Teaching therapeutic assessment for self-harm in adolescents: training outcomes.

OBJECTIVES To describe the teaching programme of Therapeutic Assessment (TA), a brief intervention at the point of initial assessment for adolescents with self-harm; to describe trainees' preferences and choices regarding their use of specific aspects of TA. DESIGN This is a comparative study investigating the differences in the TA skills before and after training. This design was chosen to establish whether or not TA training is efficacious. METHODS  Twenty-four clinicians volunteered to participate in five half-day TA training sessions. Their scores on the Therapeutic Assessment Quality Assurance Tool (TAQAT, primary outcome measure) were compared before and after training. Satisfaction with training and therapeutic strategy choices as well as ability to perform TA in an RCT were investigated. RESULTS Clinicians who participated in TA training had significantly increased scores on TAQAT after training. The clinicians who achieved the required quality of TA post assessments were likely to be able to carry out TA in an RCT with high fidelity. In addition, prior to training, significant differences in the quality of assessments as measured by TAQAT were identified depending on the experience of the clinician. This discrepancy was no longer present post training. Therapeutic strategy based on solution-focused brief therapy (SFBT) was the option of choice post training. CONCLUSIONS TA training is feasible and associated with improved quality of self-harm assessment. PRACTITIONER POINTS TA is a brief intervention associated with improved treatment engagement. TA training is feasible and is associated with improved quality of self-harm assessment. SFBT-based exit is the most commonly used strategy in TA.