Working with clients who engage in self-harming behaviour: experiences of a group of counsellors

Abstract

This study aimed to explore the experiences of a group of counsellors regarding working with clients who engage in self-harming behaviour, in order to gain an understanding of what it is like to work with this client group. A series of six individual, semi-structured qualitative interviews were carried out, which were then transcribed and analysed using thematic analysis. Counsellors' experiences were characterised by a number of themes, including the nature of self-harm, in terms of severity and vividness of description, stopping self-harm, incorporating social norms and therapeutic outcome, and organisational issues around balancing expectations from the agency, managing risk, and the counsellors' own working. Findings suggest that working with clients who self-harm raises significant challenges for counsellors in relation to organisational policy and/or context, the impact that working with this client group may have on the therapist themselves, while the issue of stopping self-harm, and how this might be communicated to the client, raises implications for the therapeutic relationship. Here, the supervisory relationship may offer an invaluable resource.

Experiences of therapists who integrate walk and talk into their professional practice

“…In a qualitative study, Doucette (2004) explored the benefits of walk and talk therapy for behaviourally challenged youths by conducting interviews with clients and found that the impact of therapy was enhanced by being outdoors and engaging in exercise and that the walking component allowed for physical release and aided problem-solving. Studies of professional knowledge, in which practitioners report on their experience in relation to a specific area of work, represent a valuable research strategy in emerging areas of practice (Chartas & Culbreth, 2001;Christianson & Everall, 2009;Finn & Barak, 2010;Fox, 2011;Karakurt, Dial, Korkow, Manfield & Banford, 2013;van Rooij, Zinn, Schoenmakers & van de Mheen, 2012). To date, one professional knowledge study has been carried out in the area of walk and talk.…”

A preliminary investigation into counselling student attitudes towards self‐harming behaviour

“…Discussion might consider how the attitudes and beliefs of the practitioner can influence communication and the therapeutic relationship with a client (Saunders et al., ). This might also provide an early point of intervention for stigma reduction (Anderson et al., ; Fox, ). Despite limitations and the exploratory nature of the study, counselling student attitudes towards self‐harm warrant further investigation.…”

“…Type of self-harm appears to have an effect on counselling student response. Previous research has also found severity to have an impact on the counsellor themselves (Fox, 2011). It would seem appropriate to allow time and space during training to explore thoughts and feelings around self-harm.…”

“…Mental health staff also report working with individuals who self-harm as stressful. Counsellors find working with this client group challenging (Fox, 2011), and community psychiatric nurses describe it as impacting on their own feelings and experiencing a sense of professional responsibility to manage risk (Thompson, Powis & Carradice, 2008). However, there is some evidence to suggest that the attitudes of mental health professionals are more favourable than those of general medical staff (Commons Treloar & Lewis, 2008;Platt & Salter, 1987).…”

Social Representations About the Functions of Deliberate Self-Harm: Construction and Validation of a Questionnaire for Portuguese Adults

“…Several studies have explored and described adults’ perceptions and attitudes towards deliberate self-harm. Most of the existing literature has focused on the perspectives of parents of adolescents who self-harm (Ferrey et al, 2016; McDonald, O'Brien, & Jackson, 2007; Oldershaw, Richards, Simic, & Schmidt, 2008; Rissanen, Kylmä, & Laukkanen, 2009), healthcare professionals (Karman, Kool, Poslawsky, & Van Meijel, 2015; Lindgren, Oster, Aström, & Graneheim, 2011; McHale & Felton, 2010; Rees, Rapport, Thomas, John, & Snooks, 2014), counsellors (De Stefano, Atkins, Noble, & Heath, 2012; Fox, 2011; Long & Jenkins, 2010), and teachers (Berger, Hasking, & Reupert, 2014; Heath, Toste, & Beettam, 2007; Heath, Toste, Sornberger, & Wagner, 2011).…”