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Self-HarmERANCT07720063

Group Treatment for Self-harming Adolescents and Their Parents: a Randomized Controlled Trial

A study testing Emotion Regulation Group Therapy for Self-harming Adolescents, ERA and Functional habits for mental health, FUNK in people with Self-Harm and Self-Harm, Deliberate, run by Karolinska Institutet.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

Adolescent non-suicidal self-injury (NSSI) is common, strongly associated with psychiatric comorbidity and an increased risk of future suicide attempt. Although interventions targeting emotion regulation have been shown to reduce NSSI in both adults and adolescents few, are available within routine child and… Read more about this study

Who is it for?
Ages 13 to 17 years
What is being tested?
Emotion Regulation Group Therapy for Self-harming Adolescents, ERA and Functional habits for mental health, FUNK
Could I receive a placebo?
No, everyone receives an active treatment
How many people
180 participants
Where
No sites listed yet
Study dates
17 Aug 2026to 31 Dec 2034
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 13 to 17 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Age: 13 - 17 years
  • At least 5 instances of NSSI in the past year, and at least one during the past month
  • ≥5 episodes of NSSI in the past year, including ≥1 in the past month
  • If receiving antidepressant, central stimulants or neuroleptic medication, dose must be stable for least 6 weeks prior to inclusion
  • At least one participating caregiver
  • Sufficient Swedish language proficiency (adolescent and caregiver)
  • Regular access to a smartphone for SMS-based assessment

Who cannot join

  • Intellectual disability or a severe psychiatric disorder requiring immediate treatment (e.g., psychosis, bipolar disorder type 1, anorexia nervosa, alcohol/substance dependence) or conditions that prevent participation (e.g., severe social anxiety, selective mutism)
  • Acute suicide risk (i.e., current suicide plans) or recent suicide attempt
  • Previous or ongoing structured emotion regulation treatment involving at least 3 sessions during the past 12 months
  • Previous or ongoing structured emotion regulation treatment (≥3 sessions within past 12 months)
  • Social circumstances preventing participation or require immediate action (e.g., domestic violence, abuse and/or neglect in the family, inpatient care)
  • Ongoing structured psychological treatment targeting NSSI

Trial locations and contacts

No sites are listed yet. Contact the study team or a site near you to ask about taking part.

Hanna Sahlin, PhD, Ass Prof contact

+46706005920

Hanna.Sahlin@ki.se

Ann Rosén, PhD contact

+46733500371

Ann.Rosen@ki.se

About this study

Official title: A Randomised Controlled Trial of Group Emotion Regulation for Adolescent Self-harm (the ERA-study)

Adolescent non-suicidal self-injury (NSSI) is common, strongly associated with psychiatric comorbidity and an increased risk of future suicide attempt. Although interventions targeting emotion regulation have been shown to reduce NSSI in both adults and adolescents few, are available within routine child and adolescent mental health services (CAMHS). Emotion Regulation for Adolescents (ERA), adapted from an evidence-based adult intervention is a brief group-based treatment designed to increase access to effective, evidence-based care for adolescents with NSSI. A large-scale randomised controlled trial (RCT) is needed to establish its efficacy and strengthen the evidence base for emotion regulation interventions for adolescent NSSI.

The overall aim of this project is to increase the availability of evidence-based psychological treatments for adolescent NSSI by developing and evaluating Emotion Regulation for Adolescents (ERA), a novel behavioural and acceptance-based intervention. The main objectives are to establish the efficacy, cost-effectiveness, and long-term outcomes of ERA for adolesent NSSI in two arm RCT comparing ERA with an active control condition (FUNK) as well as to investigate potential mediators such as emotion regulation and self-criticism.

Read the detailed description

Primary and secondary objectives

Primary objective:

To determine the clinical efficacy of Emotion Regulation group therapy for Adolescents (ERA) in reducing NSSI frequency, as assessed by the clinician-rated Deliberate Self-Harm Inventory, Youth Version (DSHI-Y) in adolescents with NSSI, compared to an active control condition (FUNK). The primary endpoint is 1-month post-treatment.

Secondary objectives:

  1. To determine the efficacy of ERA compared to an active control condition (FUNK) in reducing NSSI severity, increasing NSSI abstinence, reducing impulsive and destructive behaviours, emotion dysregulation and self-criticism anxiety and depressive symptoms; and improving general functioning at 1-month post-treatment.
  2. To evaluate the durability of the treatment effects at 12-month follow-up
  3. To investigate whether improvements in emotion regulation and reductions in self-criticism mediate reductions in NSSI at the primary endpoint (1-month post-treatment).
  4. To conduct a health-economic evaluation of ERA compared with FUNK at 12-month follow-up from the perspectives of the healthcare payer; healthcare system resource use, and society.

Research questions:

  1. Is ERA more efficacious than FUNK in reducing NSSI frequency?
  2. Is ERA more efficacious than FUNK in reducing NSSI severity, increasing NSSI abstinence, reducing impulsive destructive behaviours, emotion dysregulation and self-criticism, anxiety and depressive symptoms; and improving global functioning?
  3. Are the treatment effects of ERA maintained at 12-month follow-up?
  4. Do improvements in emotion regulation and reductions in self-criticism mediate effects on NSSI?
  5. Is ERA more cost-effective than FUNK from healthcare and societal perspectives?
Being tested
Emotion Regulation Group Therapy for Self-harming Adolescents, ERA, Functional habits for mental health, FUNK
Keywords
emotion regulation group therapy, non-suicidal self-injury (NSSI), randomized controlled trial
Medical subject headings
Self-Injurious Behavior

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Emotion Regulation Group Therapy for Self-harming Adolescents, ERABehavioural

    Manualized 12-week group intervention for adolescents with NSSI and a parallel five-session parent program.

    Experimental: ERA Participants receive ERA a 12-week manualized group intervention, targeting NSSI. The intervention focuses on increasing adaptive emotion regulation, reducing impulsive behaviours, and increasing acceptance of difficult emotions with integrated exercises to increase self-compassion and reduce self-criticism.

    Caregivers participate in a parallel five-session parent group focusing on preventing NSSI contagion, supporting emotion regulation and strengthening adaptive family communication and functioning.

  • Functional habits for mental health, FUNKBehavioural

    Active comparator: Active Control Condition (FUNK) Participants receive a manualized active control condition FUNK consisting of: 1) ane individual family session to develop a personalized safety plan; 2) five group-based psychoeducation family sessions over 10 weeks, covering sleep, nutrition and physical activity, anxiety, depression and emotions; and 3) weekly suicide risk monitoring.

Study groups in NCT07720063
Study groupRoleWhat they receive
Emotion Regulation Adolescents (ERA).ExperimentalManualized 12-week group intervention for adolescents with NSSI and a parallel five-session parent program.
Receives: Behavioral: Emotion Regulation Group Therapy for Self-harming Adolescents, ERA
Functional habits for mental health (FUNK)Active comparatorActive comparator: Active Control Condition (FUNK) Manualized psychoeducational group intervention with family participation, individualized safety planning, and weekly risk monitoring.
Receives: Behavioral: Functional habits for mental health, FUNK

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change from baseline in clinician-rated scores on Deliberate Self-Harm Inventory - Youth Version (DSHI-Y-7)

    Used to assess frequency, abstinence and severity of non-suicidal self-injury. Clinician-rated. Lower scores means better outcome.

    Measured: [Time Frame: Baseline; week 12 post baseline; 1 [PRIMARY ENDPOINT]-, 6- and 12-month follow-up.]

Secondary outcomes (15)
  1. Clinical Global Impression - Severity (CGI-S)

    Used to provide an overall rating of non-suicidal self-injury severity. Clinician-rated. Range: 1-7. Lower scores mean less severe symptoms.

    Measured: [Time Frame: Baseline; week 12 post baseline; 1-, 6- and 12-month follow-up.]

  2. Clinical Global Impression - Improvement (CGI-I)

    Used to assess global improvement. Clinician-rated. Range: 1-7. Lower scores mean better outcome.

    Measured: [Time Frame: Week 12 post baseline; 1-, 6- and 12-month follow-up.]

  3. Children's Global Assessment Scale (CGAS)

    Used to assess global psychosocial functioning. Clinician-rated. Range: 1-100. Higher scores means better outcome.

    Measured: [Time Frame: Baseline; week 12 post baseline; 1-, 6- and 12-month follow-up.]

  4. Deliberate Self-Harm Inventory - Youth Version (DSHI-Y-7)

    Used to assess frequency, abstinence and severity of non-suicidal self-injury. Adolescent-rated. Lower scores mean better outcome.

    Measured: [Time Frame: Baseline; Mid-treatment: once every week (0-12 weeks post baseline); 1-, 6- and 12-month follow-up.]

  5. Borderline Symptom List, supplement (BSL-23, suppl)

    Used to assess frequency of impulsive self-destructive behaviors. Adolescent-rated. Lower scores mean better outcome.

    Measured: [Time Frame: Baseline; Mid- treatment: once every week (0-12 weeks post baseline); 1-, 6- and 12-month follow-up.]

  6. Difficulties in Emotion Regulation Scale - 16 item version (DERS-16)

    Used to assess difficulties in emotion regulation. Adolescent-rated. Parent-rated. Range: 16-80, Higher scores mean greater difficulties.

    Measured: [Time Frame: Baseline, Mid-treatment: once every week (0-12 weeks post baseline), 1-,6- and 12- month follow-up.]

  7. Everyday Adolescent Emotion Regulation-scale (EARS)

    Brief measure of emotion regulation developed for this project. Adolescent-rated. Lower scores indicate better outcomes

    Measured: [Time Frame: Baseline, Mid-treatment: once every week (0-12 weeks post baseline), 1-,6- and 12- month follow-up.]

  8. Self-criticism And Kindness Scale (SAK)

    Brief measure of self-criticism and self-compassion, developed for this project. Adolescent-rated. Lower scores indicate better outcomes.

    Measured: [Time Frame: Baseline, week 12 post baseline, 1-,6- and 12- month follow-up.]

  9. Short Revised Children's Anxiety and Depression Scale - Short version (RCADS-S)

    Used to assess depression and anxiety symptoms. 25 items. Adolescent- and parent-rated. Range: 0-75, Lower scores mean better outcome.

    Measured: [Time Frame: Baseline; week 12 post baseline; 1-, 6- and 12-month follow-up.]

  10. The Work and Social Adjustment Scale - Youth Version (WSAS-Y)

    Used to assess functional impairment. Adolescent and parent-rated. Range: 0-40. Lower scores means better outcome.

    Measured: [Time Frame: Baseline; week 12 post baseline; 1-, 6- and 12-month follow-up.]

  11. The Coping with Children's Negative Emotions Scale Adolescent Version (CANES-P).

    Used to assess parents' perceived ability to cope with children's negative emotions. Parent-rated. Six subscales: minimization; punitive; emotion-focused coping; problem-focused coping; encourage emotion expression; personal distress. Range: 1-7, higher scores in minimization and punitive subsclaes mean more difficulties. Higher scores in the rest mean better outcome.

    Measured: [Time Frame: Baseline; week 12 post baseline, 1-, 6- and 12-month follow-up.]

  12. Me as a parent (MaaP)

    Questionnaire used to assess parents' beliefs about their locus of control (personal agency) and ability to self-monitor and self-manage. Four subscales: self efficacy; personal agency; self sufficiency; self management. Parent-rated. Range:4-16/ 1-4 (subscales). Higher scores mean better outcome.

    Measured: [Time Frame: Baseline; week 12 post baseline, 1-, 6- and 12-month follow-up.]

  13. Working Alliance Inventory - Group version (WAI-S)

    Used to assess perceived working alliance. Adolesent-rated. Parent-rated. Range: 0-30. Higher scores means better outcome.

    Measured: [Time Frame: Mid-treatment (3 weeks post-baseline)]

  14. The Client Satisfaction Questionnaire (CSQ-8)

    Used to assess client satisfaction with treatment. Adolescent-rated. Parent-rated. Range: 8-32. Higher scores mean better outcome.

    Measured: [Time Frame: 12 weeks post baseline]

  15. Treatment Credibility and Expectancy Scale (TCES)

    Questionnaire revised by the research team. Used to assess treatment credibility and expectations. Adolescent-rated. Parent-rated. Range: 0-40. Higher scores means better outcome

    Measured: [Time Frame: Mid-treatment (3 weeks post-baseline)]

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted22 Jul 2026
  2. Study start17 Aug 2026 (estimated)
  3. Primary completion31 Dec 2032 (estimated)
  4. Study completion31 Dec 2034 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Interventional Model Description: Single-blind parallel-group randomised controlled trial. Following completion of the primary endpoint assessment, participants in the active control condition may be offered crossover to ERA upon request.
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
180 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07720063
Sponsor's protocol ID
2025-08964-01
Other IDs
2025-06882, 2025-00347, 2026-03899-02, 2025
Acronym
ERA
Status last verified
Aug 2026
First submitted
17 Jul 2026
Last updated
18 Aug 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

A study testing Emotion Regulation Group Therapy for Self-harming Adolescents, ERA and Functional habits for mental health, FUNK in people with Self-Harm and Self-Harm, Deliberate, run by Karolinska Institutet.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 18 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Hanna Sahlin, PhD, Ass Prof (+46706005920, Hanna.Sahlin@ki.se), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change from baseline in clinician-rated scores on Deliberate Self-Harm Inventory - Youth Version (DSHI-Y-7) (time frame: [Time Frame: Baseline; week 12 post baseline; 1 [PRIMARY ENDPOINT]-, 6- and 12-month follow-up.]). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 Aug 2026.

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