An acceptance and commitment therapy based protocol for the management of acute self-harm and violence in severe mental illness

Razzaque, Russell

doi:10.1017/s1742646412000258

Cited by 12 publications

(12 citation statements)

References 10 publications

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“…All five participants whose case studies were presented improved significantly with marked reductions in SI/DSH. [41,42] In addition to the significant results for SI in the two pre-post studies, both of these studies showed improvements on the AAQ, a measure of psychological flexibility. [29,33] Walser et al's [29] study showed that improvements on the AAQ were associated with a reduction in SI scores across time.…”

Section: Discussionmentioning

confidence: 85%

“…[33] The two casestudies measured and reported a reduction in both SI and DSH. [41,42] Three of the five studies reported outcomes for depression. Tighe and colleagues [24] found that depression scores in the intervention group reduced by 42%, a significant reduction compared to the waitlist group.…”

Section: Discussionmentioning

confidence: 99%

“…The two studies that reported positive results on SI through case-studies (N=2 and N=3) had too few participants and lacked robust research frameworks from which to draw conclusions. [41,42] Both studies report impressive reductions in SI for all five individuals studied; however the studies had many limitations, including lack of specificity around how SI and self-harm reports were measured (apart from hospital ward reports). There is also a lack of detail on what treatment-as-usual entailed such as the administration of medication to participants.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of Acceptance and Commitment Therapy in Reducing Suicidal Ideation and Deliberate Self-Harm: Systematic Review (Preprint)

Tighe¹,

Nicholas²,

Shand³

et al. 2018

Preprint

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Background: Acceptance and Commitment Therapy (ACT) has become a reputable evidence-based psychological therapy for certain disorders since its emergence in 1999.Trials examining the efficacy of ACT are spread across a broad spectrum of presentations such as chronic pain, anxiety and depression. ACT has very rarely been trialled as an intervention for suicide ideation (SI) or deliberate self-harm (DSH).Objective: The objective of this review was to assess the efficacy of ACT in reducing SI and DSH, to examine reported SI and DSH outcomes and to examine whether a particular cohort of participants would be more likely to engage with an ACT trial targeting SI/DSH. Methods:We conducted a systematic review of ACT trials for suicidal ideation and selfharm. An electronic search of databases, including MEDLINE, PubMed, EMBASE, PsycINFO, SCOPUS, as well as the Cochrane Central Register of Controlled Trials and the Cochrane Database of Systematic Reviews was conducted. Reference lists of included studies and relevant systematic reviews were examined to identity additional publications. Search terms were identified with reference to terminology used in previous review papers on ACT and suicide prevention. Study design was not limited to randomized controlled trials.Screening was completed by two reviewers and all duplicates removed. Publications were excluded if they were not published in English, were multicomponent therapy or not based on ACT, or lacked a validated measure or structured reporting of SI/DSH outcomes.Results: After duplicates were removed 554 articles were screened for relevance. Following screening five studies were identified which used ACT as an intervention for suicidal or selfharming individuals. The methodologies used were diverse with two case studies, two prepost studies and one mHealth randomized controlled trial. Conclusions:The review found that ACT was effective for reducing suicide ideation in the two pre-post studies, but not in the other studies. However the very small number of studies included coupled with their lack of methodological rigour means that as yet, there is insufficient evidence to recommend ACT as a treatment for reducing suicide ideation or deliberate self-harm.

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Efficacy of Acceptance and Commitment Therapy in Reducing Suicidal Ideation and Deliberate Self-Harm: Systematic Review (Preprint)

Tighe¹,

Nicholas²,

Shand³

et al. 2018

Preprint

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“…Razzaque’s study [ 45 ] detailed the delivery of ACT to 3 patients in the psychiatric intensive care unit of Goodmayes Hospital in East London. All 3 had a lengthy history of regular bouts of violence toward themselves or others.…”

Section: Resultsmentioning

confidence: 99%

“…The authors of this trial concluded that ACT might help reduce the intensity and frequency of SI by increasing acceptance and valued action and by reducing risk factors, such as hopelessness and psychological pain [ 36 ]. The 2 case studies measured and reported a reduction in SI and DSH [ 44 , 45 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Acceptance and Commitment Therapy in Reducing Suicidal Ideation and Deliberate Self-Harm: Systematic Review

et al. 2018

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BackgroundSince its emergence in the 1980s, acceptance and commitment therapy (ACT) has become a reputable evidence-based psychological therapy for certain disorders. Trials examining the efficacy of ACT are spread across a broad spectrum of presentations, such as chronic pain, anxiety, and depression. Nevertheless, ACT has very rarely been trialed as an intervention for suicidal ideation (SI) or deliberate self-harm (DSH).ObjectiveThe objective of this review is to assess the efficacy of ACT in reducing SI and DSH and to examine the suitability of reported SI, DSH, and other measures in determining the efficacy of ACT.MethodsWe systematically reviewed studies on ACT as intervention for SI and self-harm. Electronic databases, including MEDLINE, PubMed, EMBASE, PsycINFO, SCOPUS, Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews, were searched. The reference lists of included studies and relevant systematic reviews were examined to identify additional publications. Search terms were identified with reference to the terminology used in previous review papers on ACT and suicide prevention. The study design was not restricted to randomized controlled trials. Screening was completed by 2 reviewers, and all duplicates were removed. Publications were excluded if they were not published in English, were multicomponent therapy or were not based on ACT, or lacked a validated measure or structured reporting of SI/DSH outcomes.ResultsAfter removing the duplicates, 554 articles were screened for relevance. Following the screening, 5 studies that used ACT as an intervention for suicidal or self-harming individuals were identified. The studies used diverse methodologies and included 2 case studies, 2 pre–post studies, and 1 mHealth randomized controlled trial.ConclusionsThe review found that ACT is effective in reducing SI in the 2 pre–post studies but not in other studies. However, given the small number and lack of methodological rigor of the studies included in this review, insufficient evidence exists for the recommendation of ACT as an intervention for SI or DSH.

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Psychosocial interventions for self-harm in adults

Hawton

Witt

Salisbury

et al. 2016

Cochrane Database of Systematic Reviews

188

177

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CBT-based psychological therapy can result in fewer individuals repeating SH; however, the quality of this evidence, assessed using GRADE criteria, ranged between moderate and low. Dialectical behaviour therapy for people with multiple episodes of SH/probable personality disorder may lead to a reduction in frequency of SH, but this finding is based on low quality evidence. Case management and remote contact interventions did not appear to have any benefits in terms of reducing repetition of SH. Other therapeutic approaches were mostly evaluated in single trials of moderate to very low quality such that the evidence relating to these interventions is inconclusive.

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An acceptance and commitment therapy based protocol for the management of acute self-harm and violence in severe mental illness

Cited by 12 publications

References 10 publications

Efficacy of Acceptance and Commitment Therapy in Reducing Suicidal Ideation and Deliberate Self-Harm: Systematic Review (Preprint)

Efficacy of Acceptance and Commitment Therapy in Reducing Suicidal Ideation and Deliberate Self-Harm: Systematic Review (Preprint)

Efficacy of Acceptance and Commitment Therapy in Reducing Suicidal Ideation and Deliberate Self-Harm: Systematic Review

Psychosocial interventions for self-harm in adults

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