Caring for Young People Who Self-Harm: A Review of Perspectives from Families and Young People

Abstract

Self-harm among young people remains largely stigmatised and misunderstood. Parents have been identified as key facilitators in the help-seeking process, yet they typically report feeling ill-equipped to support the young person in their care. The aim of this review was to examine the perspectives of both young people (aged 12–28) and parents and to develop the conceptual framework for a future qualitative study. A systematic search of MEDLINE and PsycINFO was performed to identify articles that focused on the experiences of family members and young people related to managing the discovery of self-harm. Fourteen articles were included for review. Four addressed the perspectives of young people and 10 reported on the impact of adolescent self-harm on parents. The impact of self-harm is substantial and there exists a discrepancy between the most common parental responses and the preferences of young people. In addition, parents are often reluctant to seek help for themselves due to feelings of shame and guilt. This highlights the need for accessible resources that seek to alleviate parents’ distress, influence the strategies implemented to manage the young person’s self-harm behaviour, reduce self-blame of family members, and increase the likelihood of parental help seeking.

Parents’ Experience and Psychoeducation Needs When Supporting a Young Person Who Self-Harms

“…Some parents reported having conversations about self-harm with their children, while others were uncertain and asked for information on how to do so effectively. According to young people themselves, parent's ability to "talk and listen" about self-harm is an effective support strategy [14]. In addition, our study participants emphasised another aspect of supportive communication, specifically, remaining calm and non-judgemental even during emotionally-charged situations with young people.…”

“…Similar to parents in previous studies [15,16], our participants expressed a fear that setting boundaries could trigger another episode of self-harm and observed that siblings may feel neglected or become resentful of differential treatment of the young person who self-harms. These relational challenges reflect the need to equip parents, who are the primary source of help for young people [14,34], with the right support and resources.…”

“…In addition to negative outcomes for the young person, self-harm can have a substantial impact on the well-being and functioning of parents and other carers [14]. Parents of young people who self-harm frequently report guilt and shame, fear of exacerbating self-harming behaviour, and changed perceptions of the future for themselves and the young people they care for [15,16].…”

Nonsuicidal Self‐Injury‐Related Differences in the Experience of Negative and Positive Emotion

“…Approximately 17% of adolescents and 13% of young adults (20% among university students) report a history of NSSI (Swannell, Martin, Page, Hasking, & St John, ). NSSI is associated with a range of negative consequences including permanent scarring (Lewis & Mehrabkhani, ), psychological distress for the individual as well as their friends and family (Curtis et al, ), and increased risk of future suicidal thoughts and behavior (Kiekens et al, ). Due to its prevalence and adverse outcomes, NSSI is listed as a condition requiring further study in the DSM‐5.…”

A clinician's quick guide to evidence‐based approaches: Managing suicide risk in young people

“…Consideration of developmental factors may result in some negotiation between the practitioner and the young person regarding information to be disclosed to caregivers, whereby sensitive information (e.g., drug use) may be omitted. Consideration should also be given to the information and support resources available to caregivers (who may be experiencing significant guilt or anxiety given their young person's suicide risk), and the ability of caregivers to adequately respond to suicide risk and proactively engage crisis services (Curtis et al, ). Where suicide planning is identified, clinical monitoring should be maintained, either via increasing the frequency of face‐to‐face appointments, phone contact, or inpatient care.…”