Self-harm
For health professionals
What is self-harm?
Self-harm is when someone hurts themselves on purpose (not associated with some of the habitual behaviour associated with developmental conditions such as autism).
In most cases, there is no suicidal intention but a teenager’s safety must always be kept in mind. Risk assessment is one of the key tasks for a professional.
About self-harm
Self-harm is not a new phenomenon, but it appears to be growing in frequency. Whilst both teenagers and adults, male and female, self-harm, it is most prevalent in teenage girls. However, boys who self-harm tend to cause more damage to themselves and suicide is more common in boys and men.
Self-harm is a serious problem for teenagers with around 1 in 12 children aged between 10 and 16 carrying out a variety of self-harm behaviours.
The self-harm management techniques that are described, are separate to those that are recommended for autism, or for children with neurological damage or special needs, where the intention of the self-harm and therefore the management, has a different focus.
Identification
Self-harm is usually identified by regular self-inflicted injuries that are noted on various parts of the body.
Why change?
The first part of a professional’s job is to increase motivation to change. It’s really important to manage self-harm early because it can become habitual and increase in intensity. A good starting point is to explore what benefits the person sees in self-harming and to ascertain negative reasons for why it would be helpful to make positive change. Once motivation to change is established, children and young people can be referred to the ‘Steps to change’ part of the stem4 website and to our Calm Harm app whilst they wait specialist treatment.
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Some benefits to self-harm
- “It helps me calm.”
- “It lets others know that everything is not alright.”
- “It takes my mind off upsetting things.”
Some negatives to self-harm
- “It makes me feel alone.”
- “Others think I’m weird.”
- “I hate the marks it leaves on my skin.”
- “I can’t wear revealing clothes.”
- “It doesn’t help me sort out my real problem.”
Four steps to bringing about change
- Self-harm minimisation
- Educate on sterilising equipment, how to prevent infection, using ‘safe’ implements, teach basic first aid
Encourage the child or young person to take positive action to break the circle of self-harm.
Try and help them think about what their self-harm is expressing:
- If it’s COMFORTING suggest they do alternative comforting actions instead – for example, have a bath, cuddle someone or something, do something relaxing, listen to some music
- If it RELEASES FEELINGS, recommend some other outlets of feeling release instead – for example, talk to someone, exercise, write down how you feel, draw your emotion
- If it RELEASES TENSION, suggest another way to release tension instead – for example listen to some very loud music, run on the spot as fast as you can, rip some paper. PRACTICE for at least 5 minutes
- DISTRACT from the temptation to self-harm. Do something – go for a walk, give yourself something difficult to do. Sit it out – the urge will pass
This clinician-developed app can be downloaded from the App Store or Google Play.
It can be password-protected and has a range of tasks you can do to help manage the urge to self-harm.
Calm Cards are also available from our Shop.
- Encourage maintaining the strategy that works over the long term. Keep regular contact to monitor
- Try it. Give yourself a seven day period to put into action. If you have success, try another seven days. Build up to 30 days
Visit our Further Advice page for details of other organisations that can help.
