Accepted for/Published in: JMIR Formative Research
Date Submitted: Jun 18, 2020
Date Accepted: Mar 16, 2021
Experiences of an Online Treatment for Adolescents with Nonsuicidal Self-injury and Their Caregivers: Qualitative Study
ABSTRACT
Background:
Nonsuicidal self-injury (NSSI) is becoming more prevalent among adolescents and is associated with several adverse outcomes. Despite this, few established treatment options exist. Online treatment seems promising for several conditions, but for NSSI the knowledge is scarce. It is important to explore how online treatment for NSSI is experienced to improve such interventions and learn more about factors that are important in treatment for adolescents engaging in NSSI.
Objective:
To explore the experiences of a novel online treatment for adolescents engaging in NSSI and their caregivers.
Methods:
A qualitative study using thematic analysis was conducted through semi-structured interviews with 9 adolescents and 11 caregivers at post-treatment or at 6-month follow-up of the online emotion regulation individual therapy for adolescents (online ERITA).
Results:
We found three overarching themes. (1) “Support can come in different shapes” showed how support could be attained through both interaction with the therapist, but also through the format itself (such as through the fictional characters in the material and the mobile app). Caregivers found it helpful to have their own online course, and adolescents accepted their involvement. (2) “Independence: empowering and challenging” showed that the flexibility of the format was highly appreciated, but also challenging, causing occasional emotional distress for some. (3) “Skills use and positive effects beyond the expected” showed the advantages and challenges of learning several different emotion regulation skills, and that decreased distress and impairment associated to NSSI were important treatment outcomes for the adolescents.
Conclusions:
Online ERITA seems to be (1) offering an accepted way to deliver family interventions for this target group, (2) facilitating skills training, with several means of support, from both the mobile-app and the online therapist, (3) contributing to decreased distress and impairment associated with NSSI, and (4) causing, for some individuals, emotional distress due to the individual responsibility inherent in the online format, which needs to be addressed.
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