Character Strengths-Based Intervention for Adolescent Nonsuicidal Self-Injury: A Scoping Review

Adolescent nonsuicidal self-injury (A-NSSI) is a significant mental health problem that is stigmatized with limited treatment interventions. Positive psychotherapy (PPT) (Seligman et al., 2006), a humanistic modality, provides a character strengths (CSs) approach that can be integrated with current evidence-based interventions to contribute to effective treatment. This scoping review maps the literature on treatment interventions for A-NSSI that integrate CSs and specifically investigates the extent to which PPT has been used for this problem. Peer reviewed studies published between January 2004 and June 2024 were identified using five databases- PsycINFO, Scopus, CINAHL, PubMed, and Embase- with keywords (“nonsuicidal self-injury” AND “intervention” AND “adolescent”) AND each of the 24 universal CSs in separate searches. Inclusion criteria were the following: adolescents aged 10-19 years having the disorder NSSI as defined by DSM-5 (2013); intervention present in study design with CS from the 24 universal CSs (Seligman & Peterson, 2004) associated with a treatment intervention; dates of studies between 2004-2024; peer reviewed journal articles; English language source. Studies were analyzed using a five-phase review process developed by Arksey and O’Malley’s (2005). A total of 2,063 records were retrieved with 25 (1.2%) of the studies meeting the inclusion criteria. Inclusive studies used interventions in methodology with CSs of self-regulation (80%), open-mindedness (8%), hope (4%), hope with self-regulation (4%), and open-mindedness with self-regulation (4%) implemented in treatment modalities. Treatment interventions utilizing CSs were the following: dialectical behavior therapy (DBT) (28%), emotion regulation therapy (ERT) (20%), cognitive behavioral therapy (CBT) (16%), mentalization (4%), mindfulness-based (4%), expressive (4%), and miscellaneous eclectic-based (24%). PPT as a stand alone approach or integrated modality was not identified in the research as a current intervention for A-NSSI.