How should I approach the management of self-harm in adolescents compared to adults?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Management of self-harm in adolescents involves conducting a psychosocial assessment, developing a care plan, and considering psychological interventions such as cognitive-behavioural therapy (CBT) or dialectical behaviour therapy (DBT) adapted for adolescents, especially for those with frequent episodes or emotional dysregulation difficulties ,.

In adolescents, it is important to involve family and carers in developing safety plans and providing support, and to ensure multidisciplinary collaboration, including specialist child and adolescent mental health services (CAMHS) ,.

For adults, management includes offering structured psychological interventions, typically between 4 and 10 sessions, tailored to individual needs, and may involve problem-solving therapy or CBT-informed approaches .

Harm minimisation strategies may be discussed with adults who are engaged in ongoing care but are not yet able to resist self-harm urges, ensuring these are collaborative and part of a recovery-focused approach .

In both groups, referral to mental health services and psychosocial assessment are priorities, but in adolescents, there is a greater emphasis on involving family, safeguarding, and age-appropriate multidisciplinary care ,.

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