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Table 1 Characteristics of the 25 studies in the meta-analysis

From: Does treatment method matter? A meta-analysis of the past 20 years of research on therapeutic interventions for self-harm and suicidal ideation in adolescents

StudyOutcome (Measures)Age Group% femaleTherapeutic InterventionControl
Dose / DurationDrop-outEligibility Criteria (Recruitment Setting)
[2•]SI (SIQ-HS), D (BDI II)15–18 yrs0%Dialectical Behaviour Therapy for Adolescents10Mode Deactivation Therapy106 months0n. r. (residential care)
[3•]SI (HASS)10–18 yrs69%Family-based Cognitive Behaviour Therapy89Enhanced Usual Care921 month21Presented to ED with a suicide attempt or SI (ED)
[6•]SH (interview developed in house)15–18 yrs75%Cognitive Analytic Therapy35Good Clinical Care349 months82–9 DSM-IV criteria for BPD, and during childhood ≥1 of any personality disorder criteria, disruptive behaviour symptoms, depressive symptoms, low socioeconomic status, and abuse or neglect (ED, primary care, family, school or self-referral)
[11•]SH (SASII), SI (BSS)11–17 yrs89%Family Therapy268Treatment as Usual2106 months99≥2 self-harm episodes and living with a primary caregiver willing to participate (mental health services)
[14•]SI (SIQ-JR), D (BDI-II)12–17 yrs83%Attachment-Based Family Therapy35Enhanced Usual Care313 months13SI (SIQ-JR score ≥ 31) and depression (BDI-II ≥ 20) (primary care services and ED)
[13•]SI (SIQ),
12–18 yrs82%Attachment-Based Family Therapy66Family-Enhanced Nondirective Supportive Therapy634 months14SI (SIQ-JR ≥ 31) and depression (BDI-II ≥ 20) (ED, inpatient, mental health agencies, primary care services, schools, and community, or self-referral)
[15•]SI (SIQ),
12–17 yrs82%Skills-based Treatment15Supportive Relationship Treatment166 months8Presented to ED or inpatient unit after a suicide attempt (ED and inpatient)
[18•]SI (SIQ),
D (RADS-2)
13–17 yrs67%Internet-based Cognitive Behaviour Therapy19Enhanced Usual Care176 months4Suicide attempt within the past 3 months, or suicidal ideation (SIQ ≥ 41), alcohol or cannabis disorder, and lived with a caregiver willing to participate (inpatient)
[23•]SH (SH interview),
12–17 yrs89%Eclectic Group Therapy181Enhanced Usual Care1811.5 months7≥ 2 episodes of SH within the past 12 months (mental health services)
[29•]SH (PHI),
12–16 yrs90%Eclectic Group Therapy34Treatment as Usual341 month3≥ 2episodes of self-harm in the past year, and ≥ 1 in the past 3 months (mental health services)
[31•]SI (SIQ),
D (RADS-2)
13–19 yrs82%Internet-based Cognitive Behaviour Therapy + Treatment as Usual26Treatment as Usual242.5 months11Engaged with a well-being staff member, and any level of suicidal ideation in the last 4 weeks (secondary schools)
Kaess et al., 2019SH (SITBI-G),
12–17 yrs96%Cognitive Behaviour Therapy (with elements of Dialectical Behaviour Therapy)37Treatment as Usual374 months2NSSI ≥5 times in the past 6 months, and ≥ 1in the past month. (inpatient, outpatient, and community notices)
[38•]SH (C-SSRS), SI (SIQ-R)12–18 yrs89%As Safe As Possible Program (ASAP) + Treatment as Usual34Treatment as Usual323–4 h. + TAU6Presented to inpatient with recent SI or a recent suicide attempt (inpatient)
[41•]SH (CAFAS),
12–17 yrs68%Psycho-educational social network intervention + Treatment as Usual113Treatment as Usual123~ 1 h. + TAU102Suicide attempt or SI within the past month and score of 20 or 30 on the self-harm subscale of the CAFAS (inpatient)
[40•]SH (No. episodes)
13–17 yrs71%Psychoeducational network intervention + Treatment as Usual175Treatment as Usual171~ 1 h. + TAU/telephone calls92Suicide attempt or SI within the past month (inpatient)
[39•]SI (SIQ-JR), D (RADS-2)14–19 yrs80%Motivational Interviewing27Enhanced Usual Care22~ 1 h. + TAU3SI, a recent suicide attempt, or both depression and substance abuse (ED)
[47•]SH (No. episodes),
12–18 yrs95%Dialectical Behaviour Therapy for Adolescents86Individual and Group Supportive Therapy876 months40≥1 lifetime suicide attempts, suicidal ideation (≥24 SIQ-JR) in the past month, ≥3 lifetime SH, including 1 in the 12 weeks before screening, and ≥ 3 BPD criteria (ED, inpatient, outpatient, and community services)
[51•]SH (No. episodes), SI (SIQ-JR), D (MADRS)12–18 yrs88%Dialectical Behaviour Therapy for Adolescents39Enhanced Usual Care384.75 months0≥3 self-harm episodes, ≥1 within past 16 weeks; ≥2 DSM-IV BPD criteria (or 1, with ≥2 subthreshold-level criteria) (outpatient)
[56•]SH (No. episodes)12–18 yrs81%Therapeutic Assessment35Assessment as usual34~ 7 h.1Not engaged with psychiatric services, presented to emergency services with SH, and referred for psychosocial assessment (ED or community services)
[59•]SH (ASQ-R)12–17 yrs75%Resourceful Adolescent-Parent Program22Treatment as Usual181.5 months8≥1 episode of suicidal behaviour (SI, suicide attempt, or SH) within the past 2 months, living with 1+ parent, and a primary diagnosis of either major depression, posttraumatic stress disorder, or anxiety disorder (ED and primary care)
[64•]SH (RTSHI),
13–18 yrs85%Mentalization-based Therapy for Adolescents40Treatment as Usual4012 months37≥1 episode of SH within the past month (community mental health services and ED)
[65•]SH (No. episodes)14–19 yrs88%Emotion regulation group training (with elements of Cognitive Behaviour Therapy and Dialectical Behaviour Therapy)14Treatment as Usual174.25 months12Mood instability due to increased reactivity, two forms of potentially self-damaging impulsivity, recurrent SH, inappropriate, intense anger, or difficulty controlling anger (outpatient)
[66•]SH (No. episodes)14–19 yrs96%Emotion regulation group training (with elements of Cognitive Behaviour Therapy and Dialectical Behaviour Therapy)48Treatment as Usual494.25 months9≥2 DSM-IV BPD criteria (outpatient)
[68•]SI (BSS),
12–18 yrs66%Intensive Interpersonal Psychotherapy-Adolescent35Treatment as Usual381.5 months3Moderate-severe depression (BDI > 19), suicide ideation or previous suicidal attempt (BSS > 0), moderate-severe anxiety, or significant hopelessness in the past 2 weeks (secondary schools)
[73•]SH (interview;),
12–16 yrs78%Eclectic Group Therapy32Treatment as Usual292 months1≥1 SH episode in the past year and referred following an episode of SH (mental health services)
  1. n. r. not reported. Outcomes: D Depressive Symptoms, SH Self-harm, SI Suicidal Ideation, Measures: ASQ-R Adolescent Suicide Questionnaire-Revised, BDI-II Beck Depression Inventory-II, BSI-D Brief Symptom Inventory-Depression items, BSI-SI Brief Symptom Inventory-Suicidal Ideation items, BSS Beck Scale for Suicide Ideation, CAFAS Child and Adolescent Functional Assessment Scale, CES-D Center of Epidemiologic Studies-Depression Scale, C-SSRS Columbia Suicide Severity Rating Scale, HASS Harkavy-Asnis Suicide Scale, MADRS Montgomery–Åsberg Depression Rating Scale, MFQ Mood and Feelings Questionnaire, PHI Parasuicide History Interview, RADS Reynolds Adolescent Depression Scale, RADS-2 Reynolds Adolescent Depression Scale, RTSHI Risk-Taking and Self-Harm Inventory, SASII Suicide Attempt Self-Injury Interview, SIQ Suicide Ideation Questionnaire, SIQ-HS Suicide Ideation Questionnaire High school Form, SIQ-JR Suicidal Ideation Questionnaire Junior, SITBI-G Self-Injurious Thoughts and Behaviours Interview-German version. Eligibility criteria: BPD Borderline Personality Disorder, ED Emergency Department