Please select the eligibility criteria that correspond to the clinical trial below.
Title: Commitment and Motivation in a Brief DBT Intervention for Self Harm
Brief Summary: Research suggests that individuals with Borderline Personality Disorder (BPD) experience low motivation for change (Skodal, Buckley, \& Charles, 1983). Dialectical Behavior Therapy (DBT; Linehan, 1993) includes commitment strategies that are designed to improve motivation. No studies have examined the effectiveness of these strategies. The proposed study will evaluate the efficacy of a brief DBT intervention consisting of commitment strategies plus skills training for people who self-harm. Participants will be randomly assigned to either a single orientation session of (1) commitment strategies plus psychoeducation or (2) psychoeducation. Immediately following their orientation session, all participants will be enrolled in a 90 minute group skills training session. Primary outcomes include autonomous motivation and frequency of self harm behaviours. Assessments will be conducted at six time points: baseline, after the initial orientation session, after the skills training group session, and at one week, one month, and three month follow-up


Options:
A: Inclusion Criteria:

1. Has a valid health card issued by a Canadian province or Canadian student organization (ie: UHIP)
2. Has had at least 3 self-harm episodes (either suicidal or non-suicidal) in the past 5 years, including at least 1 in the past eight weeks
3. Is literate in English
4. Absence of 4 or more formal weeks of DBT in the past year (individual or group therapy components)
5. Indicates absence of knowledge of the DBT Skills
6. Is able to attend all sessions on scheduled study day

Exclusion Criteria:

1) Evidence of organic brain syndrome or mental retardation
B: Inclusion Criteria. The adolescent must:

* be 11 to 18 years old;
* self-report an act of self-harm in the past 6 months,
* meet criteria for cut-off on two of the four underlying/maintaining factors (depression, emotion dysregulation, family conflict, substance use), and
* live with at least one parent-figure who agrees to participate in assessments and treatment Participants should be willing and able to participate fully in the protocol (e.g., to accept assignment to either condition, to provide sufficient locator information for follow-up, to allow their treatment sessions to be recorded for fidelity/process assessment and supervision).

Exclusion Criteria. Youth who:

* have a history of DSM V Developmental Disorders, Elective Mutism, Organic Mental Disorders, Schizophrenia, Delusional Disorder, Psychotic Disorder, and Bipolar Affective Disorder.
* are actively in crisis and reporting current ideation with a specific plan and with means to complete the plan.
C: Inclusion Criteria:

1. Current suicide ideation;
2. More than one intentional self-injury or suicide attempt;
3. Has difficulties with emotion and impulsive behavior or has characteristics similar to borderline personality disorder;
4. 13-17 years of age;
5. At least one family member or responsible adult available to participate in assessments and treatment.

Exclusion Criteria:

* Has significant developmental delays
* Has significant current mania, psychosis or life threatening anorexia
* Has a court order for treatment
D: Inclusion Criteria:

* Patient admitted to Massachusetts General Hospital inpatient psychiatric unit
* Age 18 and older
* Able to read/write in English
* SI documented on admission OR admission due to a suicide attempt
* Admission diagnosis of MDD (and current major depressive episode), confirmed using the Mini International Neuropsychiatric Interview (MINI) and inpatient chart review

Exclusion Criteria:

* Psychotic symptoms, as assessed using the MINI and inpatient chart review
* Cognitive disorder, assessed using a six-item cognitive screen developed for research
* Primary admission diagnosis of substance use disorder

Answer: A