“…Some studies have examined compliance with outpatient treatment among adolescent self-harm populations and have found an association with higher psychopathology and premeditated attempts (Granboulan, Roudout-Thoraval, Lemerle et al, 2001;Spirito, Lewander, Levy et al, 1994;Taylor & Stansfield, 1984). Although previous self-harm (Litt, Cuskey, & Rudd, 1983;Spirito, Lewander, Levy et al, 1994) and alcohol or substance misuse (Burns, Cortell, & Wagner, 2008;Granboulan, Roudout-Thoraval, Lemerle et al, 2001;Spirito, Lewandeer, Levy et al, 1994), have resulted in conflicting results of both improved and worse compliance.…”