How to Respond Appropriately to Clients Who Self-Harm

The COVID-19 pandemic has affected the mental and physical well-being of adults and teens alike. The disastrous impact of social isolation and regulations forced many to quarantine alone. Without healthy social outlets and access to helpful resources, the rates of self-destructive behavior increased exponentially. As a therapist, you may have observed the escalation of dangerous behaviors such as self-harm. Although the availability of telehealth services increased, it didn’t prevent the rates from rising. However, if you have a client who has committed an act of self-harm, you can find a path to healing for you and your client.

The Rise in Self-Harm

In the early stages of the pandemic, more people reported mental health issues like depression and anxiety than in the previous year. The isolation and uncertainty of COVID-19 were driving causes for this increase. Other potential causes for the rise are a lack of interacting with others or being in an environment that is physically, mentally, or emotionally harmful. Teenagers and young adults are especially vulnerable because they no longer have the opportunity to go to school or contact adult figures who could guide them to the help they require.

The National Alliance of Mental Illness reports studies conducted on self-harm and teenagers to reveal that one in six of United States (U.S.) youths between the ages of six and 17 are diagnosed with a mental health disorder every year. However, when this rate is compared to the rate of diagnoses of mental health disorders in adults (one in 20), the contrast is troubling. 

The nonprofit FAIR Health, which monitors insurance claims connected to mental health issues, found a range of factors that play into this increase of self-harm. The insurance industry experienced a 99.8% increase in self-harm claims for youths between 13 to 18. Even more shocking has FAIR reporting a 333% increase in cases of self-harm in the Northeast for this age group between November 2019 and November 2020. How can you address your client’s mental health while also helping them cope with the aftereffects of a self-harm incident?

Coping With Your Feelings

Despite the expansion of telehealth services during the pandemic, a mental health crisis still exists across the nation. You may have wrestled with feelings of fatigue, depression, and anxiety yourself. When you learn that a client has attempted to or was successful in harming themselves, there is a chance you will experience a flood of emotions. The tendency to review your treatment is normal. Yet, before you react to the dangerous act, consider how your feelings can influence the relationship you have with your client. 

Experiencing an array of emotions is normal. You took on a role that includes guiding, listening, and observing your client’s thoughts and behaviors. However, you can’t catch everything. Some clients won’t or don’t talk about their circumstances or emotions freely. A client who doesn’t disclose their depression or anxiety presents difficulty in treatment. You can’t guess their mental state. When your client attended telehealth appointments, you couldn’t determine if their appointment space was safe for an open and honest discussion. You did the best you could.

If you have feelings of anger or sadness, don’t bottle them up. You have every right to express how you feel. However, that right doesn’t extend to expressing those thoughts or feelings to your client. Instead, make an appointment with your therapist to process your emotions. During the session, discuss possible coping mechanisms that can aid you in healing.

Treating Your Client

The client-therapist relationship is integral to your client’s path to mental health wellness. The trust and bond you share can allow your client to feel safe when speaking with you. 

When clients disclose their self-harm incident, they trust you to remain non-judgmental. You are the person they need to help them process their feelings and find the root cause. A healthy relationship is also a practical way to introduce coping methods.

To help your client feel supported, consider utilizing the skills you learned throughout your educational and professional career. If you lack specific skills in treating those who self-harm, you can enroll in or attend classes or conferences that provide the skills needed for those who harm themselves. In addition, finding creative and therapeutic ways to help your client heal can include these steps:

• Be supportive of their needs and let them know you’re there for them.

• Treat them as a whole, not an incident. A person who self-harms requires comprehensive care. Don’t focus on the harmful act without considering the whole person.

• Empathize with them. 

• Help them learn to control their decisions and, ultimately, their relationships or environment.

• Point out their positive traits.

Comprehensive care that includes acts of self-care is also necessary for your client’s physical and mental well-being. Work with them to incorporate healthy behaviors or habits like yoga, meditation, or journaling. Help your client understand self-care is not being lazy or selfish. Instead, it’s a way to show compassion to themselves.

Clients who self-harm are trying to release the internal pain caused by feelings of depression or anxiety through external pain. Some teens and young adults harm themselves because the act of inflicting pain relieves them from emotional numbness. Most acts are cries for help. If your client relies on cutting or burning themselves to express or feel their pain, you can include holistic therapies as healthy alternatives to harmful behaviors. While you’re in session with your client, discuss self-care and the various acts included in being kind to themselves. SokyaHealth combines experience with helping your client find mind, body, and spiritual balance. We strive to provide concierge-style care regardless of your client’s current location. Your client will discover mental health and wellness techniques through telehealth and in-person. At SokyaHealth, we guide your clients to feel and express their feelings positively. To learn more about our services, call us today at (877) 840-6956.