Faculty of Health, School of Medicine, Deakin University, Geelong, Victoria, Australia
Centre for Chronic Conditions and Injuries, Public Health Foundation of India, New Delhi, India.
Evid Based Ment Health. 2021 Feb;24(1):e2. doi: 10.1136/ebmental-2020-300188. Epub 2020 Nov 18.
There is an urgent need for context-specific research leading to development of scalable interventions to address self-harm and suicide in low and middle-income countries (LMICs).
The current study was conducted to determine the contents of a psychological intervention to reduce recurrence of self-harm and improve functioning in youth who self-harm in India and finalise its delivery mechanisms.
A systematic, sequential approach was used to integrate available scientific evidence, expert service providers' knowledge and experience, and service users' lived experiences in the codesigning and development of a psychological intervention. The steps included: identifying prioritised outcomes for youth who self-harm as well as a selection of feasible and acceptable elements from self-harm interventions that have been trialled in LMICs, intervention development workshops with mental health professionals and youth to finalise elements, a review of relevant treatment manuals to decide on the treatment framework, and finalising the treatment structure and schedule in the second round of intervention development workshops.
We developed ATMAN treatment with three key elements; problem solving, emotion regulation and social network strengthening skills. The delivery schedule emphasises on the engagement elements, and allows for involvement of other stakeholders such as family members when acceptable to the clients.
ATMAN treatment could prove to be especially effective in reducing self-harm recurrence in youth in India due to its brief schedule, elements that have been selected in collaboration with the service users and its potential to be scaled up for delivery by non-specialist treatment providers.
迫切需要针对特定情境的研究，以开发可扩展的干预措施，解决中低收入国家（LMICs）的自伤和自杀问题。
本研究旨在确定一种心理干预措施的内容，以减少印度自残青少年的复发率并改善其功能，并最终确定其实施机制。
采用系统的、循序渐进的方法，将现有科学证据、专家服务提供者的知识和经验以及服务使用者的生活经验整合到心理干预措施的共同设计和开发中。步骤包括：确定自残青少年的优先结果，以及从在 LMICs 中进行过试验的自伤干预措施中选择可行和可接受的要素，与心理健康专业人员和青少年一起开展干预措施开发工作坊以敲定要素，审查相关治疗手册以决定治疗框架，以及在第二轮干预措施开发工作坊中敲定治疗结构和时间表。
我们开发了 ATMAN 治疗方案，其中包含三个关键要素：解决问题、情绪调节和社会网络强化技能。交付时间表强调参与要素，并允许在客户可接受的情况下，让其他利益相关者（如家庭成员）参与进来。
由于 ATMAN 治疗方案的治疗时间表较短，其要素是与服务使用者合作选择的，并且有可能由非专业治疗提供者扩大规模进行交付，因此它可能在减少印度青少年的自伤复发方面特别有效。
