Our researchers
Jo Lockwood (University of Nottingham), Camilla Babbage (University of Nottingham), Chris Greenhalgh (University of Nottingham), Marina Jirotka (Oxford University), Ellen Townsend (University of Nottingham), Lily Roberts (University of Nottingham)
Self-harm is a complex behaviour and we still have much to learn about it. There are many different factors that interact and evolve over time that may lead a young person to self-harm. There are not currently many evidence-based interventions to support young people who self-harm and most have not been co-developed with young people. In our project we worked to understand the key ingredients required for a digital collaborative understanding and assessment tool for adolescent self-harm (an app). In this case, where a young person and practitioner works together during their care journey. This was based on the Card-Sort Task for Self-harm (CaTS), a tool previously developed for research.
Our work has been driven by being comprehensive, responsible and engaging with our involvement and co-production methods, which have also been adopted across the Digital Youth programme.
The card sort task for self-harm (CaTS)
CaTS helps young people tell the story of their self-harm journey by mapping the thoughts, feelings and events involved in a self-harm episode. A timeline is set out with multiple timepoints starting from 6 months prior to self-harm and ending after self-harm. Young people are provided with a bank of cards grouped into thoughts and feelings, events, behaviours, services and support, afterwards. Young people choose cards with items relevant to their experience of a self-harm episode at and arrange the cards along the timeline.
Key findings
- We’ve gained critical knowledge about optimum conditions (such as design,
content, setting and delivery) through coproduction with proposed end-users (key frontline staff and adolescents seeking help for self-harm) which has informed the development of our prototype. This matters because there are a lack of evidence-based interventions for adolescent self-harm that demonstrate effectiveness or appeal, and a systemic failure to include key stakeholders in decision making around development and implementation of perceived sensitive interventions. - We’ve shown there is appetite for the proposed CaTS-App© evidenced by support for our proposals via survey data, and interview and focus group findings. (See reports below).
- Our dyad-study brings a first-of-its-kind realworld prototype testing of a co-produced collaborative assessment and intervention tool. This matters because working collaboratively and comprehensively to develop a shared understanding of patient needs is the crucial foundation to clinical provision as set out in NICE guidelines for practitioners. Real-world testing offers an
early evaluation opportunity of CaTS-App© as an assessment and understanding tool, taking into account how it interacts with the context within which it will be implemented, and how it can be further refined to suit implementation.
Our latest videos
Video 1: Why Use the CaTS-App?
Video 2: Deeper Dive & Demo into the CaTS-App
Work completed so far
Phase 1: Planning and Preparation – understanding attitudes towards CaTS
Supported by Sprouting Minds we have consulted with young people and frontline professionals across healthcare, education, social care and the third sector to understand key stakeholder thoughts about CaTS and a new digital version (CaTS-App©).
We have done this by conducting an online survey, individual interviews, focus groups and workshops with professionals and frontline staff across different settings.
We have also conducted a series of three online and face to face co-production workshops with young people aged 17-24 years with lived experience of self-harm. Together we explored how the CaTS–App© should look, feel and how best to use the tool.
Key findings from this work are detailed here:
Phase 2: Design and Development – to co-develop a working prototype of the app
The second stage of the project turned the thoughts and insights from key stakeholders in Phase 1 into prototype development of the CaTS-App©.
During Summer 2024, we ran a series of three follow-up co-production workshops with our young people to co-create a working prototype.
Over the past year we have worked closely with our partners in Computer Science to talk through and develop our ideas into a working prototype.
Our Latest Reports:
Phase 1: Planning and Discovery
Please see below for our first report, which pulls together our first round of stakeholder and co-production work:
Phase 2: Design and Development
Please see below for our most recent report, pulling together findings from our 2024 co-production workshops with young people:
Phase 3: Feasibility
This involved a smallscale, multimethod study to assess the app’s acceptability, usability, and user experience in clinical and community settings, and evaluating its integration into routine care for adolescents.
Partnership with young people during CaTS-App© development
We recruited five young people (Sprouts) from our young person’s advisory group, Sprouting Minds to join our project. Having involvement from Sprouts from the beginning has enabled us to ensure all aspects of the co-production workshops were designed and tailored to how young people believed would
be the most supportive and productive for other young people involved in our project. This involvement has improved the level of co-production throughout the project, and we believe has had an instrumental impact on helping to retain young people to the project and keep them safe.
Co-production workshops
Our Sprouts also helped us to conduct a series of three online and face-to-face co-production workshops with young people aged 17-24 years with lived experience of self-harm. Together we explored how the CaTS–App© should look and feel, and how best to use the tool.
What’s it like being a sprout on work package 8?
“My experience has been positive and meaningful. I feel proud to be part of the group, but nervous before sessions and anxious about keeping up with tasks. I think it has been a hugely positive experience, and the anxiety has made it feel more important of a role which is positive. I’ve learnt confidence in my ability to make a meaningful difference.”
Young Person
If you’re a young person and interested in joining our sprouting minds team to take part in research, please register your interest by clicking this link: Sprouting Minds Register Interest
Join us?
If you’re a professional interested in our work and would like updates about how we are progressing or if you would like to be involved in research, please register your interest at this link: CaTS Register Interest
Project partners
