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National Collaborating Centre for Mental Health (UK). Self-Harm: Longer-Term Management. Leicester (UK): British Psychological Society; 2012. (NICE Clinical Guidelines, No. 133.)

Cover of Self-Harm: Longer-Term Management

Self-Harm: Longer-Term Management.

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Appendix 7Analytic framework and clinical questions

For the following clinical questions, separate analyses will be conducted (where data are available) for groups identified in the scope that have specific care needs:

  • young people and older adults
  • black and minority ethnic groups.
  1. Assessments

    For people who self-harm, does formal risk assessment, needs assessment and psychosocial assessment improve outcomes?

    (Note: Impact of setting/organisational context and content of assessment to be taken into account if data are available)


    What are the risk and protective factors (internal and external) amongst people who self-harm that predict outcomes (for example, suicide, non-fatal repetition, other psychological outcomes)?

  2. Psychological and psychosocial interventions

    For people who self-harm, do psychological and psychosocial interventions (compared with no treatment or other interventions) improve outcomes? What are the associated adverse effects?

    Interventions: problem-solving, interpersonal therapy, CBT, peer support groups, self-help, computer-based interventions, DBT, counselling, psychodynamic interventions, family interventions, group therapy, postcards, assertive outreach, multi-systemic therapy, respite care, crisis management (refer to Borderline Personality Disorder guideline)


    For people who self-harm, do psychological and psychosocial interventions in combination with pharmacological interventions (compared with psychosocial or pharmacological interventions alone) improve outcomes? What are the associated adverse effects?

  3. Pharmacological interventions

    For people who self-harm, do drug treatments improve outcomes? What are the associated adverse effects?

    Interventions: Antidepressants, antipsychotics, lithium, anticonvulsants (for example, valproate, carbamazepine, lamotrigine), benzodiazepines, analgesics.


    For people who self-harm, what are the key principles underlying safer prescribing?


    prescribing frequency (weekly, monthly)

    toxicity of drug.

  4. Self-management and harm minimisation

    For people who self-harm, does the provision of self-management and/or harm minimisation strategies, compared with no treatment or treatment as usual, improve outcomes?

    Interventions include: replacement therapy, positive emotion technique.

  5. Training

    Does the provision of staff training (knowledge, skills based) improve outcomes (for example, staff attitudes, user satisfaction, user engagement with services)?

    (Note: Impact of setting and content of training to be taken into account if data are available.)

Copyright © 2012, The British Psychological Society & The Royal College of Psychiatrists.

All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Enquiries in this regard should be directed to the British Psychological Society.

Bookshelf ID: NBK126790


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