# Culturally Adapted Manual‐Assisted Psychological Intervention (CaMaPI) for Adolescents/Young People With a History of Self‐Harm and Suicidal Ideation in Nigeria: A Randomised Controlled Feasibility Trial

## TL;DR

A culturally adapted psychological intervention called CaMaPI was found to be feasible and acceptable for reducing self-harm and suicidal thoughts in Nigerian youth.

## Contribution

The study introduces a culturally adapted manual-based intervention tailored for Nigerian adolescents and young people with self-harm and suicidal ideation.

## Key findings

- CaMaPI showed higher satisfaction and greater reduction in self-harm and suicidal ideation compared to Treatment as Usual.
- Qualitative feedback highlighted cultural appropriateness and positive participant experiences with CaMaPI.
- Both groups showed no significant reduction in hopelessness, suggesting a need for further intervention refinement.

## Abstract

Globally, suicide is the second leading cause of death for adolescents/young people aged 15–30‐years old. The mainstream care for these affected persons is mostly unsuccessful due to limited culturally appropriate care.

This is a mixed‐methods randomised controlled feasibility trial design. A culturally adapted manual‐assisted psychological intervention (CaMaPI) was utilised to treat adolescents/young people with histories of self‐harm and suicidal ideation. CaMaPI is a manualised intervention consisting of 10 sessions, grounded in psychoeducation and cognitive behavioural therapy. Participants aged 18–29 were screened for self‐harm and suicidal ideation. N = 20 participants were randomised into CaMaPI (n = 10) or Treatment as Usual (TaU) (n = 10) groups. One focus group with n = 8 participants, and n = 3 individual interviews were conducted with the experimental group.

Satisfaction with intervention (CaMaPI, 100%; TaU, 50%). Reduction in self‐harm and suicidal ideation was higher in CaMaPI on the suicide and self‐harm scale at Md = 1.00 with z = −2.264, compared to TaU, Md = 3.00 with z = −0.378. Both groups showed no significant reduction in hopelessness. Emerging themes from the qualitative findings showed acceptance of self‐harm and suicidal ideation as a treatable condition, mood management and behaviour modification, alongside cultural appropriateness and positive experience of the CaMaPI.

CaMaPI is feasible, culturally appropriate and acceptable in reducing self‐harm and suicidal ideation in adolescents/young people with histories of self‐harm and suicidal ideation in Nigeria. A fully powered randomised control trial is recommended to evaluate the clinical and cost‐effectiveness of CaMaPI compared with TAU.

Trial Registration:
ClinicalTrials.gov (No. NCT06440031)

Suicide is one of the leading causes of death among 15‐ to 29‐year‐olds globally.Seventy‐three percent of all suicides and self‐harm happen in low‐ and middle‐income countries, including Nigeria.CaMaPI is acceptable, culturally appropriate and feasible for treating suicidal ideation and self‐harm behaviours in adolescents and young people.CaMaPI is manualised and delivered with minimal resources by trained clinical psychology researchers.

Suicide is one of the leading causes of death among 15‐ to 29‐year‐olds globally.

Seventy‐three percent of all suicides and self‐harm happen in low‐ and middle‐income countries, including Nigeria.

CaMaPI is acceptable, culturally appropriate and feasible for treating suicidal ideation and self‐harm behaviours in adolescents and young people.

CaMaPI is manualised and delivered with minimal resources by trained clinical psychology researchers.