Cognitive behavioral therapy after deliberate self-harm in adolescence

doi:10.1017/CBO9780511550423.012

11 - Cognitive behavioral therapy after deliberate self-harm in adolescence

Published online by Cambridge University Press: 04 December 2009

Richard Harrington and

Younus Saleem

Edited by

Robert A. King and

Alan Apter

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Richard Harrington: Affiliation:
University Department of Child Psychiatry, Royal Manchester Children's Hospital, Pendlebury, Manchester, UK e-mail: r.c.harrington@man.ac.uk tel: +44-161-727-2401
Younus Saleem: Affiliation:
University Department of Child Psychiatry, Royal Manchester Children's Hospital, Pendlebury, Manchester UK tel: +44+161-727-2401
Robert A. King: Affiliation:
Yale University, Connecticut
Alan Apter: Affiliation:
Tel-Aviv University

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Summary

Circumstances of suicidal attempts

The kinds of cognitive behavioral interventions that are provided for adolescents who have taken a deliberate overdose, or who have deliberately harmed themselves in other ways, will depend to a large extent on the circumstances in which attempts occur. These include (1) acute problems that are faced by the young person; (2) the chronic problems that they face; (3) the presence of psychiatric disorders such as depression; and (4) the thoughts associated with suicidal attempts.

Acute problems

Many episodes of self-poisoning or self-harm in young people are preceded by stressful events. In a study in Manchester, England, adolescents who had deliberately poisoned themselves were found to have experienced a much greater level of personal difficulties in the three months prior to the episode than matched subjects from the general population (Kerfoot et al., 1995). In particular, they were more often reported to have problems with friendships, to be poor school-attenders, and to be having arguments with members of their families. Very commonly, there was some kind of quarrel with a key person in the young person's life. An example was an adolescent girl who had a chronically poor relationship with her mother. She had been out late repeatedly. One morning her mother confronted her and was very critical of her. The girl took a large overdose of paracetamol later that day.

Chronic problems

Many of the problems that adolescent suicide-attempters must deal with are chronic, that is, have been present for several months.

Keywords

anxiety behavioral disorders CBT cognitive restructuring stress psychiatric disorders suicidal adolescents deliberate self-harm

Type: Chapter
Information: Suicide in Children and Adolescents , pp. 251 - 270

DOI: https://doi.org/10.1017/CBO9780511550423.012 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2003

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References

Birmaher, B., Brent, D. A., Kolko, D., Baugher, M., Bridge, J., Holder, D., Iyengar, S., and Ulloa, R. E. (2000). Clinical outcome after short-term psychotherapy for adolescents with major depressive disorder. Archives of General Psychiatry, 57(1), 29–36Google Scholar

Brent, D. A. (1997). The aftercare of adolescents with deliberate self-harm. Journal of Child Psychology and Psychiatry, 38, 277–286Google Scholar

Brent, D. A. (2001). Assessment and treatment of the youthful suicidal patient. Annals of the New York Academy of Sciences, 932, 106–128; discussion 128–131Google Scholar

Brent, D. A., and Lerner, M. S. (1994). Cogntive therapy with affectively ill, suicidal adolescents. In Wilkes, T. C. R., Belsher, G., Rush, A. J., and Frank, E. (eds.) Cognitive Therapy for Depressed Adolescents (pp. 298–322). New York City, NY: Guilford Press

Brent, D., Holder, D., Kolko, D. et al. (1997). A clinical psychotherapy trial for adolescent depression comparing cognitive, family, and supportive treatments. Archives of General Psychiatry, 54, 877–885Google Scholar

Burgess, S., Hawton, K., and Loveday, G. (1998). Adolescents who take overdoses: outcomes in terms of changes in psychopatholgy and the adolescents' attitudes to care and to their overdose. Journal of Adolescence, 21, 209–218Google Scholar

Chandler, M. J. (1973). Egocentrism and anti-social behavior: the assessment and training of social perspective-taking skills. Developmental Psychology, 9, 326–332Google Scholar

Clarke, G., Lewinsohn, P., and Hops, H. (1990). Leaders Manual for Adolescent Groups. Adolescent Coping with Depression Course. Eugene, OR: Castalia Publishing Company

Durlak, J. A., Fuhrman, T., and Lampman, C. (1991). Effectiveness of cognitive-behavior therapy for maladaptive children: a meta-analysis. Psychological Bulletin, 110, 204–214Google Scholar

Harrington, R., Whittaker, J., Shoebridge, P. et al. (1998a). Systematic review of efficacy of cognitive behaviour therapies in child and adolescent depressive disorder. British Medical Journal, 316, 1559–1563Google Scholar

Harrington, R. C., Kerfoot, M., Dyer, E. et al. (1998b). Randomized trial of a home based family intervention for children who have deliberately poisoned themselves. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 512–518Google Scholar

Harrington, R. C., Whittaker, J., and Shoebridge, P. (1998c). Psychological treatment of depression in children and adolescents: a review of treatment research. British Journal of Psychiatry, 173, 291–298Google Scholar

Harrington, R. C., Wood, A., and Verduyn, C. (1998d). Clinically depressed adolescents. In Graham, P. (ed.) Cognitive Behaviour Therapy for Children and Families (pp. 156–193). Cambridge: Cambridge University Press

Hawton, K., and Catalan, J. (1982). Attempted Suicide. Oxford: Oxford Medical Publications

Hawton, K., Arensman, E., Townsend, E. et al. (1998). Deliberate self harm: systematic review of efficacy of psychosocial and pharmacological treatments in preventing repetition. British Medical Journal, 317, 441–447Google Scholar

Jayson, D., Wood, A. J., Kroll, L. et al. (1998). Which depressed patients respond to cognitive-behavioral treatment?Journal of the American Academy of Child and Adolescent Psychiatry, 37, 35–39Google Scholar

Kazdin, A. E. (1997). Practitioner review: psychosocial treatments for conduct disorder in children. Journal of Child Psychology and Psychiatry, 38, 161–178Google Scholar

Kendall, P. C. (1991). Child and Adolescent Therapy. Cognitive-Behavioural Procedures. New York City, NY: Guilford Press

Kerfoot, M., Harrington, R. C., and Dyer, E. (1995). Brief home-based intervention with young suicide attempters and their families. Journal of Adolescence, 18, 557–568Google Scholar

Kerfoot, M., Dyer, E., Harrington, V. et al. (1996). Correlates and short-term course of self-poisoning in adolescents. British Journal of Psychiatry, 168, 38–42Google Scholar

Kuhn, D., Amsel, E., and O'Loughlin, M. (1988). The Development of Scientific Thinking Skills. San Diego, CA: Academic Press

Lewinsohn, P. M., Clarke, G. N., Hops, H. et al. (1990). Cognitive-behavioural treatment for depressed adolescents. Behavior Therapy, 21, 385–401Google Scholar

Miller, I. V., Epstein, N. B., Bishop, D. S. et al. (1985). The McMaster Family Assessment Device: reliability and validity. Journal of Marital and Family Therapy, 11, 345–356Google Scholar

Piaget, J. (1970). Piaget's theory. In Mussen, P. H. (ed.) Carmichael's Manual of Child Psychology, Volume 1 (pp. 703–732). New York City, NY: Wiley

Puig-Antich, J., and Chambers, W. (1978). The Schedule for Affective Disorders and Schizophrenia for school-aged children [unpublished interview schedule]. New York City, NY: New York State Psychiatric Institute

Stark, K. D. (1990). Childhood Depression: School-based Intervention. New York City, NY: Guilford

Trautman, P. D., Stewart, N., and Morishima, A. (1993). Are adolescent suicide attempters noncompliant with outpatient care?Journal of the American Academy of Child and Adolescent Psychiatry, 32, 89–94Google Scholar

Vostanis, P., Nicholls, J., and Harrington, R. C. (1994). Maternal expressed emotion in conduct and emotional disorders of childhood. Journal of Child Psychology and Psychiatry, 35, 365–376Google Scholar

Wilkes, T. C. R., Belsher, G., Rush, A. J. et al. (1994). Cognitive Therapy for Depressed Adolescents. New York City, NY: Guilford Press

Wood, A. J., Harrington, R. C., and Moore, A. (1996). Controlled trial of a brief cognitive-behavioural intervention in adolescent patients with depressive disorders. Journal of Child Psychology and Psychiatry, 37, 737–746Google Scholar

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11 - Cognitive behavioral therapy after deliberate self-harm in adolescence

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