Women Offenders Repeat Self-Harm Intervention Pilot II
ISRCTN | ISRCTN18761534 |
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DOI | https://doi.org/10.1186/ISRCTN18761534 |
Secondary identifying numbers | 11830 |
- Submission date
- 19/12/2012
- Registration date
- 19/12/2012
- Last edited
- 13/08/2020
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Mental and Behavioural Disorders
Plain English Summary
Background and study aims
The female prison population is growing at a much faster rate than men in prison. Recent government policy has identified women prisoners as having special health and service needs which are currently not met. Repeated self-harm (SH) (including suicide attempts) has become a considerable problem amongst women prisoners. It is associated with psychosocial problems, depression and increased risk of suicide, which is far greater in women prisoners than women in the community. Interpersonal conflicts are the commonest cause of SH in women and nearly 50% report histories of domestic violence, and around a third, previous sexual abuse, including one incident of rape in 1 in 20 women. Women prisoners also have high rates of mental illness. Managing SH is a significant call on scarce resources. Currently, no solution for women who SH in prison have been evaluated; none focuses explicitly on women's needs and no methodology for follow up has been developed. In this study, we developed and began evaluating a targeted intervention for SH using Psychodynamic Interpersonal Therapy (PIT) which focuses on resolving women's interpersonal and emotional difficulties which drive them to harm themselves. The researchers have tested how feasible and acceptable it is to deliver PIT in a prison and now want to find out how well PIT works for women prisoners with a recent history of repeat self-harm.
Who can participate?
Female prisoners aged 18-65 who have committed an act of self-harm in the previous month
What does the study involve?
Participants are randomly allocated to receive 4-8 sessions of PIT or control therapy (AC) after they have completed the initial assessments. Women's thoughts of suicide and SH, and the number and severity of SH events are assessed at the start of the study, after therapy and 6 months later. The study tests out methods of following women for 6 months and tests ways to collect information on the use of prison resources resulting from women's SH.
What are the possible benefits and risks of participating?
This study may reduce suicidal thoughts and risk, and improve female prisoners' self-harm behaviour. Secondary benefits of this will be to improve safety and quality of life for female offenders, help the prison system improve care and treatment and provide women with equal opportunity to get SH therapies. The potential risk to women who participate in the PIT treatment group may be that if they explore their interpersonal problems perhaps for the first time this may bring out their negative past experiences and feelings, worsen their distress which could subsequently increase their self-harming behaviours. However, by engaging in a short-term therapy which focuses on women's distress, we hope to help women offenders self-manage their SH longer term.
Where is the study run from?
Styal, Foston Hall and Newhall prisons (UK)
When is study starting and how long is it expected to run for?
January 2013 to June 2015
Who is funding the study?
Research for Patient Benefit Programme (UK)
Who is the main contact?
Dr Tammi Walker
tammi.walker@manchester.ac.uk
Contact information
Scientific
University of Manchester
Jean MacFarlane Building
Oxford Road
Manchester
M13 9PL
United Kingdom
tammi.walker@manchester.ac.uk |
Study information
Study design | Randomised interventional study |
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Primary study design | Interventional |
Secondary study design | Randomised controlled trial |
Study setting(s) | Other |
Study type | Prevention |
Participant information sheet | Not available in web format, please use the contact details below to request a patient information sheet |
Scientific title | Women Offenders Repeat Self-Harm Intervention Pilot II |
Study acronym | WORSHIP II |
Study hypothesis | 1. In the Psychodynamic Interpersonal Therapy (PIT) intervention group, levels of self-harm and suicidal ideation will be reduced further than those of the participants in the active control group. 2. By engaging female offenders in a short-term intervention which focusses on women's distress, we hope to help female offenders self-manage their self-harm in the longer term. |
Ethics approval(s) | NRES Committee East of England - Essex, 25/06/2012, ref: 12/EE/0179 |
Condition | Mental Health Research Network - Suicide and self-harm |
Intervention | Active control (AC): AC comprises a basic control for women being taken out of their cells and having non prison staff company for a set period of time per week. Thus, women prisoners will be taken out of their cell once a week for 50 minutes by the Research Assistant and can engage in activities such as card games, reading magazines or practical topics (e.g. money management). No personal support/active listening is undertaken; women are told they cannot talk about emotional topics. PIT, Psychodynamic Interpersonal Therapy (PIT) involves identifying and helping resolve interpersonal difficulties that exacerbate psychological distress. Specialist psychiatry trainees, from Manchester Mental Health & Social Care Trust will come into the prison to deliver this intervention. Sessions will be weekly and last for 50 minutes. Permission will be sought from participants for the sessions to be audio-recorded. Therapy will be monitored. Followed up at 6 months |
Intervention type | Other |
Primary outcome measure | Beck's Scale for Suicidal Ideation measured at baseline, post-therapy and at 6 month follow-up |
Secondary outcome measures | 1. Beck's Depression Inventory measured at baseline, post-therapy and at 6 month follow-up 2. Suicide Attempt Self-Injury Interview measured at baseline, post-therapy and at 6 month follow-up 3. The Prison Screening Questionnaire measured at baseline 4. Therapy satisfaction questionnaire measured post-therapy 5. Zanarini Rating Scale for Borderline Personality Disorder measured at baseline |
Overall study start date | 17/12/2012 |
Overall study end date | 01/06/2015 |
Eligibility
Participant type(s) | Patient |
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Age group | Adult |
Lower age limit | 18 Years |
Sex | Female |
Target number of participants | UK Sample Size: 140 |
Participant inclusion criteria | 1. Women offenders aged over 18 years old 2. On an ACCT (Assessment, Care in Custody and Teamwork) 3. Self-harmed in the previous month 4. The female prisoners will also be screened for date of release or trial 5. If on remand they will need to have a minimum of 6 weeks to complete sessions |
Participant exclusion criteria | 1. Women currently at serious risk of harm to others or suicide 2. Moderate to severe learning disability or without capacity to consent 3. Women who don't speak English 4. Women who are currently receiving a therapeutic intervention in prison |
Recruitment start date | 01/01/2013 |
Recruitment end date | 01/09/2014 |
Locations
Countries of recruitment
- England
- United Kingdom
Study participating centre
M13 9PL
United Kingdom
Sponsor information
University/education
Oxford Road
Manchester
M13 9PL
England
United Kingdom
Website | http://www.manchester.ac.uk/ |
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https://ror.org/027m9bs27 |
Funders
Funder type
Government
Government organisation / National government
- Alternative name(s)
- NIHR Research for Patient Benefit Programme, RfPB
- Location
- United Kingdom
Results and Publications
Intention to publish date | |
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Individual participant data (IPD) Intention to share | No |
IPD sharing plan summary | Not provided at time of registration |
Publication and dissemination plan | Not provided at time of registration |
IPD sharing plan |
Study outputs
Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
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Results article | results | 04/03/2017 | 13/08/2020 | Yes | No |
Editorial Notes
13/08/2020: Publication reference added.
12/12/2017: No publications found, verifying study status with principal investigator.