The goal of this study is to develop and test an outpatient intervention for preadolescents (ages 7-12) with self-injurious thoughts and behaviors (SITBs). The main questions it aims to answer are: 1. Does the newer intervention lead to better engagement of families in treatment compared to treatment as usual (TAU)? 2. Is the new intervention feasible, acceptable, and appropriate? 3. Does the new intervention lead to more improvements in SITBs, mental health symptoms, and treatment targets compared to TAU? Preadolescent participants with SITBs and their families will be randomized to either the new intervention or TAU, which will consist of the typical interventions the study therapist would use for preadolescents with SITBs. Participants will: 1. Complete an initial baseline assessment to determine eligibility and assess SITBs, mental health symptoms, executive functioning, and emotion regulation 2. Participate in a \~weekly, outpatient intervention lasting around 3-4 months 3. Complete additional assessments at mid-treatment, post-treatment, and 3-month follow-up 4. Participate in an interview sharing their perceptions of the intervention
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Treatment Engagement
Timeframe: From enrollment to post-treatment at 12 weeks
Feasibility of Retention
Timeframe: From enrollment to the end of treatment at 12 weeks
Feasibility of recruitment
Timeframe: Calculated at enrollment
Feasibility of Measurement
Timeframe: From enrollment to follow-up at 24 weeks
Perceived acceptability of intervention
Timeframe: From enrollment to the end of treatment at 12 weeks
Perceived Feasibility of Intervention
Timeframe: From enrollment to the end of treatment at 12 weeks
Perceived Appropriateness of Intervention
Timeframe: From enrollment to the end of treatment at 12 weeks