@article{ref1,
title="Psychosocial interventions for self-harm in low-income and middle-income countries: systematic review and theory of change",
journal="Social psychiatry and psychiatric epidemiology",
year="2021",
author="Berk, Michael and Patton, George and Aggarwal, Shilpa and Patel, Vikram",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="PURPOSE: To synthesise the evidence on effectiveness, acceptability and the delivery mechanisms of psychosocial interventions for self-harm in low and middle income  countries and to develop a pathway of change specific for self-harm interventions. <br><br>METHOD: Studies reporting one or more patient or implementation outcomes of a  psychosocial intervention targeting self-harm and conducted in low- and  middle-income countries were included. Taxonomy of treatment components and a theory  of change map was created using information from the studies. <br><br>RESULTS: We identified  thirteen studies including nine randomised controlled trials (RCT), three non-RCTs,  and a single experimental case design study. A single study using postcard contact  and another using cognitive behaviour therapy (CBT) reported a reduction in  self-harm attempts. Suicidal ideations were significantly reduced with CBT,  volitional help sheets and postcard contact in different studies. Suicide risk  assessment, problem solving and self-validation were the most frequently used  elements in interventions. Goal-setting was the technique used most commonly. Cultural adaptations of psychotherapies were used in two studies. High attrition  rates in psychotherapy trials, limited benefit of the delivery of treatment by  non-specialist providers, and variable benefit observed using phone contact as a  means to deliver intervention were other important findings. <br><br>CONCLUSION: There were  no strong positive findings to draw definitive conclusions. Limited availability and  evidence for culturally adapted interventions in self-harm, lack of evaluation of  task sharing using evidence based interventions as well as a dearth in evaluation  and reporting of various intervention delivery models in low- and middle-income  countries were major literature gaps.<p /> <p>Language: en</p>",
language="en",
issn="0933-7954",
doi="10.1007/s00127-020-02005-5",
url="http://dx.doi.org/10.1007/s00127-020-02005-5"
}