Self-Injurious Behavior Clinical Trial
— ImaginatorOfficial title:
Imaginator: a Pilot of a Brief Functional Imagery Training Intervention for Self-harm in Young People, Supported by a Smart-phone 'App'
Self-harm has substantial personal impacts as well as costs on the National Health Service
(NHS). Around 13-17% of young people report experiences of self-harm. In Cambridgeshire,
this is a significant issue with the number of admissions to hospital for self-harm in young
people being higher than the United Kingdom (UK) average. Treating underlying mental illness
can lead to a reduction in self-harm, but these are long interventions for complex disorders
and many people who self-harm are not under treatment for mental illness. Moreover, young
people struggle to access traditional mental health services where these therapies are
delivered. No short interventions specifically tailored for young people have been developed
so far.
The Imaginator project aims to address the urgent need for an effective and innovative
short-term therapy for self-harm in young people. The investigators will pilot a new
imagery-based psychological intervention for young people aged 16-25 who experience
repetitive self-harm. Mental imagery (the experience of "seeing through the mind's eye") can
carry intense emotions (positive and negative), and imagining something can facilitate
behaviour. Imagery-based therapies have proven useful (i) for problems that feature intense,
hard to manage emotions such as those associated with self-harm, and (ii) for promoting
healthy behaviour. Our new intervention called Functional Imagery Training will support
young people to imagine more adaptive behaviours to cope with the emotional distress that
triggers self-harm, and motivate them to reduce self-harm. Imaginator will comprise of just
two sessions followed by phone support over three months.
Moreover, the investigators will address the challenge of young people accessing and staying
in therapy by using a smartphone app to support the therapy, as apps are widely used and
favoured by this age group. The app will enable participants to continue with the strategies
they have learnt in therapy by themselves, thus ensuring a potential longer-term benefit and
self-empowerment.
Status | Not yet recruiting |
Enrollment | 40 |
Est. completion date | April 2017 |
Est. primary completion date | December 2016 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | Both |
Age group | 16 Years to 25 Years |
Eligibility |
Inclusion Criteria: - Age 16 - 25 years old - Have adequate English language ability to permit the assessment and experimental measures to be completed and use of the smartphone app - Presented with at least 2 episodes of self-harm (defined in 2.2) over the last three months - Willing to receive support to reduce / improve management of self-harm urges and behaviour in person, over the phone and via Android smartphone app (own or made available by researchers*) - Willing to have letters sent/phone calls made to their General Practitioner (GP) and other relevant clinicians - Can commit to attending 2 consecutive weekly sessions, and 5 fortnightly phone follow-up sessions, and assessments over follow up period as required by the study - Resident within geographical areas covered by the Cambridgeshire and Peterborough NHS Foundation trust (CPFT) - Able to give consent Exclusion Criteria: - Experiencing current severe psychopathology that is of impediment to completing the study requirements, e.g. active psychotic symptoms (clinicians assessment) - Currently treated under the care of the CPFT Personality Disorders Pathway - Currently under the care of the CPFT Crisis Resolution and Home Treatment Team or under inpatient care - Learning difficulties, organic brain disease, severe neurological impairment - Current severe substance or alcohol abuse (clinicians assessment) - Presence of active suicidal risk on the Mini International Neuropsychiatric Interview (MINI) confirmed by convergent clinical opinion (see risk assessment protocol, Appendix 1) - Unwilling to engage actively in the Functional Imagery Training (FIT) intervention or to use an imagery-focused approach for treatment - Unwilling to use a smartphone app - Taking part in concurrent treatment studies investigating pharmacological or psychological treatment for self-harm |
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
Country | Name | City | State |
---|---|---|---|
United Kingdom | MRC CBU | Cambridge | Cambridgeshire |
Lead Sponsor | Collaborator |
---|---|
Medical Research Council |
United Kingdom,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Reduced Self-harm | Change in the presence of and number of self-reported self-harm episodes over 3 months prior to the FIT intervention to over 3 months after randomization to the FIT intervention in the Immediate FIT + Standard Care (SC) group compared to the Delayed FIT + SC group. | 3 months | No |
Secondary | Reduction of self-harm severity | Average scores on severity of self-harm ratings over 3 months | 3 months | No |
Secondary | VAS reduction | Average scores on a Visual Analogue Scale (VAS) scale of self-efficacy ratings referred to self-harm | 3 months | No |
Secondary | Imagery | Average scores on characteristics of mental imagery associated with self-harm when present (e.g. vividness, compellingness) | 3 months | No |
Secondary | Clinical outcomes | Average scores on clincial questionnaire 3 months after intervention | 3 months | No |
Secondary | 6 month outcome self-efficacy | Change from pre-randomization to 6 months after intervention in average scores on self-efficacy ratings on VAS scale referring to distress associated with self-harm | 6 months | No |
Secondary | Imaginator app | Correlations between endpoints scores and the following measures of Imaginator app use: number of app sessions/logins and total duration of app use, number activity cycles completed, number of personalised media uploaded, number of completed guided imagery sessions and total duration of guided imagery completed, at 3 and 6 months after the intervention. | 3-6 months | No |
Secondary | Feasibility Data Total | Total number of participants referred to IMAGINATOR from different recruitment sources | 3 months | No |
Secondary | Reduction of self-harm modalities | Average scores on self-harm modalities | 3 months | No |
Secondary | Reduction of Emergency Departments (ED) visits | Number of Emergency Department (ED) visits | 3 months | No |
Secondary | Average scores on functional outcomes | Average score on functional outcome | 3 months | No |
Secondary | Average score on process outcome | Average score on process outcome measure | 3 months | No |
Secondary | 6 month (Emergency Department) ED visit | Change from pre randomisation to 6 months after intervention on number of ED attendance episodes | 6 months | No |
Secondary | 6 month Clinical outcome | Average scores on clincial questionnaire 6 months after intervention | 6 months | No |
Secondary | 6 month functional outcome | Average scores on functional outcome 6 months after intervention | 6 month | No |
Secondary | 6 month process outcome | Average scores on functional outcome 6 months after intervention | 6 month | No |
Secondary | Feasibility Data Monthly | Monthly Recruitment Rate | 3 month | No |
Secondary | Feasibility data Attrition rate | Attrition rate (percentage of participants completing intervention) comparing Delayed Functional Imagery Training (FIT) to Immediate FIT | 3 month | No |
Secondary | Feasibility Completion | Completion rate of follow up assessments comparing Delayed Functional Imagery Training (FIT) to Immediate FIT | 3 month | No |
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