Self-harm - Treatment

Treatment

There is considerable uncertainty about which forms of psychosocial and physical treatments of patients who harm themselves are most effective and as such further clinical studies are required. Psychiatric and personality disorders are common in individuals who self-harm and as a result self-harm may be an indicator of depression and/or other psychological problems. Many people who self-harm suffer from moderate or severe clinical depression and therefore treatment with antidepressant drugs may often be effective in treating these patients. Cognitive behavioural therapy may also be used (where the resources are available) to assist those with Axis I diagnoses, such as depression, schizophrenia, and bipolar disorder. Dialectical behaviour therapy (DBT) can be very successful for those individuals exhibiting a personality disorder, and could potentially be used for those with other mental illnesses who exhibit self-harming behaviour. Diagnosis and treatment of the causes of self-harm is thought by many to be the best approach to treating self-harm. But in some cases, particularly in clients with a personality disorder, this is not very effective, so more clinicians are starting to take a DBT approach in order to reduce the behaviour itself. People who rely on habitual self-harm are sometimes psychiatrically hospitalised, based on their stability, and their ability and especially their willingness to get help.

In individuals with developmental disabilities, occurrence of self-harm is often demonstrated to be related to its effects on the environment, such as obtaining attention or desired materials or escaping demands. As developmentally disabled individuals often have communication or social deficits, self-harm may be their way of obtaining these things which they are otherwise unable to obtain in a socially appropriate way (such as by asking). One approach for treating self-harm thus is to teach an alternative, appropriate response which obtains the same result as the self-harm.