Lecture 3 - EBP and Self-Harm and Suicide

Question 1

Evidence-Based Practice (4)

Answer 1

need to be able to look into the research and make an informed decision. Need to keep involved through supervision and professional development.

• Need both evidence-based (statistical significance) and meaningful (clinical significance).
• Hypothesis, research designs, validity, reliability, randomisation.
• Randomised controlled trial – two equal groups, people randomly assigned. One group gets treatment, the other is waitlisted.
• Guidelines for EBT – APS treatment review, NHMRC evidence levels, Cochrane reviews, NICE guidelines and pathways in UK. Level I evidence is a systematic review/meta-analysis of Level II evidence, RCTs.

Question 2

Suicide and Self-Harm Assessment (5)

Answer 2

split into suicidal (intent to die), and non-suicidal (no intent to die). Suicidal plan, ideation, intent; non-suicidal threat/gesture, thoughts, self-injury. Intent is really important.

• Need to assess current and past ideation, self-harm, plans, attempts, intent. Can they guarantee their safety? What are their protective factors? Risk level and establish safety plan.
• Stay calm – have management plans, resources, supervision as supports.
• 40% of students who were self-harming also had suicidal ideation. Longer self-harm = more likelihood of suicidal ideation and attempts. Female, adolescence, history of mood difficulties.
• Pragmatic – how often, how long etc. and functional – why?
• Affect regulation (calming down), anti-dissociation (causing pain to stop numbness), anti-suicide (stopping suicidal thoughts), autonomy (do not rely on others), interpersonal boundaries, interpersonal influence (letting them know the extent of my pain), marking distress (creating a physical sign that I feel awful), peer bonding (fitting in), self-care (easier to care for physical than emotional pain), self-punishment (expressing anger towards myself), sensation seeking (generating excitement), toughness (standing the pain).