Efficacy and acceptability of digital safety planning therapy for self-injurious thoughts and behaviors in adolescents with depressive episodes: a randomized controlled trial
In brief
Safety-planning app reduced several self-harm and suicide measures in adolescents
In a trial of 122 adolescents with depressive episodes, adding the LIFES app to usual care led to greater reductions in several measures of self-injury and suicidal behavior over six months than usual care alone. Users reported good satisfaction, but the abstract gives no absolute effect sizes, and it remains unclear whether the results apply to other groups.
- Journal
- Journal of child psychology and psychiatry, and allied disciplines (Q1)
- Published
- 9 October 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Yi-Hui Liu, Jia-Rong Liang, Cheng-Jia Yang, Xin-Cheng-Cheng Huang, Qin-Jing Li, Dong-Ni Wen, et al.
- PMID
- 42855842
- DOI
- 10.1111/jcpp.70246
Why clinicians should know about it
- Picked for Psychiatry and Mental Health (paper of the day, 11 October 2026): RCT of digital safety planning for self‑injury
Abstract
BACKGROUND: Self-injurious thoughts and behaviors (SITB) represent a significant mental health issue among Chinese adolescents. Research on smartphone-based safety planning as digital therapeutics for SITB in China remains limited. This randomized controlled trial evaluated the efficacy and acceptability of a safety planning mobile application (LIFES) for reducing SITB in adolescents with depressive episodes. METHODS: Among 189 adolescents with depressive episodes screened, 122 were randomized to either the intervention group (LIFES app plus treatment as usual [TAU], n = 61) or the control group (TAU only, n = 61). Follow-up assessments at 1, 3, and 6 months measured SITB, depression, anxiety, and sleep quality. This trial is registered with the Chinese Clinical Trial Registry (ChiCTR2300075663; https://www.chictr.org.cn/). RESULTS: Generalized linear mixed models showed significant time-by-group interaction effects for non-suicidal self-injury frequency (F = 3.39, p = .018), suicide planning seriousness (F = 2.93, p = .034), confidence in suicide completion during preparation (F = 3.10, p = .027), suicide threat/gesture frequency (F = 3.64, p = .013), and total suicidal behavior frequency (F = 3.31, p = .020) after adjusting for depression and anxiety symptom severity, sleep quality, and years of education. The intervention group showed significantly greater reductions in SITB characteristics compared to the control group. User experience surveys indicated good satisfaction with the application. CONCLUSIONS: This study demonstrates that safety planning-based digital therapeutics are an effective adjunctive intervention for SITB in adolescents with depressive episodes. Future research should examine the applicability of this intervention to broader populations.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.