(MRC DTP) Development and evaluation of a novel intervention to enhance motivation around help-seeking for adults who engage in self-harm

Individuals who self-harm are a population in need of clinical intervention and prevention, due to the elevated risk of suicide and considerable emotional distress they often face (Hawton et al., 2012). However, rates of seeking formal help or accepting support are low in this population (Rowe et al.., 2014). This is perhaps not surprising given staff ambivalence about self-harm and the observation that this behaviour typically serves a function for individuals (Edmondson et al., 2016; Pompili et al., 2005). The current PhD project would aim to develop a brief, one-session intervention where the healthcare professional and patient would work collaboratively to build motivation around seeking support and help when experiencing an urge to self-harm. This low-intensity intervention would be deliverable by staff across various healthcare professional backgrounds with minimal prior training required. The intervention would be designed to be delivered to those who self-harm but feel ambivalent about seeking help or therapy, and would draw upon existing principles from Motivational Interviewing (Miller & Rollnick, 2002).

The proposed PhD project would comprise of a set of interconnected studies that initially focus on testing the putative mechanisms that underlie ambivalence about seeking help or engaging in therapy amongst adults who self-harm, before then developing and evaluating a novel intervention. Study 1 would adopt an internet survey design to test hypothesised associations between theorised predictors, including beliefs and expectations about help-seeking and self-harm, and help-seeking intentions and motivation. Study 2 would adopt an idiographic, repertory grid methodology (Fransella et al., 2003), to further explore how individuals who self-harm perceive and construe the different options for support available to them. The development of the intervention would then be informed by the results of these studies and also draw upon the expertise of a group of service user consultants with personal experience of self-harm. Study 3 would then provide an initial proof-of-concept test of this intervention using a multiple baseline research design, and Study 4 would use a qualitative interview methodology to provide an understanding of participants’ experiences of this intervention, including the benefits and challenges or problems.

The project would provide the preliminary development of a new intervention for enhancing motivation around help-seeking, which, once further evaluated and trialled, could be of considerable value both to those who self-harm who are unsure around seeking help, and to clinicians who are unsure how best to support these individuals.

http://www.manchester.ac.uk/research/daniel.pratt/
https://www.research.manchester.ac.uk/portal/peter.taylor-2.html
http://www.manchester.ac.uk/research/nusrat.husain/