Dr. David Palmiter's Blog for Hectic Parents

Meta-analytic studies are called “studies of studies.” They entail grouping together findings from numerous studies on the same topic in order to reach more substantive and sweeping conclusions.

In the February, 2015 edition of the Journal of the American Academy of Child and Adolescent Psychiatry, a meta-analysis is published regarding psychosocial treatments for teenagers struggling with self-harm (e.g., self-mutilation) and suicidal ideation. The authors of this research are Drs. Dennis Ougrin, Troy Tranah, Paul Moran and Joan Rosenbaum Asarnow.

This is an important piece of research as, and quoting the authors, suicide “…is the second or third leading cause of death in adolescents in the West…” For example, the authors’ review indicates that the annual suicide rate among teens is 7.8%. Moreover, and regarding self-harm “…a systematic review of 128 studies reported a pooled lifetime prevalence of 13.2%…”

In considering the extant research the authors retrieved 389 articles. Their most important conclusions are based on 17 random control treatment trials on 2,176 youth. Their bottom line regarding how teens responded post treatment: “The proportion of the adolescents who self-harmed over the follow-up period was lower in the intervention groups (28%) than in controls (33%).” The treatments “…with largest effect sizes are dialectical behavior therapy (DBT), cognitive-behavioral therapy (CBT), and mentalization-based therapy (MBT).”

I have described CBT in other posts on this blog (e.g., click here) and in Chapter 10 of my parenting book. As I reviewed in more depth elsewhere, CBT involves teaching a collection of cognitive and behavioral skills for managing mood, anxiety and stress based symptoms. It is a time-limited and structured treatment approach.

Quoting from the New York University Langone Medical Center: “DBT strategically blends the change techniques from traditional cognitive behavioral therapy with acceptance-based strategies from Zen mindfulness practice.” Mindfulness strategies essentially involve garnering feelings of peacefulness and contentment by tuning into the details of the moment.

Quoting from PsychCentral.com “Mentalization based therapy (MBT) is a specific type of psychodynamically-oriented psychotherapy…Its focus is helping people to differentiate and separate out their own thoughts and feelings from those around them… In …MBT, the concept of mentalization is emphasized, reinforced and practiced within a safe and supportive psychotherapy setting. Because the approach is psychodynamic, therapy tends to be less directive than cognitive-behavioral approaches.”

As I’ve reviewed elsewhere on this blog (e.g., click here) and in my parenting book, most teens who could benefit from mental health services don’t receive it, including kids who self-mutilate or struggle with suicidal thinking. This new research confirms and elaborates on an established finding in the scientific literature: mental health treatments for teens work!

If you even suspect that your teen is struggling with these issues, please consider taking the (sometimes lifesaving) step of seeking out a mental health evaluation. For a referral, click here. For other content pertaining to suicide, just enter that word in the search bar above.