Supporting adolescents with self-harm: practitioners’ experiences of delivering a rapid brief psychological intervention to adolescents presenting to Emergency Departments
Year: 2026
Type: article
Abstract: Background: The risk of suicide is increased amongst young people following attendance at the Emergency Department (ED) for self-harm. Evidence is limited for effective interventions. Early intervention is crucial before self-harm becomes established as a coping mechanism. The Supporting Adolescents with Self-Harm (SASH) intervention focuses on supporting young peoples' agency and resources-comprising Therapeutic Assessment, Enhanced Safety Planning and Solution-Focused Follow-Up sessions-and was evaluated in a randomised controlled trial. Aim: To explore the experiences of CAMHS crisis team practitioners delivering the SASH intervention to young people presenting to EDs with self-harm in the SASH trial. Methods: The trial assessed the effectiveness of the SASH intervention. This study forms part of the qualitative process evaluation exploring the experiences of practitioners delivering the intervention. Semi-structured interviews were conducted with 15 practitioners who delivered the intervention and four senior staff members. Interviews were analysed using thematic analysis. Results: Six overarching themes were identified: (1) A transformation in practice, bridging the gap in crisis care by offering an immediate therapeutic intervention and time to build rapport and work with the system around young people; (2) Patient-centred care that builds shared understanding of the reasons underlying self-harm between the young person, carer and practitioner; (3) Harnessing young people's strengths and motivating change; (4) Carer involvement in individual/joint sessions leads to better outcomes when the young person wants them involved and they are available; (5) SASH worked well for most young people, although it may be less suited to those who are less able to express themselves, or have complex difficulties or difficulties that are outside their control; and (6) At first, a paradigm shift for practitioners from focusing on problems to solutions, but over time practitioners gained confidence and motivation in using the SASH intervention and continue to use it in their practice. Discussion: The SASH intervention offers continuity of care after ED attendance for young people following a self-harm crisis by focusing on building shared understanding of the underlying reasons for self-harm and harnessing their strengths, bridging the gap in crisis care. Supporting carers may also improve outcomes for young people. Clinical Trial Registration: https://www.isrctn.com/, identifier ISRCTN81846131.
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: gold
Estimated APC paid: $2,353
OpenAlex ID: W7221778705