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.

Resources

You may also find this information useful:

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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