UK SBS IT16003 Imaginator Project

Purpose of this project

Aim of the Imaginator project is to pilot test a brief cognitive therapy intervention for self-harm in young people. Up to 10% of 15-16 year old young people deliberately self-harm over a year in England, with substantial personal/family impacts and costs on the NHS. Studies demonstrate that treating underlying mental illness leads to reductions in self-harm, but these are long treatments for complex disorders. Moreover, often individuals are left without support at managing the distressing self-harm behaviour while they wait (increasingly long periods) before they start the above treatments. The Imaginator project aims to remedy the lack of an effective short-term therapy for self-harm. The focus is on young people who are a most vulnerable group and struggle to access traditional mental health services.

The Imaginator project will deliver a type of cognitive therapy intervention called Functional Imagery Training (FIT). FIT combines motivational interviewing and mental imagery cognitive techniques to promote adaptive behaviours, in this case focusing on building an alternative behaviour to self-harm. FIT will train individuals to:

• Develop and use images of an alternative adaptive behaviour rather than self-harm when distressed. During the training individuals experience mental images unfolding as multi-sensory ‘movies’ in their mind that also include experiencing the reward and success of engaging in the behaviour and at overcoming a challenge. As imagining something makes it more likely to act, functional imagery can increase motivation to engage in alternative adaptive behaviours and reduce likelihood of self-harm.
• Develop and use positive helpful images when distressed, thus reducing negative feelings associated with self-harm.

FIT will be delivered in two face-to-face sessions followed by five review sessions over the phone, over three months. Functional imagery practice at home will be supported by a smartphone app, called ‘Imaginator App’. Imagery-focused techniques focus on visual techniques and are easily amenable to be supported by a smartphone app. Smartphone access by young people is now almost universal and usage is high; hence this technology offers an opportunity to increase access and engagement in acceptable forms of support by young people. A key element of the project is to build the Imaginator App to support the FIT intervention.

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