A pragmatic randomised controlled trial and economic evaluation of family therapy vs. treatment as usual for young people seen after second or subsequent episodes of self-harm: the Self-Harm Intervention - Family Therapy (SHIFT) trial

Cottrell DJ, Wright-Hughes A, Collinson M, Boston P, Eisler I, Fortune S, et al.
Record ID 32010000407
Original Title: SHIFT. Self-Harm Intervention, Family Therapy: a randomised controlled trial of family therapy vs. treatment as usual for young people seen after second or subsequent episodes of self-harm
Authors' objectives: Adolescents who self-harm are at increased risk of poor emotional and health development, and death by suicide. Many adolescents who self-harm experience difficulties in their family relationships. Therefore family therapy may be an effective treatment for this group of young people, but there is no conclusive research evidence for or against this idea. This study will be a randomised, controlled, trial comparing family therapy with the treatment usually offered to adolescents aged 11 - 17 years who self-harm by the NHS child and adolescent mental health services. The main outcomes will be repetition of self-harm needing hospital treatment 18 months after entering the study. Other important outcomes are repetition at 12 months, the nature of further self-harm, suicidal thoughts, cost effectiveness and quality of life. Adolescents aged 11-17 years who have self-harmed on at least 2 occasions will be recruited at their first follow up contact with child & adolescent mental health services in Yorkshire, Manchester and London. Adolescents will receive either family therapy or treatment as usual. Family therapy will be delivered by specially trained therapists using a research-based and clinically tested manualised approach. Both groups will be treated in the service local to where they live and will receive approximately 8 sessions of treatment. Adolescents with severe depression, sucidality or other serious mental illness will not be asked to take part in the study. Service user groups (adolescents and parents) are involved in the study and ethical approval will be sought prior to commencement. The study team have extensive experience in both research and clinical treatment of adolescents who self-harm and their families. The team includes experts in adolescent self-harm, family therapy, conducting trials, the epidemiology of self-harm and health economics. In order to find enough adolescents who will meet the study criteria a large number of collaborating centres are required and it will take three years to recruit and a further 18 months to complete collection of follow-up data. Costs include funding for a trial manager, statistician, research assistants at each collaborating site, travel and consumables. The training and checks to ensure the family therapy is delivered with good fidelity are also included. The costs outlined will allow a robust trial.
Project Status: Ongoing
Anticipated Publish Date: 2022
Requestor: NIHR Health Technology Assessment programme
English language abstract: An English language summary is available
Publication Type: Full HTA
Country: England, United Kingdom
Pubmed ID: 26537599
MeSH Terms
  • Behavior Therapy
  • Self-Injurious Behavior
  • Suicide, Attempted
  • Adolescent
  • Adolescent Behavior
  • Family Therapy
Organisation Name: NIHR Health Technology Assessment programme
Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
Contact Name: journals.library@nihr.ac.uk
Contact Email: journals.library@nihr.ac.uk
Copyright: Queen's Printer and Controller of HMSO
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