Journal Article

Exploring the acceptability of a brief, rapid-access, self-harm focussed talking therapy: a qualitative analysis of patient experiences

Clements, Caroline, Mulholland, Helen, Saini, Pooja, Kullu, Cecil, Tahir, Naheed, Mills, Catherine, Hunt, Anna, Taylor, Peter, Gabbay, Mark, Kvamme- Mitchell, Kari

2026

Overview

ObjectiveTo explore the acceptability of the Community Outpatient Psychotherapy Engagement Service for Self-harm (COPESS) intervention and trial procedures for participants.DesignA mixed-method approach and a single-blind randomised controlled trial design with 1:1 allocation to either COPESS plus treatment as usual or treatment as usual alone.SettingPrimary care.ParticipantsFifteen semistructured interviews were conducted with participants in the COPESS trial; eight were randomised to the intervention arm, and seven were randomised to the treatment-as-usual arm. Interviews lasted 30–60 min.InterventionCOPESS is a brief, relational psychotherapy delivered over 4 weekly sessions plus a follow-up, focusing on understanding difficult emotional states and their links to self-harm through here-and-now relational and emotional processes.AnalysisThematic analysis allowed exploration of themes important to participants in their experiences in the COPESS trial and their experiences of care for self-harm more generally.FindingsFive themes were identified as associated with the acceptability of the COPESS intervention and trial: self-harm as a primary problem, what I needed when I needed it, being heard and understood, online delivery of the intervention and lasting impacts. Participants generally expressed positive views about the intervention, citing a need for services that specifically target self-harm and an appreciation of the rapid access to help. Strong relationships with the therapist were highly valued and not diminished by online delivery of the intervention. Positive impacts continued post therapy sessions.ConclusionsThese results support the acceptability of the COPESS intervention, the need for self-harm specific services and support moving forward to a full trial.Trial registrationPre-registered on clinicaltrials.gov (NCT04191122) on 9 December 2019.

• Publisher: British Medical Journal Publishing Group,BMJ Publishing Group LTD,BMJ Publishing Group
• Subject: Adult / Advisors / Consent / Data collection / Emergency medical care / Feasibility Studies / Female / Females / Humans / Interviews / Interviews as Topic / Male / Mental Health / Middle Aged / Original Research / Patient Acceptance of Health Care / Patients / Primary Care / Primary Health Care / Psychotherapy / Psychotherapy, Brief - methods / Qualitative Research / Self destructive behavior / Self-Injurious Behavior - psychology / Self-Injurious Behavior - therapy / Single-Blind Method / Suicide & self-harm / Young Adult