A Framework for Self-Harm Cessation in Adolescents

Self-harm is a common behavior in adolescents presenting for treatment of mental illness. This article reviews aspects of the clinical impact of youth self-harm that are of import to practicing psychologists and allied clinicians. Specific therapeutic approaches to engaging youth are described including the use of therapy commitment strategies, reinforcement of change behaviors, and involving caregivers in various stages of treatment. Description of evidence-based assessment (behavioral assessment and functional assessment) and treatment (identifying potential replacement behaviors and motivational factors) are reviewed while building on existing crisis safety planning interventions. The authors present a framework for self-harm cessation in adolescent youth whereby assessment and behavioral treatment inform each other to reduce and ultimately stop self-harm behavior.