A young person’s self-injury might already be the focus of a care or support plan. These plans will commonly specify actions for both the practitioner and the young person who has an urge to self-injure is planning to do so.
If the risk of self-injury has not been identified in advance the issue needs to be raised and worked through so that a common understanding can be reached. If the young person is too distressed to engage in this process and is wanting to find a way to self-injure immediately ask them to delay for a short period (eg. 15 minutes). This gives the practitioner time to validate the young person’s feelings and help them feel more in control and less distressed. At same time a risk assessment should be conducted in a sensitive manner. This may result in the urge to self-injure reducing.
If the urge to self-injure remains, the practitioner may suggest the practical alternatives to self-injury that might meet their needs or reduce their distress. This includes identifying strategies that have helped in the past.
In all cases practitioners are required to enact their duty of care and should follow their organisation’s policies and procedures.
The following elements from the Distress Tolerance component of Dialectical Behaviour Therapy are likely to be useful.
G3ii. Distraction from Pain
This DBT element acknowledges and validates that the young person is experieing pain and is suffering, and offer ideas for distraction from this state, which can reduce the potential harm and impact of self-injury.
G3iii. Self-soothing & relaxation
This DBT strategy also gives the young person options to consider before self-injury which may allow the acute urge to pass.