Reducing non-suicidal self-injury in Chinese adolescents through Imagery Communication Psychotherapy

Non-suicidal self-injury (NSSI) among young people remains a challenging public health problem, affecting approximately 20% of middle school students in China. NSSI is strongly correlated with psychological distress and functional impairments and has been shown to significantly increase the risk of subsequent self-harm, suicide attempts and mental health disorders in early adulthood. Difficulties in expressing and regulating emotions are often a key maintaining factor in NSSI. This study investigated the effectiveness of a 10-week group intervention based on Imagery Communication Psychotherapy (ICP) for 16 Chinese middle school adolescents (5 boys and 11 girls, aged = 12–14 years) with NSSI. Structured imagery and related exercises were developed to promote emotion expression and regulation. Results showed that participants reported significant reductions in NSSI, negative affect and overall emotional regulation difficulties. These findings provide preliminary evidence for the efficacy and feasibility of group-based ICP for adolescents with NSSI. Given the unique benefits of ICP for the awareness, expression and transformation of negative emotions, the integration of imagery techniques to improve emotion regulation in the treatment of NSSI is promising. Further research employing randomised controlled trials with larger cohorts is required to establish intervention efficacy and cultural generalisability.