Treatment for Teenagers who Self Harm

Self-harm or self-injury affects nearly 1 in 4 teenage girls in the U.S., according to a 2015 study published in the American Journal of Public Health. The study was conducted by the Centers for Disease Control and Prevention(CDC) Youth Risk Behavior Surveillance System. Self-harm also effects teenage boys although the rate for girls is twice as high. When asked if in the past year they had harmed themselves without the intention to kill themselves, 6.4% to 14.8% of boys answered yes.

According to the Suicide Prevention Lifeline, suicide is the second leading cause of death for young people between the ages of 10 and 24. Often parents believe suicidal threats are childish outbursts in an attempt to "get attention" or redirect attention from another problem. Counselors at Elk River Treatment Program advise parents to never ignore their child's cry for help.

One parent who admitted her 17-year-old son in Elk River Treatment Program's residential program reported that self-harm was definitely a driving factor in her decision to place her son. "My husband and I thought he was trying to kill himself by using any substance he could get his hands on. He went from a kid who wouldn't take Extra Strength Tylenol to taking enough Xanax to black out," she said. Today this young adult confesses that, at 17, he seriously considered taking his own life and thanks his parents for intervening.

"It seemed to happen overnight, but once he was in treatment and I wasn't in panic-mode, his counselors helped me recognize the signs were there much earlier than I had originally thought." She recalled that months earlier, a parent suggested she look at the burns on her son's arms and how he constantly picks at the wound so it doesn't heal. "I had taken his word that he had accidentally burned himself with a cigarette, but upon closer inspection, there were way too many burns to be an accident. I was more focused on his smoking cigarettes than the burns on his body."

Types of Self Harm

Scars, cuts, burns, bruised hands or long sleeves in summer might be the first alarm bell for a broader range of problems. The important thing to remember is that these behaviors are almost always in conjunction with other mental health issues such as depression, anxiety, trauma, abuse, defiance or eating disorders.

Cutting, most often seen in girls, is the most common type of self-harming behavior, said Kathy Marino, a Licensed Professional Counselor and Director of Admissions at Elk River Treatment Program. The cuts are often small, superficial and may be hidden under clothing - sometimes for years. Some teens use sharp objects to injure themselves. Others use their fingernails.

Strangely enough, they hurt themselves to feel better.

“The behavior is a way for these young people to get their feelings out,” DeMellier said, “because they struggle to express what is really bothering them. After time in the residential program, we often learn from them that feeling something – even pain, is better than feeling nothing,” she said.

Self-Harm: Signs of a Deeper Issue

Parents should understand that self-harm is usually not isolated, and it is often occurring with other struggles the child is facing. Self-harm is the symptom of a deeper issue.

It doesn’t help that teens are great at hiding things. Some websites even offer tips on how to keep parents from finding out about self-destructive behavior. “Sometimes it’s very visible, but more often the secrecy prevents parents from seeing that their child is struggling,” she said.

And then there’s the dark side of social media. “When I was young and wasn't invited to a birthday party, I probably wouldn't even know about the party. Today’s kids know it – sometimes in real time. They are living through social media,” Kathy said.

According to the Anxiety and Depression Association of America, researchers have found that using social media and the internet in general can cause depression, attention deficit hyperactivity disorder (ADHD), impulsive disorder, paranoia and loneliness. Many people compare their lives with others they see on social media. If their friends are posting parties, relationships, and great vacations, a teen who is struggling may feel more depressed and anxious because their life isn't as “perfect” as those they see on the digital screen.

“We are definitely seeing an impact from the fact that our lives are out there for everybody to see,” Kathy said. In this digital age, “everything is at your fingertips and you have immediate gratification or disappointment for anything and everything in your life.” But with therapy, support and practice, adolescents can find alternatives to this self-destructive path.

The Root of Self Harm

Teen self-harm often takes root in the middle school years. That’s a time when children are more defiant and trying to find themselves, Kathy said.

Often these behaviors manifest after some type of loss. "That doesn’t necessarily mean an actual death in the young person’s life, but possibly a divorce, a parent losing a job, or even finding out that he or she is on the autism spectrum which is often perceived by the child as the loss of a normal life." The parent mentioned earlier described her son's feelings of abandonment and loss after his father stopped visiting him.

Immersive programs at self-harm treatment centers are beneficial because they provide a safe, secure environment for teens to address issues with their peers. Perhaps most importantly, an inpatient treatment center can show kids that they’re not alone. Teens are more likely to open up and talk in group settings. “There’s a lot to be said for being in a structured program,” Kathy said. “They are hearing they aren’t the only kids in the world who have an issue like theirs.”

Treatment for Self-Harm

If your child is not safe, inpatient and/or residential treatment should be the first step in helping your child. If possible, talk to your insurance company to learn what your policy covers before searching for placement. Search for a program that offers a comprehensive treatment approach that includes traditional talk therapy (individual and group), the ability for your child to identify maladaptive behaviors in real-time, stop to consider the source of those behaviors, and practice better coping skills in a group setting.

And don't add the pressure of falling behind in school for you and your child. Ensure that the adolescent treatment program provides an accredited academic curriculum.

Therapists who specialize in self-harm treatment understand that talking is key to getting to the root of a young person’s maladaptive behaviors.

“The hard piece is practicing the new ways of coping while under stress. Our clients are in groups a large portion of the day and like a family, situations arise unexpectedly. That’s when they either revert to old coping methods or recognize the trigger and use their new coping skills. It’s practicing day-after-day that helps them continue to succeed when they return home.”

Parents should not count on an “easy fix” for self-injurious behavior, although medication might help with other co-occurring issues often found.

Through her position as Director of Admissions at Elk River Treatment Program, Marino reports that hundreds of teens have been successfully treated for self-harm while at in the program. Without the distractions of cell phones, social media, friends and sometimes well-meaning family members, teens can focus on getting better with the help of mental health professionals who are trained and experienced to work with adolescents and teens.

As an added safety measure, Elk River support staff provide around-the-clock supervision. "Our clients are not sitting in a dorm room waiting on the next group session. They are busy from the time they wake up until the time they go to bed," Marino said.

Modern life for teens is more complicated that most parents imagine. Many young people being treated for issues these days are “more clinically and behaviorally complicated than ever before,” Marino said. “There has been a huge change since I started my first job at a residential program for adolescents in 1986.”