Treatment Plan for Self-Harm
Explore a helpful tool to help in safety planning and crisis management for clients engaging in self-harm and improve their health outcomes.
Fact Checked by Ericka Pingol.
What is self-harm?
Self-harm, also known as non-suicidal self-injury (NSSI), refers to the intentional and direct infliction of harm or injury to one's body without suicidal intent (Klonsky et al., 2014). It is a complex behavior that can manifest in various forms, such as cutting, burning, scratching, hitting, or interfering with wound healing. Self-harm is often used as a coping mechanism to deal with intense emotions, thoughts, or situations, and it may temporarily provide relief or a sense of control.
It's crucial to understand that self-harm is not a mental illness itself but rather a symptom or behavior associated with underlying psychological distress, trauma, or mental health conditions like depression, anxiety, borderline personality disorder, or post-traumatic stress disorder (PTSD) (Bentley et al., 2015). While self-harm is not an attempt at suicide, it can increase the risk of suicidal thoughts and behaviors, making it a significant concern for healthcare professionals.
Printable Treatment Plan for Self-Harm PDF
Download this Treatment Plan for Self-Harm to help in safety planning and crisis management for clients engaging in self-harm.
Examples of self-harming behaviors and actions
Self-harm can manifest in various forms, and it's essential to be aware of the different behaviors and actions that individuals may engage in. Common examples of self-harming behaviors include the following:
Direct physical injury
This includes acts that deliberately damage the body's surface, such as:
- Cutting, scratching, or burning the skin with sharp objects or heat sources
- Bruising oneself through punching, hitting objects, or pinching
- Hair pulling (trichotillomania) that results in noticeable bald patches
- Biting oneself or picking at scabs to reopen wounds and prolong healing
Substance abuse
This involves misusing substances like alcohol, drugs, or medications in a way that can lead to physical harm. This might include taking an overdose of medication (not necessarily with suicidal intent) and engaging in excessive alcohol or drug use despite negative consequences.
Risky behaviors
Engaging in self-injurious behaviors with a high potential for injury without any regard for safety, which includes reckless driving or speeding, self-starvation or purging in eating disorders, unprotected sexual intercourse, or engaging in unsafe sexual practices.
Treating self-harming behaviors
When it comes to treating self-harming behaviors, a comprehensive and individualized approach is crucial. The treatment plan should address the underlying causes and factors contributing to the self-harm, as well as provide effective coping strategies and support. The following are some key aspects to consider:
- Psychotherapy: Various forms of psychotherapy have been shown to be effective in treating self-harm. Cognitive Behavioral Therapy(CBT) helps individuals identify and modify negative thought patterns and behaviors, while Dialectical Behavioral Therapy (DBT) focuses on developing emotion regulation skills and distress tolerance. Other approaches, such as Acceptance and Commitment Therapy (ACT) and Mentalization-Based Treatment (MBT), can also be beneficial.
- Medication: In some cases, medication may be prescribed to manage underlying mental health conditions that contribute to self-harm. Selective Serotonin Reuptake Inhibitors (SSRIs) and mood stabilizers are commonly used, but it's important to note that medication should be used along with psychotherapy.
- Harm reduction strategies: While the ultimate goal is to stop self-harming behaviors, harm reduction strategies can minimize the risk of injury and physical harm. These may include providing safe alternatives, such as using a red marker instead of cutting or engaging in physical activities like hitting a punching bag.
- Emotional regulation and coping skills: It is crucial to teach individuals effective coping strategies and emotional regulation skills. This may involve practicing mindfulness, deep breathing exercises, distraction techniques, or developing a support system.
- Family and social support: Involving family members or loved ones in the treatment process can be beneficial. Educating them about self-harm and providing resources for support can create a more understanding and supportive environment for the individual.
- Inpatient or intensive outpatient treatment: In severe cases or when there is a high risk of suicide, inpatient or intensive outpatient treatment may be necessary to provide a safe and structured environment for the individual.
How to identify self-harm triggers?
Identifying and understanding the triggers that can lead to self-harming behaviors is a crucial aspect of effective treatment and prevention. Self-harm triggers can vary from person to person, but some common ones include:
- Emotional triggers: Intense emotions like sadness, anger, anxiety, or feelings of emptiness can act as triggers for self-harm. Individuals may use self-harm as a way to cope with or escape from these overwhelming emotions.
- Interpersonal triggers: Conflicts, arguments, or problems in relationships with family, friends, or romantic partners can trigger self-harming behaviors, especially in individuals who struggle with interpersonal difficulties.
- Environmental triggers: Certain situations or events, such as academic or work-related stress, bullying, or traumatic experiences, can increase the risk of self-harm.
- Situational triggers: Specific situations or places may be associated with past experiences of self-harm, making them potential triggers for future self-harming episodes (Washburn et al., 2015).
- Internal triggers: Negative self-talk, self-criticism, or a distorted self-image can contribute to self-harming thoughts and behaviors.
To identify triggers, a mental health professional can use a variety of methods, such as self-monitoring techniques, where individuals record their thoughts, emotions, and situations surrounding self-harm episodes. Psychotherapy can also help explore and understand the underlying reasons and triggers for self-harm.
What is typically included in a self-harm treatment plan?
A comprehensive self-harm treatment plan typically includes the following components to ensure that it can help in preventing and responding to concerns about self-harm behaviors:
Presenting concerns
Identifying the specific self-harming behaviors, frequency, severity, and any associated risk factors or triggers is crucial for developing an appropriate treatment plan. This information helps tailor the interventions to the individual's unique needs.
Assessment
A thorough assessment is essential to understand the underlying factors contributing to self-harm. This may involve psychological evaluations, medical assessments, and gathering information on the individual's mental health, trauma history, coping mechanisms, and support systems.
Goals
Setting realistic and measurable goals is essential for tracking progress and achieving desired outcomes. Goals may include reducing the frequency or severity of self-harm, developing healthy coping mechanisms, improving emotion regulation, and addressing underlying mental health conditions.
Interventions
Evidence-based interventions are essential in an effective treatment plan. These may include:
- Psychotherapy (e.g., Cognitive Behavioral Therapy, Dialectical Behavior Therapy, Mentalization-Based Treatment, Family Therapy)
- Medication management (if necessary, for co-occurring mental health conditions)
- Harm reduction strategies (e.g., safe alternatives, wound care)
- Emotional regulation and coping skills training
- Family and social support involvement
Progress monitoring
Regular monitoring and follow-up appointments are crucial to tracking progress, adjusting the treatment plan as needed, and providing ongoing support. This can include self-monitoring techniques, standardized assessments, and open communication with the individual and their support system.
Resources
Providing resources and referrals to support services can enhance the effectiveness of the treatment plan. These may include crisis hotlines, support groups, educational materials, and community-based resources specific to self-harm and mental health.
Treatment Plan for Self-Harm example (sample)
To help you maximize our Treatment Plan for Self-Harm template, we have created a filled-out version to serve as a guide to make the most out of this tool. This includes documenting the concerns, results of the assessment, short and long-term goals, interventions, progress monitoring, and resources that clients can access.
These are all laid out and optimized for both printed and digital use. If this can be helpful for your practice, feel free to check out a preview of this template by clicking on the link below. You can also choose to download this locally as a PDF.
Download our free Treatment Plan for Self-Harm template example here
What are the benefits of having such a treatment plan?
Having a comprehensive treatment plan for self-harm can provide numerous benefits for both the individual seeking treatment and the healthcare practitioners involved in their care. Here are some of the key advantages of planning this ahead:
Tailored and individualized approach
A well-structured treatment plan ensures that the interventions are tailored to the individual's specific needs, behaviors, triggers, and underlying factors contributing to self-harm. This personalized approach increases the likelihood of successful outcomes.
Multidisciplinary and holistic care
Self-harm often involves complex psychological, emotional, and social factors. A comprehensive treatment plan facilitates collaboration among various healthcare professionals, such as psychologists, psychiatrists, counselors, and social workers, to provide holistic care addressing all aspects of the individual's well-being.
Clear goals and progress monitoring
The treatment plan outlines specific and measurable goals, allowing healthcare practitioners to monitor progress, evaluate the effectiveness of interventions, and make necessary adjustments as needed. This helps us make sure that the treatment remains focused and responsive to the individual's changing needs.
Harm reduction and safety
The treatment plan addresses harm reduction strategies, safety planning, and crisis management, ensuring the individual's safety and minimizing the risk of severe injury or other negative consequences associated with self-harm.
Why use Carepatron as your therapy and mental health software?
Carepatron stands out as a therapy and mental health software as it works to address the multidimensional needs of your practice. We have designed features to help streamline various aspects of your practice and save you time and energy. Specifically, we have integrated these tools:
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- Telehealth capabilities: Conduct therapy sessions remotely via secure video conferencing, offering flexibility and convenience for clients who might have difficulty attending in-person sessions.
- Educational resources: The platform integrates educational resources and allows you to share informative materials directly with clients to support their progress outside of therapy sessions.
If you're ready to experience this for your own practice, sign up for your free trial today!
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References
Bentley, K. H., Nock, M. K., & Barlow, D. H. (2014). The four-function model of nonsuicidal self-injury: key directions for future research. Clinical Psychological Science, 2(5), 638-656. https://doi.org/10.1177/2167702613514563
Claes, L., Klonsky, E. D., Muehlenkamp, J., Kuppens, P., & Vandereycken, W. (2010). The affect-regulation function of nonsuicidal self-injury in eating-disordered patients: which affect states are regulated?. Comprehensive psychiatry, 51(4), 386–392. https://doi.org/10.1016/j.comppsych.2009.09.001
Klonsky, E. D., Victor, S. E., & Saffer, B. Y. (2014). Nonsuicidal self-injury: what we know, and what we need to know. Canadian journal of psychiatry. Revue canadienne de psychiatrie, 59(11), 565–568. https://doi.org/10.1177/070674371405901101
Commonly asked questions
People may self-harm as a way to cope with painful emotions, regulate difficult feelings, punish themselves, or seek relief from emotional numbness or dissociation. Self-harm is often associated with underlying mental health disorders.
Harm reduction strategies aim to minimize the risk of injury and physical harm while working towards cessation of self-harming behaviors. These may include providing relaxation techniques and safe alternatives, teaching wound care, and developing a safety plan.
If you or someone you know is self-harming, it's important to seek professional help from a mental health provider, counselor, or therapist. In case of an emergency or if there is an immediate risk of harm, contact emergency services or a crisis hotline.
