Background: Self-injury is an increasingly common phenomenon among clinical and non-clinical populations. Health care providers generally recommend behavioural interventions that address coping skills for people who self-injure despite a lack of a consistent evidence base about their effectiveness. There is limited understanding about experiences of counselling for self-injury from the perspectives of clients.Aim: To understand clients’ experiences of counselling for self-injury.Method: Ten interviews were conducted, audio-recorded and transcribed. Data were analysed using Grounded Theory (GT).Results: One central category, ‘‘Developing a healing reconnection with self and others’’ and four categories: (i) Building trust; (ii) seeing beyond the cutting; (iii) human contact and (iv) integrating experiences.Conclusions: Overcoming self-injury is possible within the context of a trusting and accepting therapeutic relationship. Participants perceived counselling to be helpful when counsellors were willing to work with underlying issues rather than focus primarily on the cessation of self- injury. Counsellors and mental health practitioners must look beyond the behaviour to meet with the person and facilitate the development of a therapeutic relationship, which promotes a healing reconnection with self and others.
Bibliographical noteReference text: Babiker G, Arnold L. (1997). The language of injury: Comprehending self-mutilation. Leicester: BPS Books.
Chandler A. (2012). Self-injury as embodied emotion work: Managing rationality, emotions and bodies. Sociology, 46, 442–57.
Chandler A, Myers F, Platt S. (2011). The construction of self-injury in the clinical literature: A sociological exploration. Suicide Life-Threat Behav, 41, 98–109.
Cooper M. (2007). Humanising psychotherapy. J Contemp Psychother, 37, 11–6.
Corbin J, Strauss A. (2008). Basics of qualitative research (3e). London: Sage.
Cresswell M. (2005). Psychiatric ‘‘survivors’’ and testimonies of self- harm. Soc Sci Med, 61, 1668–7.
Creswell JW, Miller DL. (2000). Determining validity in qualitative research. Theor Pract, 39, 124–30.
Gratz K, Conrad S, Roemer L. (2002). Risk factors for deliberate self- harm among college students. Am J Orthopsychiatry, 72, 128–40. Harris J. (2000). Self-harm: Cutting the bad out of me. Qual Health Res,
Harrison D. (1997). Cutting the ties. Feminism Psychol, 7, 438–40. Huband N, Tantam D. (2004). Repeated self-wounding: Women’s
recollection of pathways to cutting and of the value of different
interventions. Psychol Psychother, 77, 413–28.
Hume M, Platt S. (2007). Appropriate interventions for the prevention
and management of self-harm: A qualitative exploration of service-
users’ views. BMC Public Health, 7, 1–9.
Klonsky D, Muehlenkamp J. (2007). Self-injury: A research review for
the practitioner. J Clin Psychol, 63, 1045–56.
Downloaded by [Ulster University Library] at 04:02 04 February 2016
46 M. Long et al.
J Ment Health, 2016; 25(1): 41–46
Klonsky ED, May AM, Glenn CR. (2013). The relationship between nonsuicidal self-injury and attempted suicide: Converging evidence from four samples. J Abnorm Psychol, 122, 231–7.
Linehan MM, Comtois KA, Murray AM, et al. (2006). Two-year randomized controlled trial and follow-up of dialectical behaviour therapy vs. therapy by experts for suicidal behaviours and borderline personality disorder. Arch General Psychiatry, 63, 757–66.
Lincoln YS, Guba EG. (1985). Naturalistic inquiry. London, UK: Sage. Long A, Smyth A. (1998). The role of mental health nursing in the prevention of child sexual abuse and therapeutic care of survivors. J
Psychiatr Mental Health Nurs, 5, 129–36.
McAndrew S, Warne T. (2014). Hearing the voices of young people who
self-harm: Implications for service providers. Int J Mental Health
Nurs, 23, 570–9.
National Institute for Health and Clinical Excellence (2011). Self-harm:
Longer-term management: NICE clinical guideline 133. Available from: https://www.nice.org.uk/guidance/cg133 [last accessed 2 Mar 2015].
Pembroke LR, (editor). (1996). Self-harm: Perspectives from personal experience. Available from: http://www.kreativeinterventions.com/ SelfHarmPerspectivesfromPersonalExperience.pdf [last accessed 10 Oct 2013].
Proctor G. (2007). Disordered boundaries? A critique of ‘Borderline Personality Disorder’. In: Spandler H, Warner S, eds. Beyond fear and control: Working with young people who self-harm. Chapter 7. Hertfordshire: PCCS Books, 105–20.
Rayner GC, Allen SL, Johnson M. (2005). Counter-transference and self- injury: A cognitive behavioural cycle. J Adv Nurs, 50, 12–9.
Redley M. (2010). The clinical assessment of patients admitted to hospital following an episode of self-harm: A qualitative study. Sociol Health Illness, 32, 470–85.
Richards L. (2015). Handling qualitative data: A practical guide. London: Sage.
Schoppmann S, Schrock R, Schnepp W, Buscher A. (2007). ‘‘Then I just showed her my arms. . .’’ Bodily Sensations in moments of alienation related to self-injurious behaviour. A hermeneutic phenomenological study. J Psychiatr Mental Health Nurs, 14, 587–97.
Shaw SN. (2002). Shifting conversations on girls’ and women’s self- injury: An analysis of the clinical literature in historical context. Feminism Psychol, 12, 191–291.
Slee N, Garnefski N, van der Leeden R, et al. (2008). Cognitive- behavioural intervention for self-harm: Randomised controlled trial. Br J Psychiatry, 192, 202–11.
Spandler H, Warner S, eds. (2007). Beyond fear and control: Working with young people who self-harm. Hertfordshire: PCCS Books.
Strauss A, Corbin J. (1998). Basics of qualitative research: Techniques and procedures for developing Grounded Theory. London: Sage.
Walker T. (2009). ‘Seeing beyond the battled body’ – An insight into selfhood and identity from women’s accounts who self-harm with a diagnosis of borderline personality disorder. Couns Psychother Res, 9, 122–8.
Warner S, Spandler H. (2012). New strategies for practice-based evidence: A focus on self-harm. Qual Res Psychol, 9, 13–26.
- service user
- qualitative research