. CONCLUSIONS: The adolescents and the parents reported improvements for the main outcomes. This treatment appears promising in keeping the families in treatment and out of hospital, suggesting that an integrative approach may be beneficial and feasible for this group. TRIAL REGISTRATION: This study has been approved 19/12 2011, by the regional review board in Stockholm (Dnr 2011/1593-31/5).</p>},
  author       = {Wijana, Moa Bråthén and Enebrink, Pia and Liljedahl, Sophie I. and Ghaderi, Ata},
  issn         = {1471-244X},
  language     = {eng},
  month        = {11},
  number       = {1},
  publisher    = {BioMed Central (BMC)},
  series       = {BMC Psychiatry},
  title        = {Preliminary evaluation of an intensive integrated individual and family therapy model for self-harming adolescents},
  url          = {http://dx.doi.org/10.1186/s12888-018-1947-9},
  doi          = {10.1186/s12888-018-1947-9},
  volume       = {18},
  year         = {2018},
}