Practical Suggestions

1
Practical Suggestions

• Self Harm is often a coping strategy just
  removing it will leave a vacuum
• Need to provide young people with alternatives
• Addiction model nicotine patches!
• Imposition of advice etc will be rejected be
  available and give permission to them to talk if
  they want

2
The Stance

• Prepared to listen
• Concerned but able to cope
• Encourage emotional expression
• Non-judgmental
• Appropriately boundaried

3
FIRST STEPS

• Think about physical safety - NHS DIRECT on 0845
  4647 if worrying cuts, AE if very severe
• Be clear about boundaries
• Find out who knows and whos helping
• Does the young person WANT help?

4
Encourage Young Person to

• Talk to someone they trust
• School Counsellor
• Teacher
• Family Friend
• Family Member
• GP
• Youth Worker
• Think about triggers and alternative responses
• Substitute Behaviours (from people who self-harm)
• Safe pain (ice, elastic bands, cold baths,
  spicy food
• Marker pens
• Drawing or painting
• Writing their thoughts and feelings poetry,
  diaries
• Punching or tearing objects
• Listening to music
• Relaxation, breathing
• Exercise
• Distraction generally

5
Encourage Young Person to

• Be safe in their cutting / harming practice
• Schedule their cutting (behavioural contracts)
• Be around others at critical times
• Think about the function of the self-harm (e.g.
  emotional release, need to see blood) and
  generate alterative ways of achieving their goal

6
Remember that

• Sometimes the self harm is keeping the young
  person from more serious manifestations of
  distress. There are times when allowing the harm
  to continue is an appropriate choice

7
WHEN TO REFER ON

• Serious, ongoing self harm
• Overdoses or expressed suicidal ideation
• If you feel the young person is looking for a
  long-term supportive relationship that you cannot
  provide

8
YOUR SPECIFIC ROLES

• Your role could address some issues directly
• Facilitating contact with peers
• Helping to increase self-esteem through
  employment / education
• Just being there and listening