Integrating REBT and Motivational Interviewing in Addressing Non-Suicidal Self-Injury: A Conceptual Framework
Abstract
Non-Suicidal Self Injury (NSSI) is a complex behavioural phenomenon closely associated with emotion dysregulation and maladaptive cognitive processes. Existing psychosocial approaches tend to prioritise either motivational enhancement or cognitive restructuring in isolation, resulting in fragmented intervention strategies. Addressing this gap, the present paper proposes a conceptual framework that integrates Motivational Interviewing (MI) and Rational Emotive Behavior Therapy (REBT) to guide a stage-appropriate response to NSSI. By utilising the conceptual synthesis approach, this paper draws upon established theoretical literature on MI, REBT, and the Stages of Change model to identify complementary mechanisms underpinning motivation, belief systems, and emotional regulation. The proposed framework conceptualises a two-phase process in which MI is employed to assess and enhance individuals’ readiness for change, followed by the application of REBT to challenge and restructure irrational beliefs sustaining NSSI behaviours. By aligning intervention strategies with individuals’ motivational stages, the framework offers a structured and theoretically grounded pathway for progressive behavioural change. This conceptual paper contributes to the literature by bridging motivational and cognitive-behavioural perspectives within a unified model and provides a foundation for future empirical studies to evaluate its effectiveness in reducing NSSI behaviours and improving emotional regulation.
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Baetens, I., Van Hove, L., Azadfar, Z., Van Heel, M., & Soyez, V. (2024). The Effectivity of a School- Based Early Intervention Targeting Psychological Complaints and Non-Suicidal Self-Injury in Adolescents. Journal of Clinical Medicine, 13. https://doi.org/10.3390/jcm13071852
Barrett, S., Begg, S., O’Halloran, P., & Kingsley, M. (2018). Integrated motivational interviewing and cognitive behaviour therapy for lifestyle mediators of overweight and obesity in community- dwelling adults: A systematic review and meta-analyses. BMC Public Health, 18, 1160. https://doi.org/10.1186/s12889-018-6062-9
Barnett, J. E. (2023). Ethical and legal issues in crisis intervention. In F. M. Dattilio, D. I. Shapiro, & D. S. Greenaway (Eds.), Cognitive-behavioral strategies in crisis intervention (4th ed., pp. 24–40). The Guilford Press.
Burn A.M., Gains H, Anderson, J., (2024). A self-harm awareness training module for school staff: Coproduction and user testing study. JMIR Formative Research. https://doi.org/10.2196/preprints.69309
Daud, N. I. A. M., Sutan, R., & Isa, Z. (2025). Analisis kerangka intervensi pakej pendidikan kesihatan mental belia di Malaysia: Tinjauan naratif. e-Bangi: Journal of Social Sciences & Humanities, 22(1). https://doi.org/10.17576/ebangi.2025.2201.28
David, D., Cotet, C., Matu, S., Mogoase, C., & Stefan, S. (2018). 50 years of rational-emotive andcognitive-behavioral therapy: A systematic review and meta-analysis. Journal of Clinical Psychology, 74(3), 304–318. https://doi.org/10.1002/jclp.22514
Ellis, A., & Joffe Ellis, D. (2019). Rational emotive behavior therapy (2nd ed.). American Psychological Association. https://doi.org/10.1037/0000134-000
Emery, R. L., & Wimmer, M. (2023). Motivational Interviewing. In StatPearls. StatPearls Publishing.
Gray, N., Hasking, P., & Boyes, M. (2022). Cognitive and emotional factors associated with the desire to cease non-suicidal self-injury. Journal of Clinical Psychology, 78(9), 1896–1911. https://doi.org/10.1002/jclp.23336
Grodniewicz, J. P., & Hohol, M. (2023). Waiting for a digital therapist: three challenges on the path to psychotherapy delivered by artificial intelligence. Frontiers in Psychiatry, 14, 1190084. https://doi.org/10.3389/fpsyt.2023.1190084
Guerrero, E., Andreasson, K., Larsen, L., Buus, N., Skovgaard Larsen, J. L., Krogh, J., Thastum, R., Lindberg, L., Lindblad, K., Erlangsen, A., & Nordentoft, M. (2024). Zero Self-Harm app: A mobile phone application to reduce non-suicidal self-injury, study protocol for a randomized controlled trial. Trials, 25. https://doi.org/10.1186/s13063-024-07932-1
Hulbert, S., Eida, T., Ferris, E., Hrytsenko, V., & Kendall, S. (2023). HBSC England National Report: Findings from the 2001-2022 HBSC study for England Health Behaviour in School-aged children (HBSC). University of Kent.
Jurblum, M., & Selzer, R. (2025). Potential promises and perils of artificial intelligence in psychotherapy -The AI Psychotherapist (APT). Australasian psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists, 33(1), 103–105. https://doi.org/10.1177/10398562241286312
Klonsky, E. D., Victor, S. E., & Saffer, B. Y. (2014). Nonsuicidal self-injury: what we know, and what we need to know. Canadian journal of psychiatry. Revue canadienne de psychiatrie, 59(11), 565– 568. https://doi.org/10.1177/070674371405901101
Mahfar, M., Noah, S. M., & Senin, A. A. (2019). Development of rational emotive education module for stress intervention of Malaysian boarding school students. SAGE Open, 9(2). https://doi.org/10.1177/2158244019850246
Miller W. R. (2023). The evolution of motivational interviewing. Behavioural and Cognitive Psychotherapy, 51(6), 616–632. https://doi.org/10.1017/S1352465822000431
Miller, W. R., & Rollnick, S. (2013). Motivational interviewing: Helping people change (3rd edition). The Guilford Press.
Mittermeier, S., Seidel, A., Scheiner, C., Kleindienst, N., Romanos, M., & Buerger, A. (2024). Emotional dysregulation and its pathways to suicidality in a community-based sample of adolescents. Child and Adolescent Psychiatry and Mental Health, 18(1), 15. https://doi.org/10.1186/s13034-023- 00699-4
Nock M. K. (2009). Why do People Hurt Themselves? New Insights into the Nature and Functions of Self-Injury. Current Directions in Psychological Science, 18(2), 78–83. https://doi.org/10.1111/j.1467-8721.2009.01613.x
Orvati Aziz, M., Mehrinejad, S. A., Hashemian, K., & Paivastegar, M. (2020). Integrative therapy (short-term psychodynamic psychotherapy & cognitive-behavioral therapy) and cognitive-behavioral therapy in the treatment of generalized anxiety disorder: A randomized controlled trial Complementary Therapies in Clinical Practice, 39, 101122. https://doi.org/10.1016/j.ctcp.2020.101122
Prochaska, J. O., & DiClemente, C. C. (1983). Stages and processes of self-change of smoking: toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51(3), 390–395. https://doi.org/10.1037//0022-006x.51.3.390
Randall, J., & McNeil, D. (2017). Motivational interviewing and cognitive behavioral therapy integration for anxiety disorders. Journal of Anxiety Disorders, 48, 91-101. https://doi.org/10.1016/j.janxdis.2017.05.002
Sorgi, K. M., Ammerman, B. A., Cheung, J. C., Fahlgren, M. K., Puhalla, A. A., & McCloskey, M. S. (2021). Relationships between Non-Suicidal Self-Injury and Other Maladaptive Behaviors: Beyond Difficulties in Emotion Regulation. Archives of Suicide Research: Official Journal of The International Academy for Suicide Research, 25(3), 530–551. https://doi.org/10.1080/13811118.2020.1715906
Sorgi-Wilson, K. M., Cheung, J. C., Ciesinski, N. K., & McCloskey, M. S. (2023). Cognition and Non- Suicidal Self-Injury: Exploring Relationships with Psychological Functions. Archives of suicide
research: Official journal of the International Academy for Suicide Research, 27(3), 1002–1018. https://doi.org/10.1080/13811118.2022.2106919
Svensén, S., Bolstad, I., Ødbehr, L. S., & Larsson, G. (2024). Beyond medications: a multifaceted approach to alleviating comorbid anxiety and depression in clinical settings. Frontiers in Psychology, 15, 1456282. https://doi.org/10.3389/fpsyg.2024.1456282
Tarbox, J., Szabo, T. G., & Aclan, M. (2020). Acceptance and commitment training within the scope of practice of applied behavior analysis. Behavior Analysis in Practice, 15, 11-32. https://doi.org/10.1007/s40617-020-00466-3
Tóth, R., Turner, M. J., Mannion, J., & Tóth, L. (2023). The effectiveness of rational emotive behavior therapy (REBT) and mindfulness-based intervention (MBI) on psychological, physiological and executive functions as a proxy for sports performance. BMC Psychology, 11(1), 442. https://doi.org/10.1186/s40359-023-01486-8
Urfa, O., & Aşçı, F. H. (2023). The effects of rational emotive behavior therapy and motivational interviewing on emotions, automatic thoughts, and perceived performance of elite female volleyball players. Psychology of Sport and Exercise, 69, 102497. https://doi.org/10.1016/j.psychsport.2023.102497
Wachtel, P. L., Siegel, J. P., & Baer, J. C. (2020). The scope of psychotherapy integration: Introduction to a special issue. Clinical Social Work Journal, 48(3), 231–235. https://doi.org/10.1007/s10615-020-00771-y
Wang, B., Zhao, Y., Lu, X., & Qin, B. (2023). Cognitive distortion based on explainable depression detection and analysis technologies for the adolescent internet users on social media. Frontiers in Public Health, 10, 1045777. https://doi.org/10.3389/fpubh.2022.1045777
Wang, Y. J., Li, X., Ng, C. H., Xu, D. W., Hu, S., & Yuan, T. F. (2022). Risk factors for non-suicidal self-injury (NSSI) in adolescents: A meta-analysis. Clinical Medicine, 46, 101350. https://doi.org/10.1016/j.eclinm.2022.101350
Zhao, M., Abdul Kadir, N. B., & Abd Razak, M. A. (2024). A systematic review on the prevalence and risk factors of depression among Chinese undergraduate students. e-Bangi: Journal of Social Sciences & Humanities, 21(3). https://doi.org/10.17576/ebangi.2024.2103.23
DOI: http://dx.doi.org/10.17576/ebangi.2026.2301.15
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