How should I approach the management of self-harm in adolescents compared to adults?

Management of self-harm in adolescents involves conducting a psychosocial assessment, developing a care plan, and considering psychological interventions such as cognitive-behavioural therapy (CBT) or dialectical behaviour therapy (DBT) adapted for adolescents, especially for those with frequent episodes or emotional dysregulation difficulties ¹,³.

In adolescents, it is important to involve family and carers in developing safety plans and providing support, and to ensure multidisciplinary collaboration, including specialist child and adolescent mental health services (CAMHS) ¹,³.

For adults, management includes offering structured psychological interventions, typically between 4 and 10 sessions, tailored to individual needs, and may involve problem-solving therapy or CBT-informed approaches ³.

Harm minimisation strategies may be discussed with adults who are engaged in ongoing care but are not yet able to resist self-harm urges, ensuring these are collaborative and part of a recovery-focused approach ³.

In both groups, referral to mental health services and psychosocial assessment are priorities, but in adolescents, there is a greater emphasis on involving family, safeguarding, and age-appropriate multidisciplinary care ¹,³.