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Self-Harming Behaviors in Children and Teens



  • Self-harm means that your child hurts his or her body on purpose.
  • Self-harming behaviors may be treated with therapy or medicine. If your child is a danger to self, your child may need to be treated in the hospital.
  • Journaling, art therapy, relaxation techniques, physical activity, and other behaviors may be useful to replace self-harm behaviors.
  • Get emergency care if your child or teen has thoughts of suicide or self-harm, violence, or harming others.


What does it mean to self-harm?

Self-harm means that your child hurts his or her body on purpose. It may leave marks or cause damage. It may also be called self-injury, self-mutilation, and self-abuse. Self-harm is a way to cope with or relieve painful or hard-to-express feelings or to feel something instead of nothing. But the sense of relief your child may feel does not last long.

If your child harms himself or herself, your child is at a higher risk for suicide, on purpose or by accident. Some self-harm behaviors can be fatal.

What is the cause?

The exact cause of self-harm is not known. Factors that increase the risk of self-harm include:

  • Having mental health problems such as:
    • Depression
    • Anxiety
    • Attention-deficit-hyperactivity disorder (ADHD)
    • Autism spectrum disorder
    • Conduct disorder
    • An eating disorder such as anorexia or bulimia
  • Family poverty
  • Problems, such as conflict in the family or a family history of mental illness may increase your child’s risk. If your child is abused, your child may learn to blame self or to feel that he or she deserves to be hurt.
  • Having family members or friends who self-harm
  • Abusing alcohol or drugs or having parents who abuse drugs or alcohol

Stress and a history of being hurt plays a part. If your child deliberately self-harms, your child may be trying to:

  • Distract from something that your child feels unable to cope with
  • Express feelings your child can’t put into words
  • Feel in control
  • Feel something, instead of feeling numb
  • Release stress and tension and provide a sense of relief
  • Relieve guilt or punish self or others

The highest rate of self-harm happens in girls aged 13 to 16 years old. Self-harming as a child or teen increases the risk for mental health problems in adulthood.

What are the symptoms?

Self-harm is often done in secret. Others may not be aware of the behavior. Self-harm includes:

  • Swallowing poisons, non-food items, or large amounts of alcohol or drugs
  • Cutting, biting, rubbing, or scratching until the skin is broken and bleeding
  • Hanging or choking herself
  • Jumping from high places that are likely to cause harm
  • Scalding (burning)
  • Head banging or hitting herself
  • Pulling hair from scalp or eyebrows
  • Pulling off fingernails or toenails
  • Picking at scabs until they bleed and the sore does not heal

How is it diagnosed?

Your healthcare provider will ask about your child’s symptoms and medical history and examine your child.

How is it treated?

Do not wait to get help for your child.

Seeing a mental health therapist is helpful. Types of therapy may include:

  • Behavior therapy helps your child recognize that the way your child acts affects others. This can help your child change problem behaviors.
  • Cognitive behavior therapy (CBT) is a good way to help your child identify and change views your child has of self, the world, and the future. CBT can make your child aware of unhealthy ways of thinking. It can also help your child learn new thought and behavior patterns even after your child stops going to therapy. It can help your child learn to manage stress and improve self-esteem.
  • Dialectical behavior therapy helps your child be aware of thoughts and behavior, learn how to express needs, deal with stressful situations, and manage emotions.

Medicine may be prescribed to treat mental health conditions that increase the risk of self-harm such as depression, anxiety, or other disorders.

If your child attempts suicide or is a danger to self, your child may need to be treated in the hospital. Your child may also need to be in a day or evening treatment program for several months to learn how to manage emotions in a safe way.

What can I do to help my child?

Develop trust by not judging your child. Quietly listen to what your child tells you and try to understand what your child is feeling. Repeat back what you are hearing your child say to you. Tell your child that the feeling is understandable. Tell your child you want to offer help and support.

Take care of your child’s health. Make sure your child eats a variety of healthy foods and gets enough sleep and physical activity every day. Talk to your child about the risks of smoking, using e-cigarettes, drinking alcohol, and using drugs.

Trying to stop the behavior may be very stressful for your child. Help your child find something else to do when your child feels the need to self-harm such as writing in a journal, art therapy, relaxation practice, physical activity, or talking to you, other family members, or friends. Repeated self-harm is common. Involve the family, people who take care of your child, and teachers in watching for and reporting signs of self-harming. This can help your child’s treatment work better.

Other things that may help include:

  • Try to accept that your child has a problem and is not just trying to get attention.
  • Use a calm, assertive voice when speaking with your child.
  • Remind your child that you love and accept him or her, and let your child know that you want to help your child find healthier ways to deal with feelings.

Get emergency care if your child has thoughts of suicide or self-harm, violence, or harming others.

For more information, contact:

Developed by Change Healthcare.
Pediatric Advisor 2022.1 published by Change Healthcare.
Last modified: 2021-11-03
Last reviewed: 2020-07-06
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2022 Change Healthcare LLC and/or one of its subsidiaries
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