Some young people plan to continue self-injuring and have no intention to change. Due to experiencing a downside to self-injury, some young people begin to contemplate making a change but don’t feel ready to attempt it. Others are ready to change but either don’t know how or are fearful that it may not be possible. There are also young people who have reduced or ceased injuring themselves, who need useful strategies and support that enable them to maintain the changes that they have made. Youth AOD practitioners can provide useful responses to each of these groups of young people.

Regardless of whether a young person wants to change they should know that they are accepted and that their decisions will be respected. Where young people do plan to change their plans might include short-term goals and harm reduction strategies, as well as longer-term plans to build skills and resilience in managing distress or other states which can result in self-injury.

The ‘Transtheoretical Model of Change’ and it’s central organising construct the ‘Stages of Change’ (see Behaviour change in the theories and frameworks section) provides youth AOD practitioners with a framework for understanding how people either modify behaviours such as self-injury or adopt new, healthier behaviours.

Change is viewed as a process that unfolds over time rather than an event, and the focus is on the decision making of each  individual. The stages of change enables practitioners to assess each young person’s motivation and readiness to change and informs the composition of meaningful interventions that can be used to assist change (see the Intervention planning module).

Strategies for Practitioners to assist young people who self-injure by stage of change

Pre-contemplation: not interested in changing their self-injuring behaviour

  • Engaging and building a respectful connection featuring open and honest communication
  • Self-injury functional analysis
  • Awareness raising and education
  • Help young person address underlying issues and life stressors
  • Harm reduction strategies 

 

Contemplation: being aware that they may want to change their self-injuring behaviour

  • Engaging and building a respectful connection featuring open and honest communication
  • Support and guidance for the young person as they enact change strategies
  • Strengthen social networks to support change 
  • Seeking expert assistance where appropriate
  • Motivational interviewing
  • Awareness raising and education
  • Help young person address underlying issues and life stressors
  • Harm reduction strategies 

 

Preparation: Knowing they want to change their self-injuring behaviour, and getting ready to make the change.

 

Action: Implementing plan to use alternatives to self-injury

  • Support and guidance for the young person as they enact change strategies (including reviewing and resetting goals)
  • Strengthen social networks to support change
  • Seeking expert assistance where appropriate
  • Relapse prevention

 

Maintenance: Maintaining the changed strategies

  • Consolidating and reinforcing changes made 
  • Setting goals to enhance quality of life
  • Relapse prevention