RecruitingInterventional

Is a talking therapy, called psychodynamic interpersonal therapy, clinically and cost effective for women who self-harm in prison?

Self-harm is a serious and growing challenge in prisons, especially among women. Although women make up only about 5% of the prison population in the UK, they account for more than a quarter of all self-harm incidents. Despite this, very few therapies have been properly tested in prison settings. This study tests a talking therapy known as Psychodynamic Interpersonal Therapy (PIT). The therapy was adapted with input from women in prison and prison staff. It focuses on how past events and personal relationships affect current feelings, aiming to help women find safer ways to cope with distress. Participants are randomly placed into one of two groups: one receives standard prison healthcare, and the other receives standard care plus four to eight therapy sessions. Researchers want to see whether PIT reduces self-harm and if it is cost-effective for the NHS.

At a glance

Status

Recruiting

Sponsor

Greater Manchester Mental Health NHS Foundation Trust

Enrolment target

264

Start

01 Jun 2026

Estimated completion

31 Jan 2027

Self-harm

What is this study about?

Self-harm is an urgent issue in women's prisons across the UK. People often self-harm to cope with intense emotional pain, feel in control, or express feelings they cannot put into words. Even though women make up a small minority of the total prison population, a disproportionately large number of self-harm incidents happen in women's prisons. Currently, there is limited scientific evidence about which psychological treatments work best in this environment.

To address this gap, researchers from the University of Manchester are running a study called WORSHIP III. The trial explores whether a specific talking therapy—Psychodynamic Interpersonal Therapy (PIT)—can help. PIT gives women a safe, confidential space to explore their emotions, personal relationships, and past experiences. The goal is to help them understand why they feel the way they do and develop healthier ways to deal with overwhelming distress.

The research also looks at the bigger picture for prison healthcare. By comparing women who receive the therapy with those who receive usual prison support, the study will find out whether PIT reliably reduces self-harm. It will also examine whether offering this therapy across prisons represents good value for the NHS, potentially leading to better mental health services for women in the justice system in the future.

Key takeaways

The study tests whether a talking therapy (PIT) helps women in prison reduce self-harm.
Participants are randomly chosen to receive 4 to 8 therapy sessions or usual prison support.
Sessions last around 50 minutes and happen either face-to-face or digitally.
Taking part is completely voluntary and will not affect your sentence or release.
The findings will help the NHS understand how best to support women struggling with self-harm in custody.

Who may be eligible?

This study is open to adult women (aged 18 or older) currently staying in a UK prison, whether they are on remand awaiting trial or serving a sentence.

To be eligible, a woman must have self-harmed within the past month. She must also currently be supported by—or have been on within the last month—an ACCT plan (Assessment, Care in Custody and Teamwork), which is the standard support system prisons use to help people at risk of self-harm.

Finally, participants must have at least eight weeks remaining in the prison before their planned release date or trial. This ensures there is enough time to complete the therapy sessions while taking part in the study.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

I am a woman aged 18 or older.
I am currently in prison (on remand or sentenced).
I have self-harmed within the last month.
I am currently on an ACCT plan or was on one within the past month.
I have at least 8 weeks left before my trial date or release.

Answer every question to see your result.

What does participation involve?

Taking part in the study begins with a conversation with a researcher to see if the trial is right for you. If you agree to take part, a computer will assign you by chance (like flipping a coin) to one of two groups. This is done to make the comparison fair.

If you are placed in the therapy group, you will attend between four and eight therapy sessions. Each session lasts about 50 minutes and can take place either in person in a private prison room or via a secure video link. During these sessions, you will talk with a trained therapist about your feelings, your past, and your relationships. If you are placed in the comparison group, you will continue to receive all the usual medical and mental health care provided by the prison.

Throughout the study, researchers will check in to see how you are doing, ask questions about your mood, and review records of self-harm. No new medications are given as part of this trial, and taking part will not change or delay your release date or your sentence.

Potential risks and benefits

The main benefit of taking part is the chance to receive a specialized talking therapy that may help you better understand your feelings and reduce urges to self-harm. Even if the therapy does not help you personally, your involvement could help improve mental health care for other women in prison in the future. The main risk is that talking about past experiences, difficult relationships, and self-harm can sometimes feel upsetting or emotionally draining. Taking part is completely voluntary. You are free to stop the therapy or leave the study at any time, and doing so will not affect your prison healthcare, your legal rights, or how staff treat you.

Locations (8)

HMP Styal
City only
Wilmslow, England
HMP New Hall
City only
Wakefield, England
HMP Bronzefield
Approximate
Ashford, England
HMP Send
City only
Woking, England
HMP Downview
City only
Sutton, England
HMP Foston Hall
Unverified
Derby, England
HMP Eastwood Park
Unverified
Wotton-under-Edge, England
HMP Drake Hall
Unverified
Eccleshall, England

Common questions

What is Psychodynamic Interpersonal Therapy (PIT)?

PIT is a type of talking therapy that helps you explore the link between difficult feelings, past life events, and your relationships with others, helping you find healthier ways to cope.

Will taking part affect my prison sentence or release date?

No. Taking part in research has no effect on your legal status, sentence length, parole hearings, or release date.

What is an ACCT?

ACCT stands for Assessment, Care in Custody and Teamwork. It is the care plan system used by UK prison staff to support and monitor anyone at risk of self-harm or suicide.

Can I choose whether I get the talking therapy?

No. A computer assigns participants to either the therapy group or the usual care group by chance. This makes sure the study results are fair and reliable.

Can I stop the study if it gets too difficult?

Yes. You can leave the study at any point without giving a reason. Leaving will not affect your standard medical care or prison support.

How to find out more

Heidi Tranter

heidi.tranter@manchester.ac.uk None provided Official trial record

Always speak to your GP or specialist before deciding to take part in a study.