Self Harm – Implementing NICE Guidelines

Implementing clinical guidelines for self harm – highlighting key issues arising from the NICE guideline for self-harm , Psychology and Psychotherapy: Theory, Research and Practice, Volume 81, Number 4, December 2008 , pp. 377-397(21)

NICE guidelines – Click for access


The NICE clinical guideline on self-harm has been criticized for its reliance on expert consensus view in the absence of evidence on psychological aspects of care. The relative dearth of published experiences in implementing these guidelines is a likely consequence of these doubts. This article highlights the methodological problems inherent to the development of guidelines covering the first 48 hours after a presentation of self-harm, and reviews four areas where implementation has advanced: change in staff attitudes; triage scales; psychosocial assessments; and specific interventions for borderline personality disorder (BPD). Suggestions are made for how future versions of the guidelines might be adapted to improve the process of referral for appropriate psychological care and to provide more equitable access to care for patients in distress.

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A Better Future in Mind – Mental Health Services in the North West

A Better Future in Mind – Mental Health Services in the North West, 28th October 2008, NHS

For direct full-text access, click on the Report title above


This report is the culmination of a year-long piece of work by the NHS NW Mental Health Commission, aimed at evaluating the impact of the NSF and making recommendations to take the work forward. Chair: John Boyington

Mindfulness-Based Cognitive Therapy & Suicide

Mindfulness-Based Cognitive Therapy and Self-Discrepancy in Recovered Depressed Patients with a History of Depression and Suicidality , Cognitive Therapy and Research, Online Early 2008

Catherine Crane, Thorsten Barnhofer1, Danielle S. Duggan1, Silvia Hepburn2, Melanie V. Fennell1 and J. Mark G. Williams

(1)  Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK, OX3 7JX
(2)  Institute of Psychiatry, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK


Long-term vulnerability to depression is related to the presence of perceived discrepancies between the actual self and ideal self-guides. This study examined the immediate effects of an 8-week course of Mindfulness-Based Cognitive Therapy (MBCT) on self-discrepancies in individuals currently in recovery, with a history of affective disorder that included suicidal ideation and behaviour. Results indicated significant time × group interactions for both ideal self similarity and ideal self likelihood ratings, primarily accounted for by increases in self-discrepancy from pre-test to post-test in the waiting list group which were not seen in those receiving MBCT. Changes in self-discrepancy were not associated with changes in residual depressive symptoms, but in the MBCT group there was a significant association between increases in ideal self similarity and the adoption of more adaptive ideal self-guides post treatment. MBCT may protect against increases in self-discrepancy in people vulnerable to relapse to depression and may also facilitate a shift in the goals of self-regulation.

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