An Investigation of Family Therapy-Based Training on an Adolescent's Self-Harm and Character Strengths
Keywords:Family therapy, Adolescent, Self-Harm, Character Strengths
Background: The prevalence of non-suicidal self-injury has increased in adolescents. This study aimed to assess the effectiveness of family therapy compared with treatment as usual in improving character strengths and reducing self-harm repetition in adolescents.
Methods: The research was designed as semi-experimental with a pre-test, post-test, and control group. The statistical population was all students of Tehran's middle schools with self-injury from October to September 2022. 53 eligible adolescents were selected purposefully. The participants were randomly divided into two groups: a family therapy counseling (n=27 people) and a control group (n=26 people). The experimental group received sixteen 75-min counseling sessions held weekly, while the control group underwent no interventions. Both groups received post-test evaluations following these sessions. Then, the Deliberate Self-Harm Inventory and Values in Action Inventory of Strengths scale (VIA-Youth) pre- and post-intervention were implemented. SPSS 24 used a multivariate analysis of the covariance (MANCOVA) version.
Results: The effect of family therapy on the self-injury variable was significant (F=32.61; Pvalue<0.001). Also, the effect of family therapy on character strengths (F=24.81; Pvalue<0.001) was confirmed. In addition, it related the largest effect size to the self-injury variable (0.648), which shows that 64% of the total variances of the experimental and control groups result from a family therapy approach.
Conclusions: The results showed that family therapy could effectively improve character strengths and reduce self-injurious behaviors in adolescents aged 13-16.
Keywords: Family therapy, Adolescent, Self-harm, Character strengths.
Demuth A, Demuthova S. Gender differences in adolescent self-harming behaviour. behaviour. 2022;6(S3):12291-9. https://doi.org/10.53730/ijhs.v6nS3.9026
Lim KS, Wong CH, McIntyre RS, Wang J, Zhang Z, Tran BX, Tan W, Ho CS, Ho RC. Global lifetime and 12-month prevalence of suicidal behavior, deliberate self-harm and non-suicidal self-injury in children and adolescents between 1989 and 2018: a meta-analysis. International journal of environmental research and public health. 2019 Nov;16(22):4581. https://doi.org/10.3390/ijerph16224581
Wijana MB, Enebrink P, Liljedahl SI, Ghaderi A. Preliminary evaluation of an intensive integrated individual and family therapy model for self-harming adolescents. BMC psychiatry. 2018 Dec;18(1):1-5. https://doi.org/10.1186/s12888-018-1947-9
Han S. Influencing Factors of Adolescent Self-Injury Behavior. Advances in Psychology. 2019; 9(2):248-54. http://doi.org/10.12677/ap.2019.92032
Vafaei T, Samavi SA, Whisenhunt JL, Najarpourian S. The Effectiveness of Group Training of Emotional Regulation on Adolescent’s Self-injury, Depression, and Anger. Journal of Research & Health. 2021; 11(6):383-392. http://dx.doi.org/10.32598/JRH.11.6.1602.4
Esposito C, Dragone M, Affuso G, Amodeo AL, Bacchini D. Prevalence of engagement and frequency of non-suicidal self-injury behaviors in adolescence: an investigation of the longitudinal course and the role of temperamental effortful control. European Child & Adolescent Psychiatry. 2022 Sep 19:1-6. https://doi.org/10.1007/s00787-022-02083-7
Husain N, Tofique S, Chaudhry IB, Kiran T, Taylor P, Williams C, Memon R, Aggarwal S, Alvi MH, Ananiadou S, Ansari MA. Youth Culturally adapted Manual Assisted Problem Solving Training (YCMAP) in Pakistani adolescent with a history of self-harm: protocol for multicentre clinical and cost-effectiveness randomised controlled trial. BMJ open. 2022 May 1;12(5):e056301. http://dx.doi.org/10.1136/bmjopen-2021-056301
Shekhani SS , Perveen S , Hashmi D-e-S , et al . Suicide and deliberate self-harm in Pakistan: a scoping review. BMC Psychiatry 2018;18:1–15. http://doi.org/10.1186/s12888-017-1586-6
Muehlenkamp J, Brausch A, Quigley K, Whitlock J. Interpersonal features and functions of nonsuicidal self-injury. Suicide Life-Threat Behav. 2013;43(1):67–80.
Ruch W, Niemiec RM, McGrath RE, Gander F, Proyer RT. Character strengths-based interventions: Open questions and ideas for future research. The Journal of Positive Psychology. 2020 Sep 2;15(5):680-4. https://doi.org/10.1080/17439760.2020.1789700
Shubert J, Wray‐Lake L, Syvertsen AK, Metzger A. Examining character structure and function across childhood and adolescence. Child Development. 2019 Jul;90(4):e505-24. https://doi.org/10.1111/cdev.13035
Casali N, Feraco T, Ghisi M, Meneghetti C. “Andrà tutto bene”: associations between character strengths, psychological distress and self-efficacy during Covid-19 lockdown. Journal of Happiness Studies. 2021 Jun;22(5):2255-74. https://doi.org/10.1007/s10902-020-00321-w
Kretzschmar A, Harzer C, Ruch W. Character strengths in adults and adolescents: Their measurement and association with well-being. Journal of Personality Assessment. 2022 Feb 18:1-4. https://doi.org/10.1080/00223891.2022.2043879
Shoshani, A., & Shwartz, L. (2018). From character strengths to children’s well-being: development and validation of the character strengths inventory for elementary school children. Frontiers in Psychology, 9, 2123. https://doi.org/10.3389/fpsyg.2018.02123
Raimundi MJ, Molina MF, Schmidt V, Hernández-Mendo A. Family functioning profiles and character strengths in young elite athletes from Argentina. International Journal of Sport and Exercise Psychology. 2019 Jan 2;17(1):32-51. http://dx.doi.org/10.1080/1612197X.2016.1189949
Ngai SS. Parental bonding and character strengths among Chinese adolescents in Hong Kong. International Journal of Adolescence and Youth. 2015 Jul 3;20(3):317-33. https://doi.org/10.1080/02673843.2015.1007879
Adrian, M., Berk, M. S., Korslund, K., Whitlock, K., McCauley, E., & Linehan, M. (2018). Parental validation and invalidation predict adolescent self-harm. Professional Psychology: Research and Practice, 49(4), 274–281. https://doi.org/10.1037/pro0000200
Cottrell DJ, Wright-Hughes A, Collinson M, Boston P, Eisler I, Fortune S, Graham EH, Green J, House AO, Kerfoot M, Owens DW. Effectiveness of systemic family therapy versus treatment as usual for young people after self-harm: a pragmatic, phase 3, multicentre, randomised controlled trial. The Lancet Psychiatry. 2018 Mar 1;5(3):203-16. https://doi.org/10.1016/S2215-0366(18)30058-0
Bean RA, Keenan BH, Fox C. Treatment of Adolescent Non-Suicidal Self-Injury: A Review of Family Factors and Family Therapy. The American Journal of Family Therapy. 2022 Apr 21;50(3):264-79. https://doi.org/10.1080/01926187.2021.1909513
Nezhadhamdy N, Dortaj F, Sadipour E, Sheivandi Cholicheh K, Rezaei S. The Effectiveness of a School-based Self-injury Prevention Program on Reducing Interpersonal Cognitive Distortion and Fear of Negative Evaluation in Adolescent Girls. Caspian J Neurol Sci. 2022; 8(1):49-59. https://doi.org/10.32598/CJNS.8.28.303.1
Sueki H. What character strengths are protective factors for suicidal ideation?: A cross-sectional study in Japan. Psychology, Health & Medicine. 2021 Jul 3;26(6):745-54. https://doi.org/10.1080/13548506.2020.1758334
Mousavi E, Hosseini S, Bakhtiyari M, Abasi I, Mohammadi A, Masjedi Arani A. The Effects of Mindfulness-based Stress Reduction Group Therapy on Anxiety, Depression, Stress, and the Intolerance of Uncertainty in Infertile Women. Iranian Rehabilitation Journal. 2020; 18(2):137-144. http://dx.doi.org/10.32598/irj.18.2.862.1
Lundh L, Karim J, Quilisch E. Deliberate self-harm in 15-year-old adolescents: a pilot study with a modified version of the deliberate self-harm inventory. Scand J Psychol. 2007;48:33–42. https://doi.org/10.1111/j.1467-9450.2007.00567.x
Bjarehed J, Lundh LG. Deliberate self-harm in 14-year-old adolescents: how frequent is it, and how is it associated with psychopathology, relationship variables, and styles of emotional regulation? Cogn Behav Ther. 2008;37(1):26–37. https://doi.org/10.1080/16506070701778951
Payvastegar M. The rate of deliberate self-harming in girls students and relationship with loneliness &Attachment styles. Journal of Psychological Studies. 2013. Oct 23;9(3):29-52.
Park N, Peterson C. Moral competence and character strengths among adolescents: The development and validation of the Values in Action Inventory of Strengths for Youth. Journal of adolescence. 2006 Dec 1;29(6):891-909. https://doi.org/10.1016/j.adolescence.2006.04.011Get rights and content
Khosrojerdi Z, Heidari M, Ghanbari S, Pakdaman S. Developing a mastery goal model based on character strengths in adolescents. Positive Psychology Research. 2020 Feb 20;5(4):77-92. https://doi.org/10.22108/ppls.2020.120535.1854
Fortune S, Cottrell D, Fife S. Family factors associated with adolescent self‐harm: A narrative review. Journal of Family Therapy. 2016 Apr;38(2):226-56. https://doi.org/10.1111/1467-6427.12119
Wijana MB, Feldman I, Ssegonja R, Enebrink P, Ghaderi A. A pilot study of the impact of an integrated individual-and family therapy model for self-harming adolescents on overall healthcare consumption. BMC psychiatry. 2021 Dec;21(1):1-3. https://doi.org/10.1186/s12888-021-03375-z
Glenn CR, Esposito EC, Porter AC, Robinson DJ. Evidence base update of psychosocial treatments for self-injurious thoughts and behaviors in youth. Journal of Clinical Child & Adolescent Psychology. 2019 May 4;48(3):357-92. https://doi.org/10.1080/15374416.2019.1591281
Japanese Ministry of Health, Labour and Welfare. White paper on suicide countermeasures. 2018. Retrieved March 25, 2019, from https://www.mhlw.go.jp/wp/hakusyo/jisatsu/16/index.html
Wright-Hughes A, Graham E, Farrin A, Collinson M, Boston P, Eisler I, Fortune S, Green J, House A, Owens D, Simic M. Self-Harm Intervention: Family Therapy (SHIFT), a study protocol for a randomised controlled trial of family therapy versus treatment as usual for young people seen after a second or subsequent episode of self-harm. Trials. 2015 Dec;16(1):1-2. DOI 10.1186/s13063-015-1007-4.
Nemati H, Sahebihagh MH, Mahmoodi M, Ghiasi A, Ebrahimi H, Atri SB, Mohammadpoorasl A. Non-suicidal self-injury and its relationship with family psychological function and perceived social support among Iranian high school students. Journal of Research in Health Sciences. 2020;20(1):e00469. doi: 10.34172/jrhs.2020.04. PMID: 32814690; PMCID: PMC7585761.
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