With about 1 in 100 people engaging in self-harm according to MentalHealth.gov, this group of behaviors is a significant problem. Not only does self-harm affect the individual performing the act, but it also affects countless friends, family members and loved ones. Self-harm is a confusing and complicated topic. Even experienced mental health professionals find it challenging to understand and properly treat the physical consequences and psychological roots.

With many impacted by self-harm, there needs to be an available and effective treatment. Fortunately, a variety of self-injury treatment options exist to provide the self-harm help you or your loved one needs. Some common forms of treatment include the following psychotherapy and medication options.

Psychotherapy

Psychotherapy is a term used to describe treatments involving someone meeting with a therapist to talk about concerns and stressors in an inpatient or outpatient setting. Types of psychotherapy might include:

  • Individual therapy – the client and the therapist meeting one-on-one
  • Family therapy – the client and their loved ones meeting with the therapist
  • Group therapy – the client and other people with similar problems meeting with one or more therapists

Psychotherapy for self-harm is an excellent first-line of treatment for anyone impacted by self-injurious behaviors. Psychotherapy can help the person:

  • Understand the causes of and triggers of self-harm
  • Learn ways to manage stress
  • Learn new coping skills
  • Promote healthy relationships
  • Manage emotional changes

Just as there are different types of therapies, there are different styles of therapy to assist in the battle against self-injury. Some effective self-harm therapy styles are cognitive-behavioral therapy, dialectical behavioral therapy and psychodynamic therapy.

Cognitive-Behavioral Therapy

Cognitive-behavioral therapy (CBT) is one of the most frequently used treatment styles and CBT for self-harm can help reduce unwanted behaviors. Cognitive Behavioral Therapy is based on the concept that unhealthy behavior patterns, like self-harm, are learned coping skills that need to be unlearned.

Cognitive-behavioral therapy for self-harm aims to identify thoughts, feelings and behaviors linked to self-injury; establish strategies to avoid these triggers and build new coping skills to break the cycle. Cognitive behavioral therapy can also address a range of other co-occurring mental health conditions like depression, anxiety and borderline personality disorder.

Dialectical Behavioral Therapy

Dialectical behavioral therapy (DBT) is a type of psychotherapy created from CBT principles and developed to treat people with borderline personality disorder. The treatment is now used for several mental health conditions including self-harm.

Using DBT for self-harm helps to:

  • Regulate emotions
  • Build mindfulness and awareness
  • Strengthen relationships
  • Manage stressful situations

A combination of group and individual therapy is usually included in DBT, which has been shown effective for reducing depression, anger, hopelessness, thoughts of suicide and intentional self-harm. So, DBT can reduce self-injurious behaviors like cutting and it can improve overall self-awareness and support mental health.

Psychodynamic Therapy

Like DBT, psychodynamic therapy (PDT) is a treatment for several mental health conditions like borderline personality disorder, a diagnosis frequently linked to self-harm behaviors. Unlike CBT and DBT, psychodynamic therapy pays less attention to the thoughts, feelings and behaviors of the individual. Instead, PDT focuses on the influence of unconscious or unknown factors.

Psychodynamic therapy centers on the concept that people can change and correct their course. This is accomplished with PDT by exploring past events and feelings and understanding the influence they have on the present. By bringing someone’s unconscious motivations into awareness with talk therapy, the patient can move in new directions without self-injury.

Medications

Medications can decrease symptoms and help people manage mental health issues. Self-harm be improved with medications as well.

People are not usually prescribed medication directly for self-harm because currently there are no drugs designed to address these behaviors alone. Instead, a prescriber like a primary care physician, a psychiatrist or a psychiatric nurse practitioner, will offer medications to address mental health conditions and symptoms that could be the source of self-harm behaviors. If depression is the identified cause, antidepressants for self-harm will be prescribed with the hopes that treating depression will reduce the desire for harm.

Psychiatric Hospitalization

Psychiatric hospitalizations represent the most intensive form of treatment for mental health concerns because the patient remains at the hospital for the entire treatment. If self-harm behaviors escalate to a dangerous state, hospitalization might be necessary to reduce the risk.

During a stay in a mental hospital for self-harm, the individual receives 24-hour care from a team of professionals, including:

  • Therapists
  • Social workers
  • Nurses
  • Psychiatrists

These professionals may offer medications and psychotherapies throughout the day to limit the symptoms. The duration of treatment can range from just a few days to several weeks or more, depending on the needs and progress of the patient.

Following discharge from the psychiatric hospitalization, it will be essential for the individual to find follow-up care to continue the progress made during inpatient care.

Relapse Prevention

Whether treatment for self-harm is inpatient or outpatient, the patient will need to focus on relapse prevention and aftercare once self-harming behaviors stop. Generally, a relapse is a return of the behavior a person is trying to avoid.

Each person, with the assistance of a treatment team and reliable support system, should build a customized self-harm relapse prevention plan to limit exposure to self-harm triggers and establish a clear set of actions to maintain self-harm recovery and safety.

For example, if someone knows a specific location sparks the desire to self-harm, they can work to avoid that area altogether. If the trigger is unavoidable, like a time of year or a family member, practicing relaxation skills and engaging in healthy behaviors to distract from the injury can help. Exercising and talking with supportive friends are great coping skills for preventing self-harm setbacks.

Self-Harm Support Groups

Psychotherapy and medications are professional treatments for managing self-harm, but they are not the only options. Self-harm support groups can also be used to limit the desire for self-harm while expanding someone’s social network.

Also called self-help groups or 12-step groups, support groups do not usually employ mental health professionals because they rely on the group members for guidance and encouragement. Fortunately, you do not have to decide between professional treatment or support groups. Most often, they work well together to reduce symptoms.

PsychologyToday offers a helpful tool to find available support groups in your area, as well as mental health professional trained to manage these symptoms. S.A.F.E. Focus is one example of a self-harm support group people can join to address their tendencies towards self-injury.

Crisis Hotlines

Sometimes the urge to engage in self-harm or self-injurious behaviors occurs outside of treatment and when there are no groups or friends available to assist with the discomfort of the situation. In times like these, self-harm hotlines are valuable resources that allow someone to speak to a supportive professional to maintain safety no matter the location.

Messaging options like the Crisis Text Line can connect someone with a crisis counselor who can help them through the stress by texting CONNECT to 741741. Talking to others and sharing thoughts and feelings can relieve the pressure, uncertainty and confusion surrounding the situation.

Self-harm can make anyone feel alone, but you never are. Trained mental health experts have the knowledge to steer you in a new direction. If you or a loved one is struggling with substance use disorder and co-occurring self-harm, decide to take action by contacting The Recovery Village. With treatment centers located across the country, The Recovery Village can help guide you toward lifelong recovery from addiction and self-harm.

Chapman, Alexander. “Dialectical Behavior Therapy: Current Indications and Unique Elements.” Psychiatry. September 2006. Retrieved December 20, 2018.

Fonagy, Peter. “The Effectiveness of Psychodynamic Psychotherapies: An Update.” World Psychiatry: Official Journal of the World Psychiatric Association (WPA). June 4, 2015. Retrieved December 20, 2018.

MayoClinic.com. “Self-Injury/ Cutting.” December 6, 2018. Retrieved December 20, 2018.

MentalHealth.gov. “Self-Harm.” August 22, 2017. Retrieved December 20, 2018.

National Institute of Mental Health. “Psychotherapies.” November 2016. Retrieved December 20, 2018.

National Alliance on Mental Illness. “Self-Harm.” No date. Retrieved December 20, 2018.

National Institute on Drug Abuse. “Principles of Drug Addiction Treatment: A Research-Based Guide.” January 2018. Retrieved December 20, 2018.

National Institutes of Health. “Hurtful Emotions: Understanding Self-Harm.” September 2017. Retrieved December 20, 2018.

UPMC Health Beat. “What to Expect During an Inpatient Psychiatric Stay.” May 23, 2017. Retrieved December 20, 2018.

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