Culturally Adapted Cognitive Behavioral Therapy for Prevention of Self Harm

NCT ID: NCT01308151

Last Updated: 2013-12-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

221 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-03-31

Study Completion Date

2012-10-31

Brief Summary

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Aim:

To adapt and develop a culturally appropriate psychological intervention and test its feasibility, and acceptability for the patients presenting to general hospital following self-harm in Karachi Pakistan.

Primary hypothesis:

Patients who receive cognitive behavioral therapy will show significant decrease in suicidal ideation as compared to patients with treatment as usual.

Design:

Randomized Control Trial

Setting:

Medical Departments of General Hospitals in Karachi.

Participants:

A total of 200 self harm patients will be randomized to psychological intervention and treatment as usual arm.

Intervention:

Culturally Adapted Cognitive Behavioral Therapy (CBT)

Outcome measure:

Beck Suicidal Ideation Scale

Detailed Description

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Culturally Adapted manualised Cognitive Behavioral Therapy (CBT) will be a brief problem focused therapy comprising of 6 sessions within three months after a self-harm episode. The adapted therapy/training will be delivered by therapists/trained counselors at the hospital. Sessions will be offered weekly in the first two weeks and than fortnightly and will last 50 minutes. During each session the therapists will assess the risk of suicide and will liaise with the research supervisor and patient's treating clinician.

The areas covered by the manual which has been adapted include an evaluation of the self-harm attempt, crisis skills, problem solving, and basic cognitive techniques to manage emotions and negative thinking and relapse prevention strategies. The treatment will be structured around patient's current problems with the relevant sections of the manual helping the patient to deal with specific problems leading to the self-harm act. Between the sessions the manual can be used for homework tasks by the patient.

Conditions

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Attempted Suicide Depression

Keywords

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CBT, self harm, depression, cultural adaptation, Pakistan

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Experimental Arm

Culturally Adapted Manualised Cognitive Behavioral Therapy (CBT) Sessions will be offered weekly in the first month and then fortnightly.

Group Type EXPERIMENTAL

Other

Intervention Type OTHER

No interventions other than the culturally adapted manualised cognitive behavioral therapy

Control

Patients who will be randomized to the "treatment as usual" arm will receive routine care

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Other

No interventions other than the culturally adapted manualised cognitive behavioral therapy

Intervention Type OTHER

Other Intervention Names

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C-MAP

Eligibility Criteria

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Inclusion Criteria

* An episode of self harm within 48 hours before being admitted at the department;

* age of 16 to 64 years;
* Resident in the trial site catchments area,
* Ability to complete a baseline assessment;
* Ability to provide at least 2 verifiable contacts to improve tracking for subsequent assessments; and ability to understand and provide informed consent.

Exclusion Criteria

* • A medical disorder that would prevent participation in an outpatient clinical trial.

* Temporary resident unlikely to be available for follow up.
* Diagnosis of Alcohol and other drug dependence, schizophrenia or Bipolar Disorders.
Minimum Eligible Age

16 Years

Maximum Eligible Age

64 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Manchester

OTHER

Sponsor Role collaborator

Dow University of Health Sciences

OTHER

Sponsor Role collaborator

Abbasi Shaheed Hospital

OTHER

Sponsor Role collaborator

Pakistan Institute of Living and Learning

OTHER

Sponsor Role lead

Responsible Party

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Pakistan Institute Of Learning And Living

Principal Investigators

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Nusrat Husain, MD

Role: PRINCIPAL_INVESTIGATOR

Pakistan Institute of Learning and Living, University of Manchester

Nasim Chaudhry, MRCPsych, MD

Role: PRINCIPAL_INVESTIGATOR

University of Manchester

Imran Chaudhry, MD

Role: PRINCIPAL_INVESTIGATOR

University of Manchester

Salahuddin Afsar, FRCP

Role: PRINCIPAL_INVESTIGATOR

Dow University of Health Sciences Karachi

Meher Husain, MD

Role: PRINCIPAL_INVESTIGATOR

Pakistan Institute of Living and Learning

Raza Ur-Rehman, FCPS

Role: PRINCIPAL_INVESTIGATOR

Dow University of Health Sciences

Batool Fatima

Role: PRINCIPAL_INVESTIGATOR

Pakistan Institute of Living and Learning

Farooq Naeem, MRCPsych

Role: PRINCIPAL_INVESTIGATOR

Pakistan Institute of Learning and Living, University of Southampton

Munir Hamirani, FCPS

Role: PRINCIPAL_INVESTIGATOR

Abbasi Shaheed Hospital

Locations

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Civil hospital

Karachi, Sindh, Pakistan

Site Status

Abbasi Shaheed Hospital

Karachi, Sindh, Pakistan

Site Status

Dow University of Health Sciences

Karachi, Sindh, Pakistan

Site Status

Pakistan Institute of Learning and Living

Karachi, Sindh, Pakistan

Site Status

Countries

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Pakistan

References

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Rahman A, Iqbal Z, Waheed W, Hussain N. Translation and cultural adaptation of health questionnaires. J Pak Med Assoc. 2003 Apr;53(4):142-7.

Reference Type BACKGROUND
PMID: 12776898 (View on PubMed)

Guthrie E, Kapur N, Mackway-Jones K, Chew-Graham C, Moorey J, Mendel E, Francis FM, Sanderson S, Turpin C, Boddy G. Predictors of outcome following brief psychodynamic-interpersonal therapy for deliberate self-poisoning. Aust N Z J Psychiatry. 2003 Oct;37(5):532-6. doi: 10.1046/j.1440-1614.2003.01197.x.

Reference Type BACKGROUND
PMID: 14511080 (View on PubMed)

Hawton K, Arensman E, Townsend E, Bremner S, Feldman E, Goldney R, Gunnell D, Hazell P, van Heeringen K, House A, Owens D, Sakinofsky I, Traskman-Bendz L. Deliberate self harm: systematic review of efficacy of psychosocial and pharmacological treatments in preventing repetition. BMJ. 1998 Aug 15;317(7156):441-7. doi: 10.1136/bmj.317.7156.441.

Reference Type BACKGROUND
PMID: 9703526 (View on PubMed)

Witt KG, Hetrick SE, Rajaram G, Hazell P, Taylor Salisbury TL, Townsend E, Hawton K. Psychosocial interventions for self-harm in adults. Cochrane Database Syst Rev. 2021 Apr 22;4(4):CD013668. doi: 10.1002/14651858.CD013668.pub2.

Reference Type DERIVED
PMID: 33884617 (View on PubMed)

Husain N, Afsar S, Ara J, Fayyaz H, Rahman RU, Tomenson B, Hamirani M, Chaudhry N, Fatima B, Husain M, Naeem F, Chaudhry IB. Brief psychological intervention after self-harm: randomised controlled trial from Pakistan. Br J Psychiatry. 2014 Jun;204(6):462-70. doi: 10.1192/bjp.bp.113.138370. Epub 2014 Mar 27.

Reference Type DERIVED
PMID: 24676964 (View on PubMed)

Other Identifiers

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PILL-UoM Self Harm 250410

Identifier Type: -

Identifier Source: org_study_id