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Explanatory style in youth self-harm: an Indian qualitative study to inform intervention design

Aggarwal, Shilpa, Patton, George, Bahl, Deepika, Shah, Nilesh, Berk, Michael and Patel, Vikram 2020, Explanatory style in youth self-harm: an Indian qualitative study to inform intervention design, Evidence-based mental health, vol. 23, no. 3, pp. 100-106, doi: 10.1136/ebmental-2020-300159.

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Title Explanatory style in youth self-harm: an Indian qualitative study to inform intervention design
Author(s) Aggarwal, Shilpa
Patton, George
Bahl, Deepika
Shah, Nilesh
Berk, MichaelORCID iD for Berk, Michael orcid.org/0000-0002-5554-6946
Patel, Vikram
Journal name Evidence-based mental health
Volume number 23
Issue number 3
Start page 100
End page 106
Total pages 7
Publisher BMJ Publishing Group
Place of publication London, Eng.
Publication date 2020-08
ISSN 1362-0347
1468-960X
Keyword(s) Science & Technology
Life Sciences & Biomedicine
Psychiatry
suicide & self-harm
Summary Background There are very few studies that have examined the effectiveness of psychological interventions (PIs) that have been developed and tested in high-income countries to reduce self-harm in low and middle-income countries. Objective To evaluate the perspectives and explanatory styles of youth with self-harm and their caregivers to inform the design of an evidence based PI in a non-Western cultural setting. An additional objective was to suggest ways of integrating local practices and traditions to enhance its acceptability. Methods We conducted 15 in-depth qualitative interviews with youth with self-harm and four interviews with the caregivers in the psychiatry department of a tertiary hospital located in Mumbai, India. Data were analysed using phenomenological thematic analysis. Findings Five themes were uncovered: (i) contextual factors related to self-harm including interpersonal factors, intrapersonal factors and socio-cultural factors; (ii) formulation and current feelings about the attempt (iii) family members and friends as the perceived supports and deterrents for future self-harm attempts; (iv) treatment related experiences with counselling, in-patient and outpatient treatment and barriers to treatment; and (v) coping strategies. Recommendations for key areas of adaptation include therapist adaptation, content adaptation to accommodate for cultural considerations and broader social context. Gender based socio-cultural norms, beliefs and stigma attached to self-harm need to be specifically addressed in South Asian setting. Interpersonal conflicts are the most common triggers. Conclusion and clinical implications To our knowledge this is the first study in the South Asian context evaluating explanatory styles of youth with self-harm and their caregivers to inform the design of an intervention to ensure its cultural congruence. Cultural adaptation of an evidence based PI results in competent delivery and ensures best results in diverse ethno-cultural populations.
Language eng
DOI 10.1136/ebmental-2020-300159
Indigenous content off
Field of Research 1117 Public Health and Health Services
HERDC Research category C1 Refereed article in a scholarly journal
Free to Read? Yes
Persistent URL http://hdl.handle.net/10536/DRO/DU:30140741

Document type: Journal Article
Collections: Faculty of Health
School of Medicine
Open Access Collection
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.