Monday, 22 July 2019
Techniques used to minimise self-harm in young people don’t work according to a new study from the University of Nottingham.
The Self-Harm Research Group in the School of Psychology conducted extensive analysis of young people’s views and experience of harm minimisation techniques. The results, published today in Archives of Suicide Research, show that these techniques are ineffective at preventing self-harm and in some cases are used as a form of self-harm.
Coping mechanisms
Self-harm affects approximately one in every five to ten adolescents and is used as a coping mechanism for psychological distress. It is often repetitive and is strongly associated with future suicide risk. It is also a common reason for young people needing the care of hospitals and mental health services.
‘Harm minimisation’ techniques are commonly recommended by clinicians and advocated for in self-help literature and websites. They suggest other ways young people can deal with their feelings and alternative ways of managing the urge to self-harm, some suggestions include: wearing an elastic band and pinging it against the skin, drawing on the skin with red pen and holding crushed ice.
The researchers conducted an online questionnaire of 758 young people aged 16-25 and carried out in-depth interviews with 45 young people to collect and examine their views and experiences of harm minimisation. The analysis of the responses revealed that young people viewed harm minimisation techniques for self-harm as ineffective and if they did help it was only for a short time. For some young people the techniques were used as a way to self-harm, for example piercing the skin with a pen.
“It’s not the same, it does not work”
Comments from the interviews revealed young people have tried these techniques but given up on them when they find they don’t work, comments included: “They give you leaflets about 105 ways to stop harming and things, but it’s like I’ve tried the laggy [rubber] band, I’ve tried drawing on myself, I’ve tried the ice. And it’s like, these things don’t work” and “Doesn’t work…using red pens or ice, no it’s not the same, it does not work. I have tried it, it does not work”.
We are very grateful to the young people who took part in this study who were so open and honest about their experiences. Listening to them and analysing the data we collected it is clear that, when used in isolation, harm minimisation strategies don’t work. It is really important that the use of harm minimisation strategies – and their recommendation – is monitored, but this is very difficult to do, not least because people often keep their self-harm hidden and seek help informally. While there is evidence that talking therapies are effective in helping young people who self-harm, further research is urgently needed into what works as treatment and for whom.
Professor Ellen Townsend, Director of the Self-Harm Research Group added: “Self-harm is a manifestation of psychological distress – we need to provide young people with supports and services that can help them cope in times of crisis. These must be built into care pathways in the community. There is now a robust evidence-base suggesting that talking therapies like CBT help those who are 18 years and older who self-harm. There is also some evidence that, for those under 18 years old, therapies with extended periods of contact such as Mentalisation Based Therapy and Dialectical Behaviour Therapy can be helpful. These studies now require replication.”
Story credits
More information on the is available from Emma Nielsen at the University of Nottingham on emma.nielsen@nottingham.ac.uk
Notes to editors:
About the University of Nottingham
Ranked 32 in Europe and 16th in the UK by the QS World University Rankings: Europe 2024, the University of Nottingham is a founding member of the Russell Group of research-intensive universities. Studying at the University of Nottingham is a life-changing experience, and we pride ourselves on unlocking the potential of our students. We have a pioneering spirit, expressed in the vision of our founder Sir Jesse Boot, which has seen us lead the way in establishing campuses in China and Malaysia - part of a globally connected network of education, research and industrial engagement.
Nottingham was crowned Sports University of the Year by The Times and Sunday Times Good University Guide 2024 – the third time it has been given the honour since 2018 – and by the Daily Mail University Guide 2024.
The university is among the best universities in the UK for the strength of our research, positioned seventh for research power in the UK according to REF 2021. The birthplace of discoveries such as MRI and ibuprofen, our innovations transform lives and tackle global problems such as sustainable food supplies, ending modern slavery, developing greener transport, and reducing reliance on fossil fuels.
The university is a major employer and industry partner - locally and globally - and our graduates are the second most targeted by the UK's top employers, according to The Graduate Market in 2022 report by High Fliers Research.
We lead the Universities for Nottingham initiative, in partnership with Nottingham Trent University, a pioneering collaboration between the city’s two world-class institutions to improve levels of prosperity, opportunity, sustainability, health and wellbeing for residents in the city and region we are proud to call home.
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