Abstract:
In this thesis I have presented an iterative mixed methods programme of work designed to respond to the problem of self-harm among young people in New Zealand. My overall aim was to test the acceptability and feasibility of RE:SOLVE problem solving therapy for young people at risk of self-harm and for the practitioners who delivered the intervention. The programme of work is made up of seven studies in total. The first four studies evaluated the acceptability and feasibility of a client manual and practitioner training manual both prior to and during the open trial. The fifth study tested whether it was acceptable and feasible to train practitioners in the RE:SOLVE problem solving therapy intervention via a one day workshop. The sixth study was an open trial of the RE:SOLVE problem solving therapy intervention in a clinical context and the seventh study was an evaluation of the training, the open trial, and the RE:SOLVE programme by practitioners who took part. The results showed that the client workbook and the practitioner training manual were found to be acceptable and feasible to the young people and practitioners who used them. The training workshop was found to be acceptable in terms of content although the feasibility of learning the entire content in a one day workshop was not established. The open trial had a number of limitations such as a small sample size, no control group and no randomisation. Two thirds of participants completed the therapy and assessments with one third not completing. This is of concern because it is difficult to engage and retain young people at risk of self-harm in therapy. For those who completed all assessments, the results showed statistically and clinically significant reductions in levels of depression and suicide from pre to post test. All other measures showed consistent improvements although they did not reach statistically significant levels. The intervention showed promise but it needs to be tested in a randomised control trial.
