Understanding Adolescents' Experiences of Self-Harm: Secondary Analysis of Family Therapy Sessions from the SHIFT Trial.

OBJECTIVES: To explore, using first-hand accounts, adolescents' understandings of why they self-harmed, what their responses to self-harm were, and how they resisted or ceased self-harm.

METHOD: Secondary analysis of video-recorded Family Therapy sessions from the Self-harm intervention: Family Therapy. Recordings of 22 participants, approximately 170 hours of footage, formed the dataset.

RESULTS: Five core themes were developed; (1) Distress can be difficult to convey (2) Self-harm and suicidal ideation; a complex relationship (3) Self-harm as a form of communication (4) Self-harm to manage emotions and (5) Moving forward.

CONCLUSION: Self-harm was a means of communicating distress as well as managing emotions. Accounts highlighted the complex interplay between self-harm and suicidal intent. Encouragingly, many participants described being able to resist self-harm.