Table 3.

Summary of Published Self-Injury Interventions and Respective Levels of Evidence

InterventionLevel of EvidenceSORT RatingRCTsTreatment DescriptionPatients Treated in Published Reports or RCTs (n)Effect on Self-Injury
Topiramate3CN/A200 mg/day3Cessation of self-injury
Clozapine3CN/A300 to 550 mg/day for 4 to 12 months8Cessation of self-injury
Naltrexone3CN/A50 mg/day8Cessation of self-injury
Dialectical behavior therapy1B312-month outpatient program; weekly individual modified cognitive-behavioral therapy; weekly skills training; ongoing skills coaching between sessions188Significant reduction of self-injury in 2/3 RCTs compared with TAU group
Manual-assisted cognitive behavior therapy3C22–7 individual cognitive therapy-oriented sessions; 70-page self-help book512No effect on self-injury
Transference-focused psychotherapy2C212-month outpatient program; weekly individual psychodynamic therapy23No effect on self-injury
Mentalization-based therapy2C018-month inpatient program; weekly individual psychodynamic therapy; weekly group psychodynamic therapy (3×); weekly individual psychodrama session19Significantly lower proportion of self-injurers compared with TAU group
  • The number of patients is from randomized controlled trials only when available or from available, published, nonrandomized studies if no randomized controlled trials have been conducted.

  • SORT, strength of recommendation taxonomy; RCTs, randomized placebo-controlled trials; TAU, treatment as usual.