Feasibility and acceptability of the Community Outpatient Psychotherapy Engagement Service for Self-harm (COPESS): randomised controlled trial

Saini, P ORCID: 0000-0002-4981-7914, Hunt, A, Clements, C ORCID: 0000-0003-4735-6728, Gabbay, M, Mills, C, Kvamme-Mitchell, K, Tahir, N, Mulholland, H, Kullu, C, Hann, M, Duarte, R ORCID: 0000-0001-6485-7415, Murphy, A, Guthrie, E ORCID: 0000-0002-5834-6616 and Taylor, P ORCID: 0000-0003-1407-0985 (2025) Feasibility and acceptability of the Community Outpatient Psychotherapy Engagement Service for Self-harm (COPESS): randomised controlled trial. BJPsych Open, 11 (5).

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Abstract

Background Self-harm is widespread and often occurs in the community without resulting in hospital presentation. Individuals with depressive symptoms are at elevated risk. There are limited self-harm interventions designed for community and primary care settings. The Community Outpatient Psychological Engagement Service for Self-harm (COPESS) is a brief talking therapy intervention for self-harm based in community settings. Aims To assess the feasibility of evaluating the COPESS intervention in a community setting in relation to participant recruitment, retention, data collection and the acceptability of the intervention. Method We used a mixed-method approach and a single-blind randomised controlled trial design with 1:1 allocation to either COPESS plus treatment as usual or treatment as usual alone. Adults with depressive symptoms and self-harm in the past 6 months were recruited from general practices. Secondary outcome measures were assessed at baseline and 1 month, 2 months and 3 months after randomisation. The trial was pre-registered on clinicaltrials.gov (NCT04191122) on 9 December 2019. Results Fifty-five people were randomised (of an initial target of 60). Retention rates at follow-up assessments were high (>75%), as was attendance by all participants for all therapy sessions (93%). At 3 months, there were trends towards lower levels of self-harm urges, depressive symptoms and distress in the COPESS group compared with controls. Fidelity to the manualised COPESS therapy was moderate to high. Conclusions All progression criteria were met, supporting further evaluation of the intervention in a full-scale efficacy and/or cost-effectiveness trial. These findings add to the growing evidence base supporting the utility of brief psychological interventions for self-harm. COPESS has potential as a brief primary-care-based intervention for those struggling with self-harm.

Item Type:	Article
Uncontrolled Keywords:	1103 Clinical Sciences; 1117 Public Health and Health Services; 3202 Clinical sciences; 4203 Health services and systems
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Divisions:	Psychology (from Sep 2019)
Publisher:	Cambridge University Press
Date of acceptance:	12 June 2025
Date of first compliant Open Access:	22 August 2025
Date Deposited:	22 Aug 2025 14:41
Last Modified:	22 Aug 2025 14:45
DOI or ID number:	10.1192/bjo.2025.10780
URI:	https://researchonline.ljmu.ac.uk/id/eprint/26981

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