Videoconferencing CBT: a mixed-methods analysis of outcomes amongst young people depending on current self-harm risk status
| Date | 01 August 2024 |
| Pages | 258-271 |
| DOI | https://doi.org/10.1108/MHRJ-04-2023-0017 |
| Published date | 01 August 2024 |
| Author | Katherine Brown,Laura Jenkinson |
Videoconferencing CBT: a mixed-methods
analysis of outcomes amongst young people
depending on current self-harm risk status
Katherine Brown and Laura Jenkinson
Abstract
Purpose –A notable number of young people self-harm, with only a minority receiving professional
support. Evidence suggeststhat therapy can help recovery from self-harm, but little is known aboutthe
experiencesof those who self-harm and participatein therapy delivered via videoconferencing.
Design/methodology/approach –Risk assessments were examined for evidence of self-harm and
used to identify two groups for analysis:young people who had self-harmed in the past six months and
those who had not. A mixed methodsanalysis was then conducted to examine process and outcome
data for these two groups. Data included a number of sessions attended, late-cancelled and missed
without notice; and patient-reported outcome measure scores (Young Person-Clinical Outcomes in
Routine Evaluation and Revised Children’s Anxiety and Depression Scale). End-of-treatment reports
were subsequentlyanalysed using thematic analysis.
Findings –Those with current self-harmrisk appeared to start therapy with lower well-being.No notable
differences in progress were found between groups on quantitative outcomes. There was greater
reporting of poorer clinical outcomes in the reports of those with current self-harm risk, including two
unique types of barriers to effective therapy: ‘‘general difficulties’’ (e.g. poor well-being limiting
engagement,specific components of therapy being challenging)and ‘‘CBT was not preferred’’.
Originality/value –Lower baseline well-beingcould explain the greater ongoing care needsand lower
well-beingpost-therapy among those with current self-harmrisk, despite both groups appearing to make
similar levels of therapeutic progress quantitatively. Recent self-harm does not appear to reduce the
utility of videoconferencingcognitive behavioural therapy; however, clients’individual needs should be
carefullyconsidered.
Keywords Outcomes, Self-harm, Risk, Digital, Cognitive behavioural therapy, Videoconferencing
Paper type Research paper
Introduction
Self-harm is defined by the National Institute for Health and Care Excellence as “self-
poisoning or injury, irrespective of the apparent purpose” (NICE, 2022) and appears
common among young people living in the UK. Previous research with those aged under
18years old has reported that 15.5% of those living in England (Morey et al., 2017),
12.64% of those living in Scotland (Quigley et al., 2017) and 12.1% of those living in Ireland
(Doyle et al., 2015) have self-harmed at some point in their life. Studies such as the adult
psychiatricmorbiditysurvey(whichincludesparticipantsagedbetween16and24 years
old; McManus et al., 2016) have found that rates of self-harm are increasing; a longitudinal
study of over 10,000 UK participants by Patalay and Fitzsimons (2021) reports particularly
high prevalence, with almost one in four (24%) 17-year-olds self-harming within the past
12 months.
Despite self-harm being common among young people, few seek professional support, even
if they feel the need for help (Evans et al., 2005). Up to half appear to seek no support at all
Katherine Brown is based
at the University of
Nottingham, Nottingham,
UK and University of
Lincoln, Lincoln, UK.
Laura Jenkinson is based
at The Hull York Medical
School, London, UK.
Received 2 April 2023
Revised 8 May 2024
Accepted 11 May 2024
PAGE 258 jMENTAL HEALTH REVIEW JOURNAL jVOL. 29 NO. 32024, pp. 258-271,©Emerald Publishing Limited, ISSN 1361-9322DOI 10.1108/MHRJ-04-2023-0017
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