ABSTRACT
The referral arrived by fax from the paediatric ward. It was a routine referral for assessment of deliberate self-harm (DSH) and was in keeping with the protocol agreed between the hospital paediatric services and the local Child and Adolescent Mental Health Services (CAMHS). Despite the frequency of DSH in adolescents and the important place it occupies in CAMHS, there is not a single empirically validated method of psychotherapy developed for suicidal and self-destructive behaviours in adolescents. In a systemic review of 20 randomised controlled trials on interventions in deliberate self-harm in adults, Keith Hawton, one of the foremost researchers on the subject, concluded: 'There is insufficient evidence on which to make firm recommendations about the most effective forms of treatment for patients who have deliberately harmed themselves. A problem specific to adolescents who self-harm is the high rates of clinic non-attendance and non-compliance. Hence the clinician has to pay particular attention to increasing compliance.
