Project details

Summary

What is the study about? What are you trying to find out?

Repeated self-harm is common and yet there is no treatment which works well and which is readily available for people through the NHS.

One of the issues with current therapy is that self-harm tends to be treated just as a symptom of underlying distress. But we know, from what people with personal experience say, that self-harm can also have some purpose – for example producing feelings of personal strength or being in control, and sometimes producing positive emotional feelings. The reasons for self-harm are not the same for everybody, so an important part of any new therapy is time spent understanding the meaning of self-harm for the individual.

Working with people with personal experience of self-harm and with therapists, we want to develop a new approach to assessment and therapy, which looks at all the potential reasons an individual may self-harm. The assessment would support the individual in thinking about the reasons they self-harm. If we understand why somebody self-harms, then we can understand them better as a person and this will help to identify the individual’s values and goals. The therapy would then guide the individual in choosing new, less harmful, ways of reaching these goals.

Once we have developed a new therapy, we want to test it in a clinical trial to see if it is better for people than any other help they are currently getting. The main question we are asking in the trial is whether the new therapy improves quality of life. Of course we also want to know if therapy helps with depression and helps somebody self-harm less. If this is the case, then there may also be cost-savings to the NHS, as well as to patients themselves.

What does taking part involve?

This study is no longer looking for new participants but is still ongoing.

In this larger study we are asking 630 people to take part, in 12 different hospitals in England. Half of the people taking part will receive the FReSH START therapy and half will receive the standard care offered by their local Trust. A computer will randomly decide which group each participant is in. This is called a randomised controlled trial and is the best way of studying if a new treatment really works.

If you are allocated to the intervention group: attend up to 12 sessions of therapy with a trained therapist over a maximum of 6 months. These sessions will each take about 45 minutes. The sessions will either take place at your local NHS Trust premises or via phone or video call. The method used for these sessions will depend on your preference, the preference of the therapist as well as current guidance within your NHS Trust. If necessary there will be 1 or 2 optional telephone booster sessions as part of the trial. Therapy sessions will be audio-recorded by the therapist, so we can monitor therapist training and ensure quality of the therapy, see section 7 for more details about recording.

If you are allocated to the standard care group: you will receive the care that your Trust normally provides to people who self-harm. The researcher will be able to tell you more about what the standard care in your Trust involves.

Respond to monthly secure text messages to let us know how you are doing, and whether you have self-harmed in the last month.

Complete the same set of questionnaires you filled out at the start of the study, on-line (or if this is not possible by post) after 6 and 12 months. We will send you a text message or email to let you know when and how to complete your questionnaire. If you would prefer, we can ring you to go through the questions over the phone.

Complete a much shorter questionnaire at 3 and 9 months, when we will ask you about hospital attendances, appointments and contact with other services.

The researcher may invite you to take part in an optional interview after 12 months so that you can tell us about the therapy you received. You can let us know the best way to contact you, such as phone call, text or email. If you are happy to do the interview we will ask you to consent to this separately. With your permission the interview will be recorded.

Who is it for?

This study is no longer looking for new participants but is still ongoing.

It is not possible to self-refer to this trial, recruitment to the trial is through the participating hospital trusts only. 

Why is it important? 

Whichever group you are in, even if there is no direct benefit to you, you will be helping us to learn more about how to support people who self-harm.

How can I find out more?

You can also visit the FReSH START project website here.

This study is no longer looking for new participants but is still ongoing.

However, if you have questions for the research team, click the button below to email us:

Email the research team