Addressing and Preventing Self-Harm in Kids & Teens

Available with English captions and subtitles in Spanish.

Growing up is difficult, and can result in a barrage of overwhelming thoughts and emotions in kids and teens. Self-harm is a way that they may try to cope with strong feelings they’re experiencing—but it’s also a sign of serious distress, may point to other mental health concerns, and could have lasting impacts.

Audience Questions

Dr. Michael Hollander shares signs and symptoms that there may be self-harm occurring in a child, offers methods to teach loved ones better coping mechanisms, provides insight into when it may be time to seek professional help, and answers questions about self-harm in children and adolescents.

  • Can you provide a basic overview of self-harm in young people?
  • What are the typical signs of non-suicidal self-injury in young people?
  • If an educator or other individual notices signs of self-harm in a young person, should they ask if they have the intention of taking their own life?
  • Why does self-injury “work” as a coping mechanism?
  • How can parents or caregivers monitor self-harm behavior in their children without causing issues, such as mistrust?
  • Which disorders are most commonly associated with self-harming behaviors?
  • Do some individuals engage in self-harm as a way to gain attention or be taken seriously, such as in cases of emotional neglect?
  • Is substance use (i.e., alcohol and drug use) considered self-harm?
  • How do you approach a young person who is engaging in self-injury in a way that will be productive?
  • Why is validation important?
  • Is there a connection between validation and building trust with young people?
  • Do you have any advice for parents, educators, or providers who are trying to get closed-off young people to engage with them?
  • What are the most effective treatments for addressing self-harm in young people?
  • What does dialectical behavior therapy (DBT) for self-harm look like?
  • What strategies do you suggest for providers who establish with their patients that self-harm is off the table? Are there substitute behaviors that you recommend incorporating into treatment?
  • At what age do young people typically begin engaging in self-harm?
  • As a provider, if a patient discloses that they are engaging in self-injury and they are a minor, do you recommend disclosing this information to parents and caregivers?
  • Are there differences in self-harming behavior relating to gender or race?
  • What information and recommendations do you give parents or caregivers whose child is engaging in self-harm?
  • If an individual in a child or teen’s friend group is engaging in self-harm, does that increase the likelihood that others in that group will engage in that behavior?
  • Can you speak more to what is and is not considered self-harming behavior?
  • Can you speak to the importance of young people being able to identify and label emotions? How can we help young people enhance these skills?
  • At a time when mental health services are difficult to access, how can parents/caregivers support their children while waiting for treatment to be available?
  • Do you have any suggestions of books or resources for adults looking to learn more about validation?
  • If self-injury is not addressed, does it worsen over time?
  • Do you have advice for when parents do not acknowledge self-harming behavior in their child? How can educators support these students at school?
  • Is there a connection between ADHD and self-harm?
  • Aside from being empathetic, how should parents or caregivers respond to self-harming behavior in their child?

The information discussed is intended to be educational and should not be used as a substitute for guidance provided by your health care provider. Please consult with your treatment team before making any changes to your care plan.


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About Dr. Hollander

Michael R. Hollander, PhD, is a nationally recognized expert on borderline personality disorder (BPD) and the causation and treatment of self-injury. He retired in September 2021 from his position as the Endowed Director of Training and Consultations at McLean’s 3East continuum.

In addition to his work at 3East, Hollander was a supervisor in McLean’s mentalization-based treatment (MBT) clinic and served on the faculty of the McLean Hospital/Massachusetts General Hospital Child Psychiatry Fellowship Program. Since 2004, he has been a trainer for Behavior Tech, the organization founded by Marsha Linehan, the creator of dialectical behavior therapy (DBT), training clinicians in this seminal treatment nationally and internationally.

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