Application of the cognitive-behavioral approach in psychotherapy for self-harming behavior

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription Access

Abstract

This review article discusses research and practical guidelines on the use of the cognitive behavioral approach in psychotherapy for self-harming behavior. Self-harm is an acute problem of modern psychiatry, psychotherapy and clinical psychology, affecting mainly young people. A significant part of the research on assistance is devoted to cognitive behavioral therapy and related areas. Given the complexity of the phenomenon of self-harm, the first part of the article considers the theoretical models that underlie the applied hikes. This was followed by a review of studies on various areas of psychotherapy for self-harming behavior. The main techniques and basic principles of cognitive-behavioral psychotherapy were considered, and illustrative practical examples were given. It is concluded that the quality of evidence is currently insufficient, but the methods of the cognitive-behavioral approach are recognized as “well-established” and “promising” for helping patients in this group.

About the authors

Alexander S. Granitsa

Kazan (Volga Region) Federal University

Author for correspondence.
Email: hebechblu@yandex.ru
ORCID iD: 0000-0002-0498-7397
SPIN-code: 4775-7844
ResearcherId: C-9878-2019
Russian Federation, 420008, Kazan, Kremlevskaya str., 18

References

  1. Clarke S., Allerhand L.A., Berk M.S. Recent advances in understanding and managing self-harm in adolescents. F1000Res. 2019; 8: F1000 Faculty Rev-1794. doi: 10.12688/f1000research.19868.1.
  2. Польская Н.А. Феноменология и функции самоповреждающего поведения при нормативном и нарушенном психическом развитии. Дисс. … д-ра псих. наук: 19.00.04. М.: МГППУ. 2017; 423 с. [Polʹskaya N.A. Fenomenologiya i funktsii samopovrezhdayushchego povedeniya pri normativnom i narushennom psikhicheskom razvitii. Diss. … d-ra psikh. nauk: 19.00.04. M.: MGPPU. 2017; 423 р. (In Russ.)]
  3. Favazza A., Rosenthal R. Varieties of pathological self-mutilation. Behav. Neurol. 1990; 3: 77–85. doi: 10.3233/BEN-1990-3202.
  4. Halicka J., Kiejna A. Non-suicidal self-injury (NSSI) and suicidal: Criteria differentiation. Adv. Clin. Exp. Med. 2018; 27 (2): 257–261. doi: 10.17219/acem/66353. PMID: 29521070.
  5. Hawton K., Witt K.G., Taylor Salisbury T.L. et al. Psychosocial interventions for self-harm in adults. Cochrane Database Syst. Rev. 2016; (5): CD012189. doi: 10.1002/14651858.CD012189. PMID: 27168519.
  6. Hawton K., Harriss L. Deliberate self-harm by under-15-year-olds: characteristics, trends and outcome. J. Child Psychol. Psychiatry. 2008; 49 (4): 441–448. doi: 10.1111/j.1469-7610.2007.01852.x. PMID: 18081755.
  7. Кернер К. Проведение диалектической поведенческой терапии. Практическое руководство. СПб.: Диалектика. 2019; 288 с. [Kerner K. Provedenie dialekticheskoy povedencheskoy terapii. Prakticheskoe rukovodstvo. SPb.: Dialektika. 2019; 288 p. (In Russ.)]
  8. Крылова Е.С., Бебуришвили А.А., Каледа В.Г. Несуицидальные самоповреждения при расстройстве личности в юношеском возрасте и оценка их взаимосвязи с суицидальным поведением. Суицидология. 2019; 1 (34): 48–57. [Krylova E.S., Beburishvili A.A., Kaleda V.G. Nesuitsidalʹnye samopovrezhdeniya pri rasstroystve lichnosti v yunosheskom vozraste i otsenka ikh vzaimosvyazi s suitsidalʹnym povedeniem. Suitsidologiya. 2019; 1 (34): 48–57. (In Russ.)]
  9. Андронникова О.О., Волкова Е.Н. Обзор зарубежных исследований по проблеме несуицидального самоповреждения у детей и подростков. Теоретич. и эксперим. психол. 2020; (3): 38–50. [Andronnikova O.O., Volkova E.N. Obzor zarubezhnykh issledovaniy po probleme nesuitsidalʹnogo samopovrezhdeniya u detey i podrostkov. Teoreticheskaya i ehksperimentalʹnaya psikhologiya. 2020; (3): 38–50. (In Russ.)]
  10. Холмогорова А.Б. Протокол когнитивно-бихевиоральной терапии пациентов, переживающих суицидальный кризис. СТПН. 2014; (1): 26–29. [Kholmogorova A.B. Protokol kognitivno-bikhevioralʹnoy terapii patsientov, perezhivayushchikh suitsidalʹnyy krizis. STPN. 2014; (1): 26–29. (In Russ.)]
  11. Kholmogorova A. Suicidal behavior: theoretic model and practical implications in cognitive-behavioral therapy. Counseling Psychol. Psychotherapy. 2016; 24: 144–163. doi: 10.17759/cpp.2016240309.
  12. Линехан М. Диалектическая поведенческая терапия. Руководство по тренингу навыков. 2-е изд. Пер. с англ. СПб.: Диалектика. 2020; 880 с. [Linekhan M. Dialekticheskaya povedencheskaya terapiya. Rukovodstvo po treningu navykov. 2-e izd. Per. s angl. SPb.: Dialektika. 2020; 880 р. (In Russ.)]
  13. Маккей М., Вуд Дж.С., Брэнтли Дж. Диалектическая поведенческая терапия. Руководство по тренингу навыков осознанности, межличностной эффективности, регуляции эмоций и стрессоустойчивости. Пер. с англ. СПб.: Диалектика. 2020; 272 с. [Makkey M., Vud J.S., Brehntli J. Dialekticheskaya povedencheskaya terapiya. Rukovodstvo po treningu navykov osoznannosti, mezhlichnostnoy ehffektivnosti, regulyatsii ehmotsiy i stressoustoychivosti. Per. s angl. SPb.: Dialektika. 2020; 272 р. (In Russ.)]
  14. Schulze L., Schulze A., Renneberg B. et al. Neural correlates of affective disturbances. A comparative meta-analysis of negative affect processing in borderline personality disorder, major depression, and posttraumatic stress disorder. Biol. Psychiatry: Cognitive Neurosci. Neuroimaging. 2018; 4 (3): 220–232. doi: 10.1016/j.bpsc.2018.11.004.
  15. Zaehringer J., Ende G., Santangelo P. et al. Improved emotion regulation after neurofeedback: A single-arm trial in patients with borderline personality disorder. Neuroimage Clin. 2019; 24: 102 032. doi: 10.1016/j.nicl.2019.102032. PMID: 31795041. PMCID: PMC6978219.
  16. Asarnow J.R., Berk M., Hughes J.L., Anderson N.L. The SAFETY Program: a treatment-development trial of a cognitive-behavioral family treatment for adolescent suicide attempters. J. Clin. Child Adolesc. Psychol. 2015; 44 (1): 194–203. doi: 10.1080/15374416.2014.940624. PMID: 25255931/ PMCID: PMC4289426.
  17. Bahji A., Pierce M., Wong J. et al. Comparative efficacy and acceptability of psychotherapies for self-harm and suicidal behavior among children and adolescents: A systematic review and network meta-analysis. JAMA Netw. Open. 2021; 4 (4): e216614. doi: 10.1001/jamanetworkopen.2021.6614.
  18. Glenn C.R., Esposito E.C., Porter A.C., Robinson D.J. Evidence base update of psychosocial treatments for self-injurious thoughts and behaviors in youth. J. Clin. Child Adolesc. Psychol. 2019; 48 (3): 357–392. doi: 10.1080/15374416.2019.1591281.
  19. Glenn C.R., Franklin J.C., Nock M.K. Evidence-based psychosocial treatments for self-injurious thoughts and behaviors in youth. J. Clin. Child Adolesc. Psychol. 2015; 44 (1): 1–29. doi: 10.1080/15374416.2014.945211.
  20. Kothgassner O.D., Robinson K., Goreis A. et al. Does treatment method matter? A meta-analysis of the past 20 years of research on therapeutic interventions for self-harm and suicidal ideation in adolescents. Borderline Personal Dis. Emot. Dysregul. 2020; 7: 9. doi: 10.1186/s40479-020-00123-9.
  21. Klonsky E.D. The functions of deliberate self-injury: a review of the evidence. Clin. Psychol. Rev. 2007; 27 (2): 226–239. doi: 10.1016/j.cpr.2006.08.002. PMID: 17014942.
  22. Iyengar U., Snowden N., Asarnow J.R. et al. A further look at therapeutic interventions for suicide attempts and self-harm in adolescents: An updated systematic review of randomized controlled trials. Front. Psychiatry. 2018; 9: 583. doi: 10.3389/fpsyt.2018.00583.
  23. Kaess M., Edinger A., Fischer-Waldschmidt G. et al. Effectiveness of a brief psychotherapeutic intervention compared with treatment as usual for adolescent nonsuicidal self-injury: a single-centre, randomised controlled trial. Eur. Child Adolesc. Psychiatry. 2020; 29 (6): 881–891. doi: 10.1007/s00787-019-01399-1. PMID: 31512050. PMCID: PMC7305262.
  24. McCauley E., Berk M.S., Asarnow J.R. et al. Efficacy of dialectical behavior therapy for adolescents at high risk for suicide: A randomized clinical trial. JAMA Psychiatry. 2018; 75 (8): 777–785. doi: 10.1001/jamapsychiatry.2018.1109. Erratum in: JAMA Psychiatry. 2018; 75 (8): 867. PMID: 29926087. PMCID: PMC6584278.
  25. Gunderson J.G., Choi-Kain L.W. Working with patients who self-injure. JAMA Psychiatry. 2019; 76 (9): 976–977. doi: 10.1001/jamapsychiatry.2019.1241. PMID: 31290940.
  26. Бреслав Г.М. Психология эмоций. 4-е издание, переработанное. М.: Смысл. 2019; 672 с. [Breslav G.M. Psikhologiya ehmotsiy. 4-e izdanie, pererabotannoe. M.: Smysl. 2019; 672 р. (In Russ.)]
  27. Лихи Р. Техники когнитивной психотерапии. СПб.: Питер. 2020; 656 с. [Likhi R. Tekhniki kognitivnoy psikhoterapii. SPb.: Piter. 2020; 656 р. (In Russ.)]
  28. Федунина Н.Ю., Вихристюк О.В., Банников Г.С. Практики осознанности в профилактике суицидального поведения подростков (обзор зарубежных исследований). Вестн. Московского ун-та. Серия 14. Психология. 2019; (2): 121–144. [Fedunina N.Yu., Vikhristyuk O.V., Bannikov G.S. Praktiki osoznannosti v profilaktike suitsidalʹnogo povedeniya podrostkov (obzor zarubezhnykh issledovaniy). Vestnik Moskovskogo universiteta. Seriya 14. Psikhologiya. 2019; (2): 121–144. (In Russ.)]
  29. Wenzel A., Jager-Hyman S. Cognitive therapy for suicidal patients: current status. Behav. Ther. (NY NY). 2012; 35 (7): 121–130. PMID: 26388663. PMCID: PMC4574874.
  30. Ougrin D., Tranah T., Stahl D. et al. Therapeutic interventions for suicide attempts and self-harm in adolescents: systematic review and meta-analysis. J. Am. Acad. Child Adolesc. Psychiatry. 2015; 54 (2): 97–107.e2. doi: 10.1016/j.jaac.2014.10.009.

Supplementary files

Supplementary Files
Action
1. JATS XML
2. Fig 1. An example of the analysis of the behavioral chain of patient A., 22 years old

Download (146KB)
3. Fig 2. An example of cognitive conceptualization of a 22-year-old client

Download (193KB)

Copyright (c) 2021 Granitsa A.S.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies