Help in your conversations and interactions with children and young people who are self-harming

When supporting children and young people who self-harm, identifying the function of the unhelpful coping strategy or behaviour that challenges them can better inform how to support a different response or choice which has a more positive long-term impact upon their wellbeing and resilience.

Here we are talking about self-harming behaviours and these include actions that lead to deliberate harm to the self, and include responses such as self-cutting, burning or bruising oneself, and intentionally taking too much (or too little) medication. Usually, children and young people who self-harm are trying to deal with difficult feelings and situations, rather than being actively suicidal, although accidental death can sometimes occur following a self-harming behaviour.

Self-harming behaviour can have different functions for different young people, which can include reducing tension in high emotional moments, wanting to feel physical pain (sometimes to distract from emotional distress), as a self-punishment for themselves or others, or as an expression of identity with another person (such as a peer).

As we have discussed in the previous video there are actions that you can take as a non-mental health professional to support the child or young person and where needed refer them to specialist services.

Top tips to help you providing support might include:

• Stay calm and gentle in your behaviour and communications
• Sometimes completing an activity together whilst a child or young person talks can help them feel more comfortable and able to share what they are struggling with
• Reassure them you want to understand and help them
• Highlight from what they have said possible triggers that seem to increase their self-harming behaviours (this can help identify things to avoid or minimise where possible)
• Problem-solve with them things that could help as an alternative to self-harming behaviours, to put into practice when they recognise they are beginning to struggle or feel triggered
• Help bring positive balance into the conversation by recognising strengths and protective factors within the child or young person, their family, and the system around them, that they can lean upon and receive support from
• Take any talk of suicidal ideation very seriously, and activate the supportive system around the child or young person, as they may need to become more involved in keeping them safe
• Be aware of local and national numbers and resources that the children and young people can gain support from (e.g. The Samaritans, Papyrus, Childline, Shout) and provide them with these contacts.

It may be that children and young people can be supported to find alternatives to self-harming which can help to soothe, distress and act as distractors. These could include:

• Doing something active, like taking a walk or exercising (even tidying their room or planting seeds) with a focus on nurturing self-care activities
• Getting difficult thoughts and feelings out of their head and onto paper and then tearing it up to help bring some distance from them
• Listening to music, singing and dancing
• Contacting helplines such as Childline to talk and share concerns
• Being creative, making art, writing a story, or cooking

Spend some time with the child or young person exploring what may help them and support them to problem solve, including how to actively build appropriate alternative ways to cope when they are feeling like self-harming. Where appropriate, ensure that you are following your place of work’s safeguarding procedures for keeping a child young person safe, which may involve making a referral for a specialist mental health assessment. Remember you may need to also break confidentiality and inform a parent or guardian for the child or young person if you are concerned about their wellbeing. We will talk about these actions later in this course.

If you would like to find out more about this topic, you can explore self-harm coping techniques via Childline here.