Please select the eligibility criteria that correspond to the clinical trial below.
Title: Imaginator: a Pilot of a Brief Functional Imagery Training Intervention for Self-harm in Young People, Supported by a Smart-phone 'App'
Brief Summary: Self-harm has substantial personal impacts as well as costs on the National Health Service (NHS). Around 13-17% of young people report experiences of self-harm. In Cambridgeshire, this is a significant issue with the number of admissions to hospital for self-harm in young people being higher than the United Kingdom (UK) average. Treating underlying mental illness can lead to a reduction in self-harm, but these are long interventions for complex disorders and many people who self-harm are not under treatment for mental illness. Moreover, young people struggle to access traditional mental health services where these therapies are delivered. No short interventions specifically tailored for young people have been developed so far.

The Imaginator project aims to address the urgent need for an effective and innovative short-term therapy for self-harm in young people. The investigators will pilot a new imagery-based psychological intervention for young people aged 16-25 who experience repetitive self-harm. Mental imagery (the experience of "seeing through the mind's eye") can carry intense emotions (positive and negative), and imagining something can facilitate behaviour. Imagery-based therapies have proven useful (i) for problems that feature intense, hard to manage emotions such as those associated with self-harm, and (ii) for promoting healthy behaviour. Our new intervention called Functional Imagery Training will support young people to imagine more adaptive behaviours to cope with the emotional distress that triggers self-harm, and motivate them to reduce self-harm. Imaginator will comprise of just two sessions followed by phone support over three months.

Moreover, the investigators will address the challenge of young people accessing and staying in therapy by using a smartphone app to support the therapy, as apps are widely used and favoured by this age group. The app will enable participants to continue with the strategies they have learnt in therapy by themselves, thus ensuring a potential longer-term benefit and self-empowerment.


Options:
A: Inclusion Criteria:

* To be included in the study, a participant must be: 1) at least 12 years old and no more than 18 years old, 2) able to understand and communicate in English, 3) willing and able to participate in all study procedures, and 4) currently engaging in nonsuicidal self-injury OR have a history of nonsuicidal self-injury.

Exclusion Criteria:

* Individuals will be excluded from the study if they are experiencing a suicidal crisis at the time of the study procedures (e.g., they endorse suicidal ideation, planning, and intent as determined by the Mini International Neuropsychiatric Interview 7.0) and require crisis intervention or hospitalization.
B: Inclusion Criteria:

* Age 16 - 25 years old
* Have adequate English language ability to permit the assessment and experimental measures to be completed and use of the smartphone app
* Presented with at least 2 episodes of self-harm (defined in 2.2) over the last three months
* Willing to receive support to reduce / improve management of self-harm urges and behaviour in person, over the phone and via Android smartphone app (own or made available by researchers\*)
* Willing to have letters sent/phone calls made to their General Practitioner (GP) and other relevant clinicians
* Can commit to attending 2 consecutive weekly sessions, and 5 fortnightly phone follow-up sessions, and assessments over follow up period as required by the study
* Resident within geographical areas covered by the Cambridgeshire and Peterborough NHS Foundation trust (CPFT)
* Able to give consent

Exclusion Criteria:

* Experiencing current severe psychopathology that is of impediment to completing the study requirements, e.g. active psychotic symptoms (clinicians assessment)
* Currently treated under the care of the CPFT Personality Disorders Pathway
* Currently under the care of the CPFT Crisis Resolution and Home Treatment Team or under inpatient care
* Learning difficulties, organic brain disease, severe neurological impairment
* Current severe substance or alcohol abuse (clinicians assessment)
* Presence of active suicidal risk on the Mini International Neuropsychiatric Interview (MINI) confirmed by convergent clinical opinion (see risk assessment protocol, Appendix 1)
* Unwilling to engage actively in the Functional Imagery Training (FIT) intervention or to use an imagery-focused approach for treatment
* Unwilling to use a smartphone app
* Taking part in concurrent treatment studies investigating pharmacological or psychological treatment for self-harm
C: Inclusion Criteria:

* Female
* Age 18-60
* Meet criteria for borderline personality disorder
* Meet criteria for post-traumatic stress disorder
* Can clearly remember at least some part of the traumatic event(s)
* Recent and recurrent self-injurious behavior
* Lives within commuting distance of University of Washington, Seattle campus
* Consents to all research protocols

Exclusion Criteria:

* Male
* Court ordered to treatment
* Diagnosis of psychotic disorder, bipolar disorder, or seizure disorder requiring medication
* Less than 18 years of age or older than 60 years of age
* Problems which by their presence or severity preclude ability to attend or understand treatment and/or requires priority treatment
* Familial or domestic relationship with a current study participant
D: Inclusion Criteria:

* Ages 12 to18 years
* Youth presenting in the Emergency Department with acute suicidal ideation or suicide risk behaviour
* SIQ-Jr score ≥ 31
* Parent or caregiver able to communicate in English, or is willing to communicate using a hospital-organized translator, and willing to participate in study
* Living in the greater Toronto area and access to a telephone.

Exclusion Criteria:

* Active psychosis or hypomania/mania
* Moderate to severe intellectual disability, autism.

Answer: B