Examining the Effectiveness of a Brief Therapeutic Intervention for Reducing Self-Harm Among Adolescents

Non-suicidal self-injury (NSSI), defined as deliberate self-inflicted destruction of body tissue without intent to die, is particularly prevalent during mid-adolescence, with prevalence estimated around 16-22% in community samples. Although distinct from suicidality, NSSI is a strong predictor of suicidal attempts. Yet intervention studies addressing self-injury urges and behaviors in youth remain scarce. The Cutting Down Program (CDP) is currently one of the most promising interventions for adolescents who self-harm. This three-month intervention, evidenced in a randomized controlled trial, integrates techniques from cognitive-behavioral (CBT) and dialectic-behavioral (DBT) therapies. Recently, an updated CDP protocol was developed to more directly address suicidality and involve parents in the treatment. This study will test the updated protocol with a sample of adolescents who self-harm, recruited from schools and treated by educational psychologists of the Israeli Psychological and Counseling Services (SHEFI). We will examine the intervention's effects on mental health outcomes (e.g., self-injury) and on potential mediators (emotion regulation and parental emotion socialization), to clarify its mechanisms of change.

Inclusion Criteria: * At least one active self-injurious behavior during the past 6 months, prior to beginning of treatment. * Both adolescent and participating parent are fluent in Hebrew Exclusion Criteria: * Active psychosis * Substance use disorder * Cognitive impairments precluding understanding of consent or research questions or adhering to the treatment. * Altered levels of consciousness * Linguistic limitations precluding understanding of consent or research questions or adhering to the treatment. * Patients whose parents/legal guardians cannot comply with study requirements. * Necessity of psychiatric treatment due to depression/suicidality * Severe suicidality (active suicidal intents) * Severe depression * A history of mental health diagnoses and/or hospitalizations.