Women Offenders Repeat Self-Harm Intervention Pilot II

ISRCTN ISRCTN18761534
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
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

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

Dr Tammi Walker
Scientific

University of Manchester
Jean MacFarlane Building
Oxford Road
Manchester
M13 9PL
United Kingdom

Email tammi.walker@manchester.ac.uk

Study information

Study designRandomised interventional study
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Other
Study typePrevention
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titleWomen Offenders Repeat Self-Harm Intervention Pilot II
Study acronymWORSHIP II
Study hypothesis1. 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
ConditionMental Health Research Network - Suicide and self-harm
InterventionActive 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 typeOther
Primary outcome measureBeck's Scale for Suicidal Ideation measured at baseline, post-therapy and at 6 month follow-up
Secondary outcome measures1. 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 date17/12/2012
Overall study end date01/06/2015

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexFemale
Target number of participantsUK Sample Size: 140
Participant inclusion criteria1. 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 criteria1. 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 date01/01/2013
Recruitment end date01/09/2014

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

University of Manchester
Manchester
M13 9PL
United Kingdom

Sponsor information

University of Manchester (UK)
University/education

Oxford Road
Manchester
M13 9PL
England
United Kingdom

Website http://www.manchester.ac.uk/
ROR logo "ROR" https://ror.org/027m9bs27

Funders

Funder type

Government

Research for Patient Benefit Programme ref: PB-PG-0610-22176
Government organisation / National government
Alternative name(s)
NIHR Research for Patient Benefit Programme, RfPB
Location
United Kingdom

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
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.