Treatment Strategies

Self-injurious behavior can be reduced and eventually extinguished once the adolescent is ready to embrace alternative behaviors designed to promote healthier communication, self-comfort and genuine healing.

Psychotherapy — It is extremely important to work with a helping professional who has an expertise in self-injurious behavior or related disorders. Psychotherapy can provide a non-judgmental and supportive environment where self-injury can be processed openly and the meaning behind the injury can be explored. Trained therapists can provide safer, alternative ways to communicate, self-soothe and cope. The use of journaling, art therapy, relaxation techniques, visualizations, cognitive re-framing and affect management are all recommended and useful.

Appropriate contracts that encourage the teenager to write, draw, exercise and self-soothe before engaging in self-injurious behavior are more effective than contracts that demand the immediate cessation of the behavior. When the self-injury is severe, the teenager is unable to integrate strategies and abide by a safety contract or additional problems such as substance abuse or a threatening eating disorder are evident, inpatient treatment is often required.

In addition to working with a trained therapist some teens are able to utilize resources such as personal journaling and drawing, meditation, spiritual support and healthy self-injurious behavior substitutes such as physical exercise.

Psychopharmacology — When self-injurious behavior connects to untreated depression or anxiety, medication can be extremely useful. Anti-depressants can dramatically reduce the negative feelings and cognitions associated with the cycle of self-harm. Anxiolytics prevent the escalation of panic and generalized anxiety, which decreases the need for dissociation and self-injury. Providing a pharmacological safety net also may allow adolescents to process painful trauma memories without becoming flooded or overwhelmed.

[taken in part: *PRP Online]* Performance Resource Press