Clinical Research Directory

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.

Real-time Examination of Skills and Coping Use in Teen's Everyday Lives

The goal of this clinical trial is to compare two core intervention skills among adolescents with a history of engaging in at least 3 lifetime incidents of self-inflicted injury (SII), at least one of which was a suicide attempt of at least moderate lethality and moderate intent to die. The main questions it aims to answer are: Whether and when youth use skills in daily life, how quickly skill use declines after teaching, and whether exposure to life stress influences skill learning and retention. The Investigators also want to know whether brain-related, family-related, and physiology-related factors influence skills practice and any associated changes in self-harm/suicide risk and emotion dysregulation. Participants will complete surveys 5 times a day on their phones at baseline, and following each skill learning session. All participants will learn and practice the two skills with a parent while discussing topics they often argue about. During these discussions, participants will be hooked up to psychophysiological equipment to measure their cardiovascular functioning and their palm sweat. Participants' discussions will be coded for skill use and also for indices of family functioning. Approximately half of the participants will undergo two sets of fMRI scans to assess potential neural underpinnings of skill use.