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Self-harm in children refers to the act of intentionally harming themself through various behaviours. Typically, children engage in self-harm as a way to cope with difficult emotions or situations. It is a manifestation of their distress and a call for help. We are going to look at what self-harm entails and explore potential ways to address it.

What is self-harm in children?

Self-harm in children is when they intentionally harm themselves physically without the intention of committing suicide. It can manifest itself through actions such as cutting, burning, hitting themselves, picking at wounds, or pulling out hair. It can also be destructive behaviours such as drinking alcohol, taking drugs, putting oneself in dangerous situations or partaking in sexually risky behaviours. This type of behaviour is often a way for a child to deal with and express deep emotional pain, stress, anxiety, or frustration.

Self-harm behaviour acts as a maladaptive coping mechanism where the physical expression of pain is used to deflect or manage internal psychological pain. It is essential to understand that this behaviour signals a need for help and support rather than dismissing it as attention-seeking.

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Self-harm and neuropsychiatric problems

Self-harm can often be linked to neuropsychiatric problems in children and adolescents. This includes conditions such as Attention Deficit Hyperactivity Disorder (ADHD) and autism but can also occur in other mental health conditions such as anxiety disorders and depression. Individuals with these diagnoses may experience heightened emotional sensitivity, impulse control problems, and difficulties in managing stress, which may lead them to use self-harm as a coping mechanism to manage their emotions or experience temporary relief from psychological pain.

It is essential to approach these behaviours with understanding and to seek professional help to address both the physical behaviour and the underlying mental health conditions. Treating the neuropsychiatric issues can often reduce or eliminate the need for self-harm as a maladaptive coping strategy.


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Treatment for children with self-harm

The treatment of self-harm in children requires a multifaceted and tailored approach centred around psychological support and sometimes medical intervention. A crucial component is psychotherapy, such as Cognitive Behavioural Therapy (CBT), to address negative thought patterns and behaviours. This may also involve treating underlying trauma or mental health problems such as anxiety.

For children with other underlying neuropsychiatric conditions, drug treatment may be necessary as part of a comprehensive treatment plan. In addition, education for children and families about self-harm and access to support groups are essential to build an understanding and network of support. A safe and supportive environment and close collaboration between the family and professionals are fundamental to supporting the child’s recovery.



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12 FAQs about Self-Harm in Children

What is self-harm in children?

Self-harm in children means that they intentionally harm themselves physically without the intention of committing suicide.

How can self-harm manifest itself?

It can manifest itself through actions such as cutting, burning, hitting themselves, picking at wounds, or pulling out hair. It can also be destructive behaviours such as drinking alcohol, taking drugs, putting themselves in dangerous situations or partaking in risky sexual behaviours.

Why do children engage in self-harm?

The behaviour is often a way for the child to deal with and express deep emotional pain, stress, anxiety, or frustration. It acts as a maladaptive coping mechanism where the physical expression of pain is used to deflect or manage the inner psychological pain.

Is self-harm just a way to get attention?

No, it is essential to understand that this behaviour signals a need for help and support rather than dismissing it as attention-seeking.

Is self-harm common in neuropsychiatric disorders?

Self-harm can often be linked to neuropsychiatric problems in children and adolescents. This includes conditions such as Attention Deficit Hyperactivity Disorder (ADHD) and autism but can also occur in other mental health conditions such as anxiety disorders and depression.

Why do children and young people with neuropsychiatric problems engage in self-harm?

Individuals with these diagnoses may experience heightened emotional sensitivity, impulse control problems, and difficulties in coping with stress, which may lead them to use self-harm as a coping mechanism to manage their emotions or experience temporary relief from psychological pain.

How can therapy help children and young people with self-harm?

The treatment of self-harm in children requires a multifaceted and tailored approach centred around psychological support and sometimes medical intervention. It is possible to feel better.

What is CBT?

Cognitive Behaviour Therapy (CBT) is an evidence-based therapy that helps individuals identify and challenge negative thought patterns and behaviours contributing to ill health.

What is a child psychologist?

A child psychologist is a licensed professional with knowledge and experience in working to improve the well-being and mental health of children and their parents.

What does a child psychologist do?

Child psychologists offer therapy and counselling but work with families to provide parental support and support to the whole family when needed. They also work with schools to create good conditions for the child.

Can I see a child psychologist privately?

There are many private child psychologists in South Africa. At Lavendla, we have several psychologists with extensive experience working with children and young people.

Where can I turn if I or my child needs help from a child psychologist?

At Lavendla, we have experienced child psychologists who can also help.

How can treatment for self-harm in children work?

Treatment for self-harm in children requires an integrated and individualized approach that addresses both the immediate dangers of the behaviour and the underlying psychological causes. Here are some essential aspects of treatment:

  1. Professional evaluation: The first step is a thorough psychological evaluation by a child psychiatry team to identify any underlying diagnoses or contributing factors to the self-harm behaviour.
  2. Psychotherapy: Cognitive Behavioural Therapy (CBT) is effective in helping children develop healthier ways to deal with negative emotions and thought patterns.
  3. Family therapy: Including the family in the treatment process is vital for creating a supportive home environment and addressing family-related stressors.
  4. Education and support groups: Education and support groups on self-harm for both the child and the family can be helpful depending on the need.
  5. Medical treatment: In some cases, medication may be necessary to treat underlying psychiatric conditions, such as depression or anxiety, that may contribute to self-harm.
  6. Environmental adaptations: Creating a safe environment that minimizes opportunities for self-harm and promotes healthy coping strategies is an integral part of treatment.

Parents and guardians need to work closely with professionals to create a coordinated and comprehensive treatment plan. Encouraging open communication and showing unconditional support for the child is crucial throughout the treatment process.


Written by Samantha Pieterse

Sr. Samantha Pieterse is a registered psychiatric nurse who is deeply committed to mental health and well-being. Samantha brings a unique and valuable perspective to her role as an editor for Lavendla South Africa. She has worked in Government and Private mental healthcare institutions in Gauteng and her expertise ensures that the articles on our website are accurate and accessible. Samantha is dedicated to enhancing mental health awareness and education in South Africa.