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Implementing clinical guidelines for self harm – highlighting key issues arising from the NICE guideline for self‐harm
Author(s) -
Pitman Alexandra.,
Tyrer Peter.
Publication year - 2008
Publication title -
psychology and psychotherapy: theory, research and practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.102
H-Index - 62
eISSN - 2044-8341
pISSN - 1476-0835
DOI - 10.1348/147608308x306897
Subject(s) - psychological intervention , harm , psychosocial , referral , psychology , guideline , nice , triage , distress , medicine , nursing , clinical psychology , psychiatry , social psychology , pathology , computer science , programming language
The NICE clinical guideline on self‐harm has been criticized for its reliance on expert consensus view in the absence of evidence on psychological aspects of care. The relative dearth of published experiences in implementing these guidelines is a likely consequence of these doubts. This article highlights the methodological problems inherent to the development of guidelines covering the first 48 hours after a presentation of self‐harm, and reviews four areas where implementation has advanced: change in staff attitudes; triage scales; psychosocial assessments; and specific interventions for borderline personality disorder (BPD). Suggestions are made for how future versions of the guidelines might be adapted to improve the process of referral for appropriate psychological care and to provide more equitable access to care for patients in distress.