SCIE Research briefing 17: Therapies and approaches for helping children and adolescents who deliberately self-harm (DSH)
Published August 2005
Introduction - What is the issue?
This briefing focuses on other therapies or measures to help children and young people who deliberately self-harm (DSH). The aim of the therapy is either to reduce the amount they self harm or to stop them self-harming completely. The population covered by this briefing are children and adolescents up to the age of 19 who live in the community. The characteristics of self-harm, and the psychological and psychosocial factors associated with self-harm among children and adolescents are covered in a previous briefing in this series.
This earlier briefing also covers the problems of identifying young people who self-harm. The interventions described in the current briefing are therefore for children and adolescents who have been identified as self-harming or who have approached professionals or services seeking some sort of help or support. A great deal of the research and policy literature on these interventions does not distinguish between self-harm with the intention of committing suicide or self-harm without that intention, sometimes called self-injury or self-mutilation. The interventions described here are also principally designed for use with people who self-harm repeatedly and have done so over a long period, rather than those who have self-harmed on a single occasion. Although this briefing recognises that self-harm, specifically self-injury or mutilation, and attempted suicide have very different motivations, the term "self-harm" is used throughout the briefing to denote both self-injury or mutilation and attempted suicide.
The focus of this briefing therefore is non drug-based interventions to prevent or limit self-harm, including suicide, among people who repeatedly self-harm.
- There are a growing number of projects to help young people who self-harm
- There is a sizeable body of research into interventions to prevent or reduce episodes of self-harm among adults, but comparatively little for children and adolescents
- Interventions explored to help children and adolescents who self-harm include forms of cognitive behavioural therapy, and group and family therapy
- No form of treatment has been found to be effective in stopping or significantly reducing self-harm among children and young people, but some interventions do positively affect other factors associated with self-harm in this population, such as depression and emotional control
- Self-help groups and peer support programmes have been proposed as potentially effective means of providing some sort of help to children and adolescents who self-harm
- Young people have complained that many A&E and other health staff can be judgmental, unhelpful and unwilling to understand. They want to be treated with respect and sympathy
- No intervention is known which can stop young people self-harming completely, but there are therapies that can successfully reduce the amount a person self-harms. Also, young people can be reluctant to say they have stopped altogether