For Self-Harm, Approaches Using Cognitive-Behavioral Therapy Are the Most Effective

Self-harm, regardless of suicidal intent, is a growing problem. It is often repeated, results in frequent emergency-department visits, and is the strongest risk factor for completed suicide. Researchers have now updated a previous meta-analysis on the efficacy of psychotherapeutic interventions for self-harm.

There were 29 randomized, controlled studies (8480 adults; mean age, 26), and each included treatment had to have been examined in at least three studies — cognitive-behavioral therapy (CBT), including problem-solving therapy (combined, 18 studies); dialectical behavioral therapy (DBT; 3 studies); case management (4 studies); and a program of regularly sending postcards expressing empathy to patients (4 studies).

At both 6 and 12 months,…