In 2004 researchers at the University of Auckland, led by Dr Simon Hatcher, were contracted to investigate whether a brief psychological intervention could be effective in reducing psychological distress and repetition of deliberate self harm in people who had presented to a hospital emergency department following an episode of self harm. We selected problem solving therapy (PST) and we have spent the last three years conducting a large scale randomised controlled trial of PST following self harm. We recruited nearly 600 patients in four District Health Boards in New Zealand.

The aim of this study was to determine whether the addition of PST to the usual care that people receive after presenting to a hospital emergency department following an episode of self harm would result in better outcomes for these people than usual care alone. People randomised to receive PST were offered a course of six to eight one hour face to face sessions of PST with one of the research therapists employed by our study.

Our primary outcome measure was the Beck Hopelessness Scale, which has been shown to be a valid and reliable predictor of the likelihood of future self harm episodes. We found that people who agreed to be included in the PST group reported significantly greater reductions in their reported levels of hopelessness than those in the control group at three month follow-up. We also found that the PST group reported significantly greater reductions in depression, anxiety and suicidal thinking than the control group, and significantly greater improvements in their approach to problem solving and their problem solving skills. At three month follow-up we did not find a significant difference between the two groups in the number of people who re-presented to hospital following an episode of self harm. Full twelve month results will be reported later in 2008.

Read more about Problem Solving Therapy: Workshop pre-reading

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