Quality standard

Quality statement 7: Psychological interventions

Quality statement 7: Psychological interventions

Quality statement

People receiving continuing support for self‑harm have a discussion with their healthcare professional about the potential benefits of psychological interventions specifically structured for people who self‑harm.

Rationale

There is some evidence that psychological therapies specifically structured for people who self‑harm can be effective in reducing repetition of self‑harm. The decision to refer for psychological therapy should be based on a discussion between the person and healthcare professional about the likely benefits.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Structure

Evidence of local arrangements to provide psychological interventions specifically structured for people who self‑harm.

Data source: Data can be collected from information recorded locally by provider organisations.

Process

a) Proportion of people receiving continuing support for self‑harm who have a record of a discussion with their healthcare professional about the potential benefits of psychological interventions specifically structured for people who self‑harm.

Numerator – the number of people in the denominator who have a record of a discussion with their healthcare professional about the potential benefits of psychological interventions specifically structured for people who self‑harm.

Denominator – the number of people receiving continuing support for self‑harm.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records.

b) Proportion of adults who self‑harm who accept referral for structured, person-centred cognitive behavioural therapy that is specifically tailored for adults who self-harm and receive at least 4 sessions.

Numerator – the number of people in the denominator who accept referral for structured, person-centred cognitive behavioural therapy that is specifically tailored for adults who self-harm and receive at least 4 sessions.

Denominator – the number of adults who self‑harm.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records.

c) Proportion of children and young people with significant emotional dysregulation difficulties and frequent episodes of self‑harm who discuss referral for dialectical behaviour therapy adapted for adolescents with a healthcare professional.

Numerator – the number of people in the denominator who discuss referral for dialectical behaviour therapy adapted for adolescents with a healthcare professional.

Denominator – the number of children and young people with significant emotional dysregulation difficulties and frequent episodes of self‑harm.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records.

What the quality statement means for different audiences

Service providers ensure that systems are in place for healthcare professionals to refer people receiving continuing support for self‑harm for a psychological intervention specifically structured for people who self‑harm.

Healthcare professionals ensure that they discuss with people receiving continuing support for self‑harm the potential benefits of psychological interventions specifically structured for people who self‑harm.

Commissioners ensure that they commission services that discuss potential benefits of psychological interventions specifically structured for people who self‑harm with people receiving continuing support for self‑harm and can refer them.

People who are having long‑term support after self‑harming discuss the possible benefits of psychological treatments for self‑harm with their healthcare professional.

Definitions of terms used in this quality statement

People receiving continuing support for self‑harm

People who have carried out intentional self‑poisoning or injury, irrespective of the apparent purpose of the act, and who are receiving longer‑term psychological treatment and management. This includes people with both single and recurrent episodes of self‑harm. It does not include people having immediate physical treatment or management for self‑harm in emergency departments. [Adapted from NICE's guideline on self-harm, terms used in this guideline; self-harm, and evidence review J]

Psychological interventions

Structured, person-centred, cognitive behavioural therapy (CBT)-informed psychological interventions that are specifically tailored for adults who self-harm. Dialectical behaviour therapy adapted for adolescents (DBT-A) should be considered for children and young people with significant emotional dysregulation difficulties who have frequent episodes of self-harm. [Adapted from NICE's guideline on self-harm, recommendations 1.11.3 and 1.11.4]