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Psychological interventions
Systemic family therapy is not superior to treatment as usual in preventing repeat self-harm in adolescents
  1. Shilpa Aggarwal
  1. Correspondence to Dr Shilpa Aggarwal, Department of Psychiatry, Deakin University, Geelong VIC 3125, Australia; shilpazq{at}

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Commentary on: Cottrell DJ, Wright-Hughes A, Collinson M, et al. Effectiveness of systemic family therapy versus treatment as usual for young people after self-harm: a pragmatic, phase 3, multicentre, randomised controlled trial. Lancet Psychiatry 2018;5:203–16.

What is already known on this topic

Families influence self-harm in adolescents by either contributing towards it or offering protection against it.1 With limited evidence for individually focused interventions for repeat self-harm in adolescents, evaluation of interventions making use of family’s strengths and resources is a potential option.2 Attachment-based family therapy (ABFT) and multisystem family therapy (MST) are specific family therapy (FT) frameworks that have been tested for self-harm in adolescents.3 ABFT decreased suicidal ideation (secondary outcome) at the end of treatment over 3 months and over 12 weeks of follow-up after completion of treatment.3 MST found a reduction in suicide attempts in adolescents in the home-based …

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  • Contributors SA is the sole contributor.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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