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Introduction to adolescent mental health
Introduction to adolescent mental health

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1.2 Self-harm

In this activity we ask you to put yourself in the position of the practitioner who is listening to a young person who is revealing they have been self-harming. The young person has shown you the scars and starts to cry.

Activity 3: Responding to self-harm

Timing: Allow about 30 minutes

1. Think carefully about what your initial response would be, what emotions do you think would drive your reaction? Would it be fear, compassion, disgust?

Note your reflections here.

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It is understandable to feel uncertain about how you might respond. It could be that you immediately go into a panic mode, thinking of an emergency level response. There is a burden of responsibility associated with being made aware of the extreme distress of a young person. However, it is important to remember that if such a disclosure is made that the primary response should be to think carefully about how to connect with the young person, who is clearly revealing emotions of distress. Provide a safe space for that person to discuss what is going on for them before then developing a plan with them about how to get additional support.

2. Now, watch the video and make a note of the main messages that are suggested for guiding a professional response to this type of disclosure. Consider the skills and characteristics a practitioner would need to demonstrate in order to support the young person effectively.

Video 1: No Harm Done film for professionals (The Open University is not responsible for external content.)
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Skills you might have identified include:

  • observation skills
    • Through noticing injuries or behaviour changes, a parent or practitioner may become aware of a problem and ask the young person or their child if they would like to talk.
  • listening skills
    • The young person should be the sole focus of attention.
  • relationship building skills
    • While a parent can build upon an established relationship, a practitioner needs to build trust, whilst not making unrealistic promises about confidentiality.
  • teamworking skills
    • A young person may feel comfortable talking to one particular practitioner and may need help from many people, including family, peers and other practitioners.
  • skills around protecting the parent and/or practitioner’s own wellbeing.
    • This work can be challenging, so it is important to be supported and to seek support or take up training opportunities where needed. It is important not to keep any uncomfortable feelings about any disclosures to yourself.

Characteristics for both parents and practitioners that might be helpful include:

  • being supportive and accepting
  • being non-judgemental
  • being calm.

Although it is not mentioned in the video, helping young people find practical alternatives to self-harm, such as making a self-soothe box (a collection of things that will soothe or distract) could also be a useful option. You will recall Dr Pooky Knightsmith in Session 6 [Tip: hold Ctrl and click a link to open it in a new tab. (Hide tip)] talking about the importance of self-soothing.