Working with young people who self-harm

What is self-harm?

Self-harm as defined by the 2004 NICE Guidelines is: “An expression of personal distress usually made in private by an individual who hurts him/herself.  The nature and meaning of self-harm may vary greatly from person to person.  The reason a person harms him/herself may be different on each occasion and should not be presumed to be the same”

Self-harm includes

  • Self-injury – cutting, stabbing, jumping from heights
  • Self-poisoning – overdosing, ingesting poisons

The spectrum includes smoking, tattooing, alcohol and drugs, food restriction, promiscuity and other risk-taking behaviour but these are not included in the medical application of the term.

Self-harm is more common among disadvantaged groups and those who have been abused in childhood.

There is no clear link between self-harm generally and suicide.  However, following an act of self-harm that requires hospital admission the rate of suicide increases 50-100 times that of the rate of suicide in the general population.


Working with self-harm

While there is limited evidence on the most effective treatment for self-harm, NICE guidelines stress the importance of involving service users in their care and risk assessment.

“Self-harming behaviour is not an illness and may be an expression of unmet need or a way of dealing with emotional pain. Engagement in dialogue with the young person is crucial in developing a shared understanding of their behaviour and risks.”  Alison Wood

Professionals should be:

  • Calm
  • Containing
  • Non-judgemental
  • Able to respond to any need for medical attention
  • Able to look after themselves in the situation and seek support/guidance as necessary


Self Harm Resource Pack

MAP’s Self Harm Resource Pack has been developed through a project funded by Norwich Clinical Commissioning Group.  It provides information and guidance on self-harm together with strategies and principles that will be useful when working with young people who self-harm.



MAP is able to provide half and whole day training on working with young people who self-harm which features the resources available in the downloadable pack as well as activities designed to allow for reflection, consideration and practical integration of the understanding, principles  and strategies. Please contact Tonia Mihill our Therapeutic Services Manager or call 01603 766994 for further details and to make a booking.


Other Sources of Information and Guidance