A Feasibility Study to Evaluate a Self-Harm Group in Psychiatric Inpatient Settings

Despite being the most common reason for admission to psychiatric inpatient services in the UK (Bowers, 2005), no evidence-based treatment currently exists for self-harm in this setting (Turner, Austin & Chapman, 2014; Winter et al., 2007). Dialectical Behavioural Therapy (DBT) has found promising results in treating self-harm in outpatient settings (Linehan, 1993a). More recently, there have been favourable results from a DBT-informed group in an inpatient setting (Gibson, Booth, Davenport, Keogh & Owens, 2014), however the intervention was longer than the average stay on an inpatient ward (23 days; Health and Social Care Information Centre, 2014). The aim of the current study was to assess the feasibility of a novel DBT-informed group for people who self-harm within the average length of an inpatient stay. The ‘Coping with Crisis’ (CwC) group protocol was compiled using DBT skills (Linehan, 1993a), with particular focus on crisis management strategies. In line with the Consolidated Standards of Reporting Trials (CONSORT) guidelines for feasibility studies (Eldridge et al., 2016), the aim was to collect data on the rates of recruitment, retention, outcome measure completion and participant feedback, in order to inform the design of a main study. Twenty-four participants were recruited from an inpatient ward in a National Health Service (NHS) Trust. Results suggest that the clinicians and participants found the CwC group acceptable and it was found to be feasible to run the group and research study on an inpatient ward. However, the study experienced several challenges in terms of recruiting to target (80% achieved), retaining participants in the treatment groups and completed post-intervention outcome measures (n = 9; 38%). This information, in addition to feedback from the participants can be used to inform adaptions to the study design and make recommendations to improve outcomes for future research.