Parent Education and Resources for Self-Injurious Youth

描述(申请人提供)：非自杀性自我伤害(NSSI)是青少年和年轻人中越来越常见的一种自我伤害行为，目前估计青少年NSSI的比例在12%至37%之间。虽然NSSI与其他精神健康问题(如抑郁、焦虑、饮食失调)有关，也是自杀和严重意外伤害的危险因素，但NSSI的循证治疗和预防模式很少。此外，尽管有证据表明，父母在青少年从自残行为中恢复方面发挥了重要作用，但可供父母使用的资源很少。父母对NSSI和青少年发展过程的基本知识，以及父母自身的情感和沟通能力等因素，都直接影响青少年的康复过程。然而，由于家庭(例如，时间、关于自我伤害行为的耻辱)和临床医生(例如，平衡青少年和父母的需求)的障碍，让父母参与孩子的康复过程可能是具有挑战性的。基于网络的心理教育计划提供了一种克服这些障碍的机制，以便为父母提供教育、技能和支持，以帮助他们的孩子。拟议的SBIR项目将开发和测试父母教育和自我伤害青少年资源(PERSY)，这是一个专门为正在接受NSSI治疗的青少年的父母提供网络服务的方案。通过这笔SBIR第一阶段拨款，我们将开发PERSY的原型，并进行可行性和可用性测试，以在全面产品开发之前收集关键利益相关者的反馈。这个第一阶段的项目将实现三个具体目标：(1)创建PERSY原型，包括三个基于网络的模块和所附计划材料的概要；(2)对PERSY原型进行利益相关者可行性和可用性测试，以评估NSSI临床治疗中30名心理健康专业人员和30名12-20岁儿童的父母的可行性、可用性、创新性和质量；以及(3)使用从可行性测试中汇编和分析的数据建立最终的原型规格。Persy将包括一系列基于网络的模式，包括视频演示、教学教育、交互式自我评估、社交技能建模和个性化反馈。据我们所知，没有其他产品能为NSSI青少年的父母提供这种类型的知识增强、技能发展和支持。第一阶段的研究预计将证明利益相关者对拟议产品的大力支持，并为全面产品开发提供必要的基础。一旦Persy计划在第二阶段最终敲定，我们将进行一项随机临床试验，以检查对 (1)育儿知识、技能和与子女的积极接触；(2)青少年自我伤害的康复；(3)青少年与父母的积极参与。这个SBIR项目将有助于将Persy确立为心理教育市场上的有效竞争对手。最终产品将成为父母和心理健康专业人员的宝贵资源，有可能对患有NSSI的年轻人及其家庭的生活产生重大影响。 公共卫生相关性：非自杀性自我伤害(NSSI)，如切割、焚烧和将物品埋在皮肤下，在青少年和年轻人中是一种越来越常见的自我伤害行为。目前对青年NSSI发生率的估计在中学人群中为12%-37%，在青年人群中为12%-25%。NSSI与其他严重的精神健康问题有关，包括抑郁、焦虑和饮食失调，是自杀和严重意外伤害的潜在风险因素。心理健康问题伴随着极高的经济成本，因此被认为是一个严重的公共卫生问题。在美国，每年与心理健康治疗相关的直接成本估计为575亿美元，其中精神疾病的总成本要高得多(例如，残疾、失业)。每年约有460万儿童接受某种形式的精神卫生(MH)护理，与普通人口的平均护理费用相比，青少年的平均护理费用更高。总统新成立的精神健康自由委员会特别呼吁对可能出现精神健康问题的年轻人进行识别和早期治疗，以防止共病和其他负面后果的发生。此外，多项研究表明，父母在青少年心理健康护理中发挥着关键作用。父母的作用既是工具性的(即发现问题、寻找治疗提供者、协调治疗)，也是支持性的(即，在治疗期间监测青少年，在治疗之外加强治疗概念)。考虑到与精神障碍和精神健康服务的使用相关的直接成本，为父母开发和测试创新项目尤为重要。这些方案可以支持父母在青年时期促进最佳结果，以克服NSSI并降低总体心理健康治疗成本。尽管NSSI的发病率越来越高，已知的与NSSI相关的负面后果，以及对父母在青年康复中的作用的了解，但对患有NSSI的青少年父母缺乏循证治疗。拟议的SBIR项目通过开发和测试基于网络的心理教育计划来直接解决这一关键的治疗缺口，该计划旨在满足患有NSSI的青少年和年轻人的父母的教育和支持需求。

DESCRIPTION (provided by applicant): Non-suicidal self-injury (NSSI) is an increasingly common self-harming behavior among adolescents and young adults, with current estimates of NSSI in youth ranging from 12-37%. Although NSSI is associated with other mental health problems (e.g., depression, anxiety, disordered eating) and is a risk factor for suicide and severe unintended injury, evidence-based treatment and prevention models for NSSI are scarce. In addition, few resources are available for parents despite evidence of their important role in youth's recovery from self- harming behaviors. Factors such as parents' basic knowledge of NSSI and youth developmental processes, as well as parents' own emotion and communication skills, have a direct impact on a young person's recovery process. However, engaging parents in their child's recovery process can be challenging due to barriers for families (e.g., time, stigma regarding the self-injury behavior) and clinicians (e.g., balancing youth and parent needs). A web-based psychoeducation program provides a mechanism for overcoming these barriers in order to provide parents with education, skills and support to help their children. The proposed SBIR project will develop and test Parent Education and Resources for Self-injurious Youth (PERSY), a specialized web-based program for parents of youth who are receiving treatment for NSSI. Through this SBIR Phase I grant, we will develop a prototype of PERSY and conduct feasibility and usability testing to gather feedback from key stakeholders prior to full product development. Three specific aims will be accomplished in this Phase I project: (1) creating the PERSY prototype including three web-based modules and outlines of the accompanying program materials; (2) conducting stakeholder feasibility and usability tests of the PERSY prototype to assess the feasibility, usability, innovation, and quality with 30 mental health professionals and 30 parents of 12-20 year olds in clinical treatment for NSSI; and (3) establish final prototype specifications using data compiled and analyzed from the feasibility testing. PERSY will include a range of web-based modalities including video presentations, didactic education, interactive self-assessments, social skill modeling, and personalized feedback. To our knowledge, no other product exists that provides this type of knowledge enhancement, skill development, and support to parents of youth with NSSI. Phase I research is expected to demonstrate strong support for the proposed product across stakeholders and provide the necessary foundation for full product development. Once the PERSY program is finalized in Phase II, we will conduct a randomized clinical trial to examine treatment effects for (1) parenting knowledge, skills, and positive engagement with their child, (2) youth self-injury recovery, and (3) youth positive engagement with parents. This SBIR project will be instrumental in establishing PERSY as an efficacious competitor in the psychoeducation marketplace. The final product will serve as a valuable resource for parents and mental health professionals with the potential to have a significant impact on the lives of youth with NSSI and their families. PUBLIC HEALTH RELEVANCE: Non-suicidal self-injury (NSSI) such as cutting, burning, and embedding objects under the skin is an increasingly common self-harming behavior among adolescents and young adults. Current estimates of rates of NSSI in youth range from 12-37% in secondary school populations and 12-25% in young adult populations. NSSI is associated with other serious mental health problems including depression, anxiety, and disordered eating and is a potent risk factor for suicide and severe unintended injury. Mental health problems come with a devastatingly high financial cost and are thus considered a serious public health issue. In the U.S., the annual direct costs associated with mental health treatment are estimated at $57.5 billion, with the overall costs of mental illness significantly higher (e.g., disability, unemployment). Each year, about 4.6 million children receive some form of mental health (MH) care, with higher average costs of care for youth as compared to average costs for the general population. The President's New Freedom Commission on Mental Health specifically calls for the identification and early treatment of youth who may experience mental health problems to prevent the onset of co-occurring disorders and other negative outcomes. In addition, multiple research studies have shown that parents play a critical role in youth mental health care. Parents' roles are both instrumental (i.e., detecting a problem, seeking out a treatment provider, coordinating treatment) and supportive (i.e., monitoring youth between sessions, reinforcing therapy concepts outside of the session). Given the direct costs associated with psychiatric disorders and use of mental health services, it is especially important to develop and test innovative programs for parents. These programs can support parents in promoting optimal outcomes in their youth in order to overcome NSSI and reduce overall mental health treatment costs. Despite its increasing prevalence, the known negative outcomes associated with NSSI, and knowledge of parents' role in youth recovery, evidence-based treatments for parents of youth with NSSI are lacking. The proposed SBIR project directly addresses this critical treatment gap by developing and testing a web-based psychoeducation program designed to meet the education and support needs of parents of adolescents and young adults with NSSI.