SELF HARMING
PROVIDING POSITIVE SUPPORT
Background
Hertswood Academy – 1400 students
LSA in 1992
SENCo 1994
Head of Inclusion/SENCO/DSPCP/Behaviour/Attendance 2003
Teacher
Child Protection Officer 2014
MET Child Protection Support 2014
Objectives
An understanding of self harm, who they might affect
and why
Learn about the risk factors and warning signs so we
can identify cases early
Share ideas for working with students, parents and
external agencies
Explore practical ideas for supporting students
during recovery
Changes in mental health in schools
Growing number of self-harm cases
Significant factors
Dealing with the impact
What is self-harm?
Causing harm to the body, usually through physical abuse:
Cutting / swallowing tablets / burning / bruising / hair
pulling / scratching / misusing alcohol or drugs
It is usually conducted at times of distress, fear, emotional
worry, anger depression or low self-esteem in order to
manage negative feelings
Definition
“…a deliberate act to damage yourself,
without intending to die. This varies
according to the situation the individual
carrying out the act and is a means of getting
away from intolerable thoughts or feelings”
HOTUSH
Myths
Myth:
Only girls self-harm
Fact:
Not true. Both boys and girls self-harm but it does tend to be more prevalent in girls
Myth:
People who cut and self-harm are trying to get attention.
Fact:
The painful truth is that people who self-harm generally do so in secret. They aren’t trying to manipulate others or
draw attention to themselves. In fact, shame and fear can make it very difficult to come forward and ask for help.
Myth:
People who self-harm want to die.
Fact:
Self-harmers usually do not want to die. When they self-harm, they are not trying to kill themselves—they are
trying to cope with their pain. In fact, self-injury may be a way of helping themselves go on living. However, in the longterm, people who self-harm have a much higher risk of suicide, which is why it’s so important to seek help.
Myth:
If the wounds aren’t bad, it’s not that serious.
Fact:
The severity of a person’s wounds has very little to do with how much he or she may be suffering. Don’t assume
that because the wounds or injuries are minor, there’s nothing to worry about.
helpguide.org
Difficulty
communicating
Low self-esteem
Poor problem
solving skills
High
expectations
Controlling
Neglect/abuse
Looked after
Young carer
Bereavement
SOCIAL…
Low mood /
anxiety
FAMILY...
PERSONALITY…
Risk Factors
Sexuality
confusion
Bullying
Lack of friends
Friends with
similar problems
Highly
competitive
hobbies
Facts and Figures
1.6m people in the UK are living with an eating disorder
Up to half of young girls fear becoming fat
1 in 3 boys aged 8-12 have dieted to try and lose weight
26% of 7-18 year olds have skipped a meal to lose weight
1 in 4 teenage boys would consider plastic surgery to look more
like David Beckham, Brad Pitt or Usher
1 in 10 children will have self-harmed by the age of 18
CapitaEducation
Some of the triggers
Loss of parent
Poor communication skills
Serious injury or surgery during childhood
Loneliness
Sexual or physical abuse
Bullying
Family relationship difficulties
Exam stress
Depression
Times of change i.e. primary to secondary
Poor self-image and low self esteem
helpguide.org
Warning signs
Mental health scale for self harm
• Self-harm and suicide lie on a continuum
• Not about wanting to die
Socially acceptable
self-harm
Scottish Personality Disorder Unit
Self Harm
Suicide
How do you cope as a school?
Not an easy task
Good communication – staff need to be vigilant
Time to talk with the student
Offering sound advice
Contacting parents
Sharing the responsibility
Creating an environment where young people are not frightened to disclose
Working with agencies
Strategies: Step by step advice to student
De-escalate the intensity of self harm
• A first step can be to think about trying to slowly reduce the damage caused by your
self harming behaviour (e.g. cutting less or less deeply). Then try to move to less
damaging practices like writing on your skin with red felt tip instead of cutting.
• Creating a personal self harm safety plan is a useful way to remind yourself of things
you can do when you feel an urge to self harm. These include ways to manage and
reduce self harming behaviors in the short term, so that they are less damaging, as
well as alternative ways to manage difficult feelings which can replace self harm in
the longer term.
Direct the harming urge at something else
• Some people find squeezing an ice cube provides an alternative that is helpful. Hit
pillows or cushions. Flick an elastic band on your wrist. Take a cold bath or shower.
Small steps…
Make a list of distractions
• Make a list of activities that you can use to distract yourself. Trying to be with other
people is particularly effective.
Know your triggers and reduce the risks
• Knowing what kinds of situations are particularly risky for you can help you plan to
reduce the risks. For example, it is harder to manage your feelings effectively when
you are under the influence of drugs or alcohol. Go easy on these if you are aware
that you are feeling less stable.
Learn to tune in to your feelings
• In the longer-term you can start to learn how to identify the experiences and feelings
which are most likely to trigger your urges to self harm. Learning the skill of
‘mindfulness’ – being tuned in to what you are feeling in the present moment,
without judgement or attempt to change it – is invaluable in the move towards being
able to manage or ‘ride out’ difficult feelings, rather than trying to eliminate them.
Continued…
Finding constructive outlets for feelings
• Having a good cry is the natural way to get rid of built up stress hormones and get feelings out. Experiment with
different ways to express feelings when they seem to be building up inside, to see what works for you. Keeping
a diary can be a useful habit for getting feelings ‘out’. Just write it all down without censorship, then close it
and put it away. Or it might be helpful to do something symbolic like writing it all down then scribbling it out or
tearing it up. Vigorous activity or exercise can be another helpful way to get rid of pent up feelings.
Learn how to self soothe
• Make a conscious effort to take care of yourself and comfort yourself with difficult feelings. Try out different
things to see what you find most comforting. Breathing and relaxation exercises can be very useful. A
relaxing soak in a bubble bath, hugs or a massage, eating something sweet (in moderation), stroking a pet,
listening to uplifting music, knitting or crafts… Find what works for you!
Get support and professional help
• Having people you can talk to and a good support network is a vital protection against both self harm and
suicidal thinking.
• Talking about the inner feelings that fuel your self harm is potentially useful whoever you talk to, but
counsellors are professionally trained to work with self harm and will be best placed to support you in
finding constructive alternatives i.e. counselling, GP, CAMHS etc.
Steps you can take
Talk to other
members of
staff – are
they
concerned?
Pass your
concerns onto
the
designated
member of
staff
Discretely
asks peers if
you should
be
concerned
Encourage
the pupil to
speak to you
Listen
Remember
the ‘real’
child is still
there
Make
time
How to
be helpful
Persevere
/offer
support
Be
honest
Try to
understand
How can we encourage reluctant
students to talk?
Open Questions
Third Person
friend / parent
Undershoot
(find a chink)
Responding to Self-Harm Fads
Behavioural issue
– employ usual
behaviour ladder
Address the
group / schoolzero tolerance
Injuries to be
covered
Respond
dispassionately
Talk to individuals
as well as group
Follow up with
individuals
Self-esteem / communication
/ group identity activities if
specific group
Supporting Parental GP Referrals
Write a letter to support GP appointment
Behaviours causing
concern / Health
ramifications
Change in
personality
How long this has
been going on for
History of similar
problems in family
/ friends
Any suspected
trigger
What the school
has done. Impact?
What outcome you are looking for?… spell it out
Practical Strategies
1
• Peer Support
2
• Free Pass (to leave class)
3
• Bolt Hole (somewhere safe to go)
4
• Regular access to a trusted adult
5
• Zero tolerance of teasing or bullying
Difficult Parents
A minority of parents will respond
negatively when you tell them about
their child’s difficulties
What negative responses might
you encounter?
Do you have an specific experience
you’d like to share?
Course 7486
Who to turn to out of school?
Golden rules
Staff to be vigilant
Time to listen/talk
Contact parents
Mentor/School nurse
Provision in school JEPECA, counsellor
Refer to SPA, CAMHS, GP, Social Service
Keep in contact with parents
Attend mental health meetings with professionals
Finally
You can only do your best!
You are not a psychologist or a therapist,
you are someone who cares.
If you need help ask for it!
If a self-harmer is pleased with their
friends support it’s probably because
they are enabling them.
If a self-harmer is as mad as hell with you
then you are probably helping them!