STAR-TRAIN

Non-suicidal self-harming behaviour (NSSB), dissemination, guidelines, training courses, e-learning/blended learning

• Prof Dr Paul L. Plener, Medical University of Vienna (STAR Consortium)

• Prof Dr Michael Kaess, Heidelberg University Hospital (STAR-Online)

• Prof Dr Christian Schmahl, Central Institute of Mental Health Mannheim (STAR-Neuro)

• Prof Dr Tina In-Albon, University of Landau/Koblenz (STAR-Assess)

• Prof Dr Ulrich Ebner-Priemer, Karlsruhe Institute of Technology (STAR-EMA)

• Dr Daniel Radeloff, Leipzig University Hospital (STAR-Data)

11/2017-10/2021

Background:

STAR-TRAIN is part of the STAR (Self-Injury: Treatment, Assessment, Recovery) joint project, which is researching possible psychological and neurobiological mechanisms that could contribute to the cessation of NSSV in order to plan and implement future intervention and prevention programmes in a targeted manner and to improve psychosocial care in this area.

NSSA is a widespread phenomenon among young people, so professionals working in the primary care of mentally ill young people should have knowledge of how to deal with NSSA. This knowledge is provided by the treatment guidelines for dealing with NSSA, which have been available since 2015. However, it is known from other areas of medicine that knowledge of current treatment guidelines often does not reach clinical practice. This raises the question of how the findings set out in the guidelines can be transferred into clinical practice.

Objectives:

The aim of the STAR-TRAIN sub-project is to pass on knowledge about the treatment of NSSV to doctors and psychotherapists and to research the dissemination of this knowledge. Firstly, the current state of knowledge about NSSV and the treatment guideline will be analysed and the need for information recorded. Based on this, various information offerings (print brochure, online course and blended learning) will be designed and compared in terms of how effective and helpful the training programmes are in terms of imparting skills for dealing with NSSV. To this end, all groups are surveyed using online questionnaires directly before the online course is activated or the brochure is sent out and after completion of the online course, possibly with participation in a face-to-face course, or after working through the brochure, and a catamnesis survey is conducted three months after this survey to check how sustainable the skills acquired are.

Results:

The results of the inventory analysis of 677 doctors, psychotherapists and psychologists show that the respondents are frequently confronted with NSSV in their professional context. Most of them stated that they had prior knowledge of NSSA, which they had acquired less through systematic programmes such as further training or studies, but rather through exchanges with colleagues, professional experience or self-study. Their own skills and knowledge in relation to NSSV are assessed as being at an average level. Most of the respondents saw a need for further training, especially in the treatment of NSSV and the therapeutic/medical approach. Around half stated that they were aware of the guideline, around a quarter stated that they knew the requirements of the guideline, of which around 70% followed these requirements in "all" or "most cases".

The three training courses developed (print brochure, online course and blended learning) were examined in a randomised controlled pre-post group comparison study with 671 physicians and psychotherapists in terms of knowledge, action skills, self-efficacy experience, attitudes towards NSSV and satisfaction with the training courses.

The results show that all three training formats developed contribute to an increase in knowledge, competences and positive attitudes towards NSSA, patients and treatment effectiveness. This training effect remained stable until the catamnesis survey three months later. The people who were assigned to the brochure group performed slightly worse in two scales that were surveyed. In addition, all participants reported an increase in their self-confidence in dealing with NSSV, in their clarity regarding the procedure and in their awareness of the topic, regardless of the training format assigned. This positive assessment is slightly lower in the brochure group compared to the other two programmes. The practical transfer of the specific brief intervention "Therapeutic Assessment", which was included in all training formats, was highest in the blended learning group and lowest in the brochure group. User satisfaction was very high for all three dissemination strategies and the evaluation of the training quality was positive, with the brochure receiving the lowest and blended learning the highest ratings. The choice of training format could be made according to the specific training objectives and cost-benefit considerations. Developing and reading a brochure requires the least effort and provides a short, concise overview of NSSV and the guideline recommendations. If a more in-depth discussion of the topic with more practical relevance/examples is desired, e-learning is a good choice. If the focus is on practice transfer in the sense of applied/modified work practice (in this case, the application of "therapeutic assessments"), blended learning proved to be the best method in the study.