Self-harm

Discovering that your child is hurting themselves can be a frightening moment for a parent. The instinct is to make it stop straight away. But self-harm is rarely something that can simply be switched off on demand, and what you can offer is not an off switch. It’s a calm, steady presence and a route to the right support.

This guide is here to help you understand what is happening and what genuinely helps. It explains why young people self-harm, what to say and what to avoid, when to seek professional help, and how counselling, including online therapy, can support a young person to find safer ways to cope. For many young people, self-harm is a way of coping with life, though some also have thoughts of suicide.

If your child is in immediate danger, has seriously injured themselves, or you believe they may act on suicidal thoughts, do not wait. Call 999 or go to A&E. If they are having suicidal thoughts but are not in immediate danger, or you're worried, contact your GP and ask for an urgent appointment, or call NHS 111 and choose the mental health option. Your child can talk to Childline free and in confidence on 0800 1111 if they're under 19, and you can reach the Samaritans on 116 123 or text SHOUT to 85258 at any hour. Finding Therapy is a counselling service, not a crisis or emergency service.

What is self-harm?

Self-harm is when someone intentionally hurts their own body as a way of dealing with difficult feelings. It can take many forms, including cutting, scratching, hitting or punching themselves, burning, pulling out hair, or swallowing things that are harmful. Some forms are easier to spot than others.

It helps to understand what self-harm is often for. For many young people, self-harm is not an attempt to end their life. It is, in a way that can seem hard to grasp, often a way of coping with life: a way of managing feelings that have become too big, too overwhelming, or too difficult to put into words. It can bring a brief sense of relief, release, or control when everything else feels unbearable. Reasons differ from one young person to another, and some who self-harm do also have thoughts of suicide.

Self-harm always deserves a compassionate, serious response. But understanding that it is often a way of coping can help you respond with empathy rather than panic. And empathy makes it easier for a child to keep talking to you.

How common is self-harm in young people?

Self-harm is far more common among young people than many parents realise, and it becomes more common through the teenage years.

Across international studies, around one in six young people say they have self-harmed at some point ^[2]. It often begins around the age of 13, girls report it more often than boys, and cutting is the most common form, though far from the only one. There is also a hopeful pattern in the research: in one large Australian study that followed young people into adulthood, most young people who self-harm during adolescence ease off it and stop as they move into adulthood ^[3].

What self-harm can look like

Self-harm is often hidden, and many young people go to great lengths to keep it private because they feel ashamed or fear worrying the people they love. You may not see the self-harm itself at all. What you may notice instead are quieter signs.

These can include unexplained cuts, scratches, burns or bruises, often on the arms, thighs or stomach; wearing long sleeves or trousers even in warm weather; spending long stretches alone, particularly in the bathroom or bedroom; or finding sharp objects kept somewhere private. Alongside the physical signs there are often emotional ones: low mood, irritability, a flat or numb quality, withdrawal from friends and activities, or changes in sleep and eating.

No single sign proves that a young person is self-harming, and many of these overlap with the ordinary ups and downs of growing up. Equally, some young people who self-harm show none of these signs, so treat them as prompts rather than a checklist. What matters is a pattern, and a change in your child that does not feel like them. If something seems wrong, it’s worth gently asking your child, and talking to your GP if you are worried.

Why young people self-harm

Self-harm often makes sense once you understand what it’s doing for the young person. It’s rarely about attention, and it’s not a phase to be waited out. It’s usually an attempt to manage emotional pain.

For many young people, the most common reason is relief: when feelings build to a point that feels unbearable, self-harm can briefly discharge that pressure ^[2]. For others it’s a way to feel something when they have gone numb, a way to feel a sense of control when life feels chaotic, a form of self-punishment when they believe they’re not good enough, or a way of showing pain they can’t say out loud. Often it’s several of these at once, and the young person may not fully understand it themselves.

This is why "just stopping" is so hard. The self-harm is often meeting a real need, however unhealthy the method. The work, with a therapist, is to understand the need underneath and to find safer ways to meet it. Self-harm often sits alongside other difficulties such as anxiety, low mood, trauma or bullying, and it helps to understand the whole picture rather than focusing on the behaviour alone.

Is self-harm a sign my child wants to end their life?

Self-harm and suicidal thoughts are not the same thing: self-harm is most often a way of coping with emotional distress, not an attempt to die. At the same time, the two can overlap, and self-harm is a clear sign that a young person is struggling and needs support ^[4].

Most young people who self-harm will not go on to attempt suicide. Even so, self-harm is a serious risk marker, and every episode deserves to be taken seriously.

Research has found that risk is higher when self-harm is repeated ^[6], or when a young person who self-harms also has thoughts of suicide ^[5]. That is exactly why early, compassionate support matters so much. It’s always worth asking your child directly and gently whether they have thought about ending their life. Asking does not appear to plant the idea. It can tell them you can bear to hear the answer, and it opens the door to help. If the answer worries you, contact your GP or NHS 111, and if you believe they are in immediate danger, call 999 or go to A&E.

What it's like for parents

It’s hard to overstate how distressing it is to learn that your child is hurting themselves. Parents describe fear, helplessness, guilt, anger, and a desperate urge to fix it immediately.

Some parents worry that this is their fault, but self-harm is not caused by one thing. It grows from a young person's pain and from a mix of pressures, many of which sit outside the home. What you do now, in responding with steadiness and getting them support, can help.

It's important to look after yourself too, your own calm helps your child. Talking to your GP, a trusted friend, or a parent helpline is part of helping.

What to say, and what not to say

When a child first opens up, or when you first raise it, your response shapes whether they keep talking. You don’t need the perfect words. You need to be calm, warm and curious rather than shocked or angry.

It helps to thank them for telling you, to stay calm even if you feel anything but, and to ask gentle, open questions: "How long has this been happening?", "What does it help with?", "How can I support you?" It doesn’t help to react with panic, anger or disgust, to demand they stop immediately, to make them feel guilty for upsetting you, or to issue ultimatums. These responses, however understandable, tend to drive self-harm underground.

What you can do as a parent

Beyond the first conversation, there is a great deal you can do, and most of it comes down to combining safety with connection.

On safety, it’s reasonable to reduce easy access to the things your child uses to hurt themselves, ideally with advice from your GP, and with your child involved where you can, rather than in secret. This should never delay emergency help if you believe they are in immediate danger. On connection, keep showing up and do what you can to spend time together; shared meals, small routines, and a steady message that you love them and are not going anywhere. Constant searching and monitoring, without warmth, tends to damage trust and drive self-harm into hiding. Safety and connection have to go together.

Your GP is a sensible early step, a calm conversation there can open the door to the right support.

The most up-to-date clinical guidance points the same way: away from quick fixes and towards understanding. NICE now recommends that professionals build a collaborative relationship and a shared understanding of why a young person self-harms, rather than relying on checklists to predict risk.

Coping strategies that can help

Parents often ask for a list of alternatives to self-harm, and it is a loving question. The honest answer is that there is no universal list, because what works depends on what the self-harm is doing for your child.

You may have seen older advice to hold an ice cube, ping an elastic band on the wrist, or draw on the skin in red pen. Anything that works by causing pain is not a good starting point, because it sits close to the very thing you are hoping to move away from, and it does not suit every young person. NICE advises that coping and harm-minimisation strategies are worked out with the young person themselves, rather than handed over as a general list ^[8]. So this is a conversation to have with someone who knows your child.

Rather than a set list, it can help to think about what feeling the self-harm is trying to manage, and to explore with your child, ideally alongside a counsellor, what might meet that need more safely. Some young people looking for release find something physical helps, like intense exercise or loud music. Some who feel numb find a strong sensation helps, like a cold shower or a sharp flavour such as mint. Some who need comfort turn to a warm bath, a weighted blanket or a trusted person. None of these replaces self-harm on its own, and what helps one young person may not help another. Any plan works best when it is worked out together, takes account of your child's needs, preferences and safety, and sits alongside professional support.

When to seek professional help

Self-harm always warrants attention, and you don’t need to wait for a crisis to ask for help. It’s worth talking to your GP as soon as you know or suspect your child is self-harming, whether it has happened once or many times, and you do not have to be sure how serious it is.

Your GP can assess what is happening, treat any injuries, and refer on to your local child and adolescent mental health service (CAMHS) where appropriate. Counselling, whether arranged privately or through school, can run alongside this, not instead of it, and can give your child a dedicated space to understand and ease their distress. Children referred for self-harm are among those CAMHS sees most quickly, because services prioritise the most pressing risks. Of the children who went on to be seen, the median wait was around nine days ^[9].

For urgent or out-of-hours worries, Childline (0800 1111) is there for your child if they're under 19, and the Samaritans (116 123) are there for anyone, including you, at any hour. If you're worried, you can call NHS 111 at any hour and choose the mental health option. If you believe your child is in immediate danger, call 999 or go to A&E. Finding Therapy is a counselling service rather than a crisis service.

How counselling helps with self-harm

Counselling can help a young person who self-harms in two connected ways. It can give them a safe, usually private relationship in which the feelings underneath the self-harm can begin to be understood. And it can help them build safer, more sustainable ways to cope.

Research has not crowned a single therapy as the answer for self-harm. The most thorough recent review, which pooled the individual results of 26 trials, found no evidence that any one therapy reliably outperformed good ordinary care ^[10]. What this tells us is not that therapy fails, but that the right approach depends on the child. The most promising signal in that review, though not a conclusive one, was for dialectical behaviour therapy (DBT) skills, meaning the individual techniques rather than the full programme. The same review also found that young people who had already self-harmed several times gained the most from therapy of any kind. The full structured DBT programme, designed specifically for adolescents, is a different thing, and in trials with teenagers who self-harm repeatedly it has reduced self-harm more than usual care, though the effects are modest ^[11], ^[12]. It is a specialist programme, which NICE recommends considering for young people with significant difficulty managing their emotions and frequent self-harm. Cognitive behavioural therapy, family work and creative approaches are chosen through assessment, according to what fits your child, rather than because any one of them has been shown to beat the others.

This is why Finding Therapy is integrative and person-centred rather than tied to one method. A good counsellor draws on several approaches and adapts them to the individual child. And across all of them, the relationship between a young person and their counsellor is consistently associated with better outcomes.

At Finding Therapy, if one of our counsellors becomes worried about a child's safety, they will follow their own safeguarding procedures. Depending on the child's age and the situation, this may mean talking to the parent about next steps, such as an urgent GP appointment or, in an emergency, calling 999 or going to A&E. Where it is needed, they may also contact the child's GP.

A clinical perspective from one of our counsellors

Becky Christian, NCPS (Accred), a Finding Therapy counsellor with experience in supporting children and young people who self-harm, shares how she works in her sessions:

"For over 20 years, I've worked with children and young people across schools, local authority services, and charities, supporting those facing some of the most difficult challenges. A significant part of my work has been with young people who use self-harm as a way of coping. Self-harm is often misunderstood, but for many young people it can be a way to manage overwhelming feelings or to express pain they don't yet have words for."

"When I first meet a young person struggling in this way, my priority is to create safety and calm. Part of this means gently understanding how and when they're self-harming, and identifying any immediate concerns about their safety. Where further assessment or specialist support is needed, I work to make sure they (and their family) are connected with the right services. I know it can feel frightening to talk about self-harm, so I move at their pace, reassuring them that they don't have to share more than they're ready to."

"Alongside this, I work to build trust and consistency. Sometimes that looks like quiet listening, sometimes creative activities, and often just showing up each week in a dependable way. The focus isn't only on the self-harm itself, but on what lies underneath: the feelings, experiences, and pressures that have led to it. Together, we explore healthier coping strategies that help ease distress without causing harm."

"The Finding Therapy platform is especially supportive here. Creative tools, grounding activities, and interactive exercises give young people safe ways to explore what triggers their self-harm and to practise alternative strategies. We might create a "warning signs" map, design a personalised "soothing box" of coping ideas, or build a step-by-step safety plan they can return to whenever they need."

"Over time, I see many young people begin to find safer ways of expressing themselves, and start to recognise moments of strength and hope again. Progress varies, and setbacks can be part of it."

"What I most want young people and parents to know is that self-harm is often a way of coping, not a life sentence. With the right support, it's possible to find other ways through pain, and to begin building a future that feels safer and more manageable."

Why online therapy can suit this work

Online therapy can be a good fit for many young people who self-harm. Self-harm often carries deep shame, and many young people find it easier to begin talking about it from the safety of their own room, with the setting under their control. The familiar environment also means coping strategies can be practised where they will actually be used. Online counselling isn't right for every situation: where there is a significant risk to safety, a safeguarding concern, or a need for more intensive or specialist assessment, other support may be better.

The evidence is reassuring. Therapy delivered remotely to children and young people has been found to help with difficulties such as anxiety and behaviour problems ^[14], and for anxiety and depression in young people, research suggests technology-assisted therapy can work about as well as meeting in person ^[15]. Neither study looked specifically at self-harm, so this is general evidence about online therapy for young people. A trusting relationship with the therapist, which is consistently associated with better outcomes, can be built over a screen too.

Online also widens the choice of counsellor. Rather than being limited to whoever is nearby, your child can be matched with someone who genuinely has experience of self-harm in young people, which can make a real difference.

Recovery: what it actually looks like

Recovery from self-harm is real, and research suggests most young people who self-harm ease off as they grow older ^[3]. But it rarely looks like a straight line. More often it looks like self-harm becoming less frequent, less severe, and less needed, as a young person builds other ways to cope and the pain underneath begins to ease.

Setbacks can be part of this, not a sign of failure. A lapse during a hard week does not undo the progress made, and how you respond to a setback, with steadiness rather than despair, can be part of the recovery itself. If self-harm returns or becomes more serious, go back to your GP or the services involved.

The aim is not a guarantee that your child will never have another difficult day. It’s a young person who has safer ways to meet their pain, who knows they can turn to people instead of turning on themselves, and who has reasons to feel hopeful about the future.

A final word

Self-harm is frightening, but it’s something many young people move through, especially with steady love at home and the right support alongside it. The right counsellor for a young person who self-harms is someone with real experience of this work, who can move at the child's pace and build trust before anything else. That fit matters, whichever approaches they draw on.

Finding Therapy has lots of counsellors experienced in working with self-harm, so you can find your child someone who suits them, their age, and what they are going through, and who offers sessions online so support can fit around school and family life. You can see the counsellors here.