Exploring the acceptability of a brief, rapid-access, self-harm focussed talking therapy: a qualitative analysis of patient experiences.

Clements, C, Mulholland, H, Hunt, A, Mills, C, Kvamme-Mitchell, K, Tahir, N, Kullu, C, Taylor, P, Gabbay, M and Saini, P ORCID: 0000-0002-4981-7914 Exploring the acceptability of a brief, rapid-access, self-harm focussed talking therapy: a qualitative analysis of patient experiences. BMJ Open. ISSN 2044-6055 (Accepted)

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Abstract

Objective: To explore the acceptability of the Community Outpatient Psychotherapy Engagement Service for Self-harm (COPESS) intervention and trial procedures for participants.

Design: 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.

Setting: Primary Care

Participants: Fifteen semi-structured interviews were conducted with participants in the COPESS trial; 8 were randomised to the intervention arm and 7 were randomised to the treatment-as-usual (TAU) arm. Interviews lasted 30-60 minutes.

Intervention: COPESS is a brief, relational psychotherapy delivered over four weekly sessions plus a follow up, focusing on understanding difficult emotional states and their links to self harm through here and now relational and emotional processes.

Analysis: Thematic analysis allowed exploration of themes important to participants in their experiences in the COPESS trial, and their experiences of care for self-harm more generally.

Findings: Five themes were identified as associated with the acceptability of the COPESS intervention and trial: self-harm as a primary problem; what I needed when I needed it; being heard and understood; online delivery of the intervention; and lasting impacts. Participants generally expressed positive views about the intervention, citing a need for services that specifically target self-harm and an appreciation of the rapid access to help. Strong relationships with the therapist were highly valued and not diminished by online delivery of the intervention. Positive impacts continued post therapy sessions.

Conclusions: These results support the acceptability of the COPESS intervention, the need for self-harm specific services, and support moving forward to a full trial.

Item Type:	Article
Uncontrolled Keywords:	Research Centre for Brain and Behaviour (RCBB); Institute for Health Research (IHR); 1103 Clinical Sciences; 1117 Public Health and Health Services; 1199 Other Medical and Health Sciences; 32 Biomedical and clinical sciences; 42 Health sciences; 52 Psychology
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Divisions:	Psychology (from Sep 2019)
Publisher:	BMJ Publishing Group
Date of acceptance:	20 May 2026
Date of first compliant Open Access:	22 May 2026
Date Deposited:	22 May 2026 14:35
Last Modified:	22 May 2026 14:35
URI:	https://researchonline.ljmu.ac.uk/id/eprint/28629

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