Previously submitted to: JMIR Mental Health (no longer under consideration since Nov 07, 2025)
Date Submitted: Nov 7, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
A family-based blended psychological intervention for adolescents with non-suicidal self-injury: A quasi-experimental study
ABSTRACT
Background:
Adolescent non-suicidal self-injury (NSSI) is a major public health concern. Digital and family-based psychological interventions have shown promise for addressing NSSI; however, evidence for the effectiveness and accessibility of blended family-based interventions that combine face-to-face and digital components remains limited.
Objective:
To evaluate the effectiveness of a family-based blended psychological intervention in reducing NSSI behaviors and improving emotional and family outcomes among adolescents with NSSI.
Methods:
A quasi-experimental controlled design was conducted in the psychiatric inpatient unit of a mental health center in Wuhan, China. Sixty adolescents with NSSI and their primary caregivers were recruited and sequentially assigned to either the intervention or control group according to admission order. The 6-week blended intervention, grounded in cognitive behavioral therapy and dialectical behavior therapy for adolescents, combined therapist-led face-to-face sessions with digital modules delivered via a WeChat mini-program. The control group received routine care and equivalent attention. Primary outcomes were adolescents’ NSSI behaviors; secondary outcomes included emotion regulation, depression, anxiety, family function, and caregivers’ depression and anxiety. Outcomes were assessed at baseline and post-intervention by blinded evaluators. Between-group differences were analyzed using analysis of covariance (ANCOVA), controlling for baseline scores.
Results:
Forty-eight participants completed the study (intervention n=23; control n=25). Compared with routine care, the blended intervention resulted in significantly greater reductions in adolescents’ NSSI behaviors (adjusted mean difference = −5.16, P = 0.03), emotion regulation difficulties (P = 0.003), depressive symptoms (P = 0.01), and anxiety symptoms (P < 0.001). Caregivers in the intervention group also showed greater improvements in depressive symptoms (P = 0.036) and anxiety symptoms (P = 0.001).
Conclusions:
The family-based blended intervention demonstrated significant effectiveness in reducing NSSI and emotional symptoms among adolescents, while also improving caregiver emotional states. Findings provide empirical evidence supporting the effectiveness and accessibility of blended family-based interventions for adolescent NSSI in real-world clinical settings. Clinical Trial: Chinese Clinical Trial Registry ChiCTR2400088438; https://www.chictr.org.cn/showproj.html?proj=205243
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