A randomised control trial – the efficacy of dialectical behaviour therapy in young adult prisoners who engage in self-harm

INTERVENTION: The intervention for young prisoners who self‐harm will be the modified dialectical behaviour therapy by Mission Australia’s Triple Care Farm. The group intervention is a 12‐week, biweekly group‐skills session conducted by two clinical psychologists who are DBT‐trained. The modules included will be on mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness. 1. Sessions will be in a group therapy format with up to 10 participants per group (Triple Care Farm, 2015). DBT is a structured, skills‐based program which will teach participants skills such as mindfulness (i.e. to encourage teaching in the 'here and now' and focus on the present), distress tolerance (i.e. coping skills whenever participants are in a crisis), interpersonal effectiveness (i.e. how to behave in relationships and to maintain respect at the same time) and emotion regulation (i.e. how to identify emotions and manage emotions that are unhelpful or unjustified). Besides teaching skills, participants will also be given a treatment workbook where they can fill in their own notes during sessions. 2. Duration of sessions will be 2‐hours 3. Strategies to monitor adherence: Register of attendance at the beginning of each session and a diary‐card, where participants will need to tick which skill they used outside therapy times and any reasons why some skills are difficult than others and this will be reviewed at the beginning of every session 4. Biweekly means two sessions a week. CONDITION: borderline personality disorder self‐harm well‐being PRIMARY OUTCOME: Borderline Personality Disorder symptoms as assessed by the Structured Clinical Interview for Borderline Personality Disorder (SCID‐BPD) Self‐harm behaviours assessed using the Inventory of Statements about Self‐Injury (ISAS) SECONDARY OUTCOME: Emotion regulation (as observed from the Difficulties in Emotion Regulation, DERS questionnaire) General well‐being (as observed from the Well‐being Survey) INCLUSION CRITERIA: ‐ Malaysian nationality ‐ Young adult prisoner aged between 14 and 21 years of age who self‐harm ‐ Males and Females ‐ Does not necessarily need to know how to read or write, but must be able to understand English or Malay ‐ Convicted prisoners only ‐ Remaining length of sentence should be at least 6 months