Created on August 5, 2017. Last updated on September 15th, 2019 at 09:28 am
Take me to the effective therapies for self-injurious thoughts & behaviors
Thoughts and behaviors about harming oneself are not common in childhood, but increase during the teenage years. They can cause big problems in a young person’s social, family, and school life.
Each year, about 16 percent of teens in U.S. high schools will consider killing themselves and 8 percent will attempt killing themselves, also known as suicide. Non-suicidal self-injury, or causing self-harm without wanting to die, is even more common among youth: around 18 percent of teens report these behaviors.
What are Self-Injurious Thoughts and Behaviors?
Self-injurious thoughts refer to thinking about hurting oneself. Self-injurious behaviors are actions that are harmful to oneself. Both can be suicidal or non-suicidal.
- Suicidal self-injurious thoughts (suicidal ideation) are thoughts about killing oneself and can include making suicide plans. Suicidal self-injurious behaviors (suicide attempts) are behaviors that are harmful to oneself and can lead to injury, (e.g., attempted overdose) in which a child or teen wants to die
- Non-suicidal self-injury (NSSI) refers to injuries cause by oneself but a child has no wish to die. The most common forms are skin cutting, burning, scratching, and banging/hitting oneself. These NSSIs are used to make oneself feel better and to stop feelings of sadness, anxiety, and anger
Effective Therapies for Self-Injurious Thoughts and Behaviors
There are currently no well-established, effective therapies for these problems. But, many therapies appear to work, including:
- Cognitive-behavioral therapy (CBT) for the youth and his/her family
- Psychodynamic therapy for the youth and her/his family
- Interpersonal therapy for the youth
- Two different family-based treatments (attachment-based and parent training)
The following child therapy activities may improve treatment for children with self-injurious thoughts or behaviors, even though there is no clear-cut, evidence-based therapy for these individuals:
- Developing and maintaining family and other relationships (e.g., increased parent/teen communication)
- Improving parent education and training (e.g., parental monitoring, including restricting access to things that teens could hurt themselves with)
- Strengthening teens’ coping skills (e.g., emotion regulation)
Tested Therapies for Children and Adolescents
- Combined CBT that includes individual, family, and parent training
- Family-based therapy (attachment and parent training)
- Psychodynamic therapy (individual and family)
- Family-based therapy-ecological
- Skills group
- Dialectical behavior therapy (DBT)
- Family-based therapy
- Resources interventions-individual
- Support-based interventions-individual
Tested and Does Not Work
- CBT-skills + DBT skills + psychodynamic therapy skills-group
To find out more about how these treatment levels are defined, click here.
Therapies and Terms Defined:
- CBT: cognitive behavioral therapy
- DBT: dialectical behavior therapy
Catherine R. Glenn, Erika C. Esposito, Andrew C. Porter & Devin J. Robinson (2019) Evidence Base Update of Psychosocial Treatments for Self-Injurious Thoughts and Behaviors in Youth, Journal of Clinical Child & Adolescent Psychology, 48:3, 357-392, DOI: 10.1080/15374416.2019.1591281