Self-harm in Adolescents

Unfortunately, self-harm is not uncommon in teenagers; it is estimated that up to 25% of teens experiment with self-injury. While for some teens it is a means of communicating needs, for others it is a source of shame, and they may go to great lengths to conceal the behavior. Although it is difficult for loved ones to understand, most teens who self-injure describe a feeling of “relief” from either intensely painful emotions, or from a feeling of numbness. This sense of relief is reinforcing for the teenager, and the longer a person engages in the behavior, the more reinforcing it becomes. Over time, a teen can come to rely on self-injury for coping with any painful emotion, creating a cycle of emotional avoidance that inhibits opportunities for learning and practicing other, more adaptive coping mechanisms.

Effective treatment of self-injury in teens involves a careful behavioral assessment, followed by an individualized, skills-based treatment plan. Critical components involve building the teen’s willingness to relinquish the behavior, and providing a tool kit of alternative coping mechanisms. When delivered by a qualified team of professionals, Dialectical Behavior Therapy (DBT) is the gold-standard of treatment for self-injurious behaviors, and has been shown to be effective for a majority of people. Other interventions may involve Cognitive Behavior Therapy (CBT), family therapy, or adjunctive pharmacotherapy.