Support a child who engages in self-harming behaviours

Self-harm refers to people deliberately hurting their bodies. The most common type of self-harm is cutting. Refer to What do you need to know about self harm.

Why do people self-harm?

Self-harm is used as a way of coping. It can bring a sense of relief and control and can be a way to express or manage distressing thoughts, feelings and memories. Sometimes a child may harm themselves because they feel lonely. Sometimes they do it to ‘punish’ themselves or to ‘feel something’.

Self-harm can be a powerful tool to support coping. The relief felt though is generally short lived and distressing thoughts and feelings will usually return. This can bring back an urge to self-harm. This cycle can be hard to interrupt.

Usually, people who self-harm are not trying to kill themselves. There is a chance they may hurt themselves more than they intended to. This increases their risk of accidental death.

People who repeatedly self-harm may also become suicidal and feel hopeless and trapped. 

Source: Beyond Blue Self-harm and self-injury

How to approach practice with children who self-harm

It can be challenging and confronting to work with a child who is managing their distress through self-harming. Remember, practitioners cannot stop someone from self-harming, only encourage them to get help to find other ways to manage their distress. It is incredibly important to discuss the concerns about a child’s self-harming in supervision and/or with the senior practitioner. This is to seek support for yourself and any worries or distress you feel.  Also, use supervision for making sure the best care, risk management and safety planning is provided to the child and their family.

Other things to do include:

• encourage the child to see a doctor or other health professional about their self-harming
• if the child is already seeking assistance, speak with their doctor or counsellor about the best ways to support the child
• work closely with the safety and support network to support the child
• call emergency services (ambulance) on 000 if you think the child is at risk of serious injury.

(SANE Australia, 2019)

What to do when someone is self-harming in your presence

• Stay calm and maintain curiosity
• Talk to the child to determine what is happening for the child and what the self-harming is achieving for them – can their needs to be met in another way?
• Support the child to apply first aid if needed
• Call emergency services (ambulance) on 000 if you think the child is at risk of serious injury.

Are there alternatives to self-harm?

It can be hard stop self-harming. Encourage the child to try alternatives to self-harm that might help them to relieve distress in the short-term.

These include:

• delay, for example, put it off until you have spoken to someone
• distract, for example, go for walk, play a game
• divert, for example, find an activity which has a similar effect to self-harm, but without causing injury, such as punching a pillow, drawing on arm instead of cutting, squeezing an ice cube
• deep breathing or other relaxation method.

These are not solutions to self-harm and need to be discussed with the treating doctor or psychologist.

(SANE Australia, 2019)