Parents' perspectives on adolescent self-harm: Qualitative study (original) (raw)
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Caring for Young People Who Self-Harm: A Review of Perspectives from Families and Young People
International Journal of Environmental Research and Public Health, 2018
Self-harm among young people remains largely stigmatised and misunderstood. Parents have been identified as key facilitators in the help-seeking process, yet they typically report feeling ill-equipped to support the young person in their care. The aim of this review was to examine the perspectives of both young people (aged 12–28) and parents and to develop the conceptual framework for a future qualitative study. A systematic search of MEDLINE and PsycINFO was performed to identify articles that focused on the experiences of family members and young people related to managing the discovery of self-harm. Fourteen articles were included for review. Four addressed the perspectives of young people and 10 reported on the impact of adolescent self-harm on parents. The impact of self-harm is substantial and there exists a discrepancy between the most common parental responses and the preferences of young people. In addition, parents are often reluctant to seek help for themselves due to fe...
Making Sense of an Unknown Terrain: How Parents Understand Self-Harm in Young People
Qualitative health research, 2015
Self-harm is common in young people, and can have profound effects on parents and other family members. We conducted narrative interviews with 41 parents and other family members of 38 young people, aged up to 25, who had self-harmed. Most of the participants were parents but included one sibling and one spouse. This article reports experiences of the parent participants. A cross-case thematic analysis showed that most participants were bewildered by self-harm. The disruption to their worldview brought about by self-harm prompted many to undergo a process of "sense-making"-by ruminative introspection, looking for information, and building a new way of seeing-to understand and come to terms with self-harm. Most participants appeared to have been successful in making sense of self-harm, though not without considerable effort and emotional struggle. Our findings provide grounds for a deeper socio-cultural understanding of the impact of self-harm on parents.
Family factors associated with adolescent self-harm: a narrative review
Journal of Family Therapy, 2016
This narrative literature review focuses on family factors that might be amenable to intervention using family therapy (n = 126). Domains of interest include parent/child interactions, inter-parental relationships, child characteristics, parental characteristics, wider system factors, treatment needs and moderators. The focus of family-orientated treatment with this population should focus on maximizing cohesion, attachment, adaptability, family support, parental warmth while reducing maltreatment, scapegoating and moderating parental control. Close working relationships with child protection services and schools represent additional opportunities. Practitioner Points 1. Over and above any inherited risk, a range of family interactional factors are strongly associated with self-harming behaviours in young people. 2. Therapy has the potential to make a positive difference by focusing on enhancing family cohesion and adaptability, whilst reducing discord and violence. Discussions that enhance perceived parental support and warmth may be particularly helpful. 3. Therapists should attend to issues of perceived difference and potential victimisation (bullying, gender orientation and identity, ethnic minority status) as these may play an important role in self-harm. Family factors associated with adolescent self-harm; a narrative review Aim: Our aim is to produce a narrative literature review of family factors associated with self-harm by adolescents in order to assist therapists in working with such families and support the development of further research in this area by highlighting what is already known (and not known). A number of factors shown to be associated with adolescent self-harm are potentially amenable to change, and even when they are not, greater awareness of these issues may change the ways in which family members think about themselves. We attempt to highlight those areas that might be amenable to change through family therapy Method/Search strategy: We expected that the current body of literature would be of variable quality and diverse methodology and therefore chose to conduct a narrative review, attempting to summarise and integrate different primary studies. However, we have tried to be as systematic as possible in our search and reporting strategies. In this review we have defined self-harm as any form of non-fatal self-poisoning or self-injury (such as cutting, taking an overdose, hanging, self-strangulation and running into traffic), regardless of motivation or the degree of intention to die. This concept overlaps with NSSI (non-suicidal self-injury) which is considered to beselfinjury in the absence of suicidal intent (for review see Swannell, 2014). The focus of the search was non-fatal acts of SH, but we included the literature on death by suicide where it was pertinent to family functioning. The first author conducted a literature search using Medline (2000 week 4,
Archives of Suicide Research, 2017
Objectives: We report the first Interpretative Phenomenological Analysis examination of self-harm and experience of clinical services in young people in the public care system. Methods: Qualitative interviews with 24 looked-after young people. Results: Prevalent themes were 1) Changes in care placement, 2) Feelings of anger, 3) Not wanting/feeling able to talk, 4) Developing coping techniques, 5) Clinical services: A relational mixed bag (subthemes: feeling (i) patronised, not listened to, (ii) nothing being done, (iii) comfortable/able to talk). Conclusions: Placement change and anger were highly salient to self-harm in this group and experiences of clinical services depended on individual relationships with clinicians. Implications include increasing compassion in therapeutic relationships, recognizing and managing emotional dysregulation and increasing support during placement changes.
Hearing the voices of young people who self-harm: Implications for service providers
International Journal of Mental Health Nursing, 2014
The incidence of adolescent self-harm and suicidal behaviour has increased globally, with many adolescents repeating the behaviour. While studies indicate that large numbers of adolescents who self-harm do not seek professional help, research focusing on barriers to help seeking from an adolescent perspective is limited. Locally, a rise in reported and unreported rates of self-harm and a number of suspected child suicides prompted the commissioning of a research project to ascertain young people's experiences of help and support for self-harm and how their future needs could be best met. Qualitative research, adopting an interpretive phenomenological analysis, was used to elicit narratives of adolescents engaging in self-harm. Data were collected via 1:1 interviews with seven participants and analysed in two stages: an analysis of each individual narrative, and thematic analysis across the group. Three themes were identified: (i) cutting out the stress; (ii) stepping onto the path of help; and (iii) cutting to the chase. In conclusion, mental health nurses have a vital role in providing knowledge and support to those likely to have initial contact with this vulnerable group and to the wider population, ensuring we more effectively address the increasing use of this risky behaviour among young people.
Archives of Suicide Research, 2019
Objective: Few studies have explored the impact that self-harm has on family members, with none specifically focussing on physical and psychosomatic responses following a family member's high-risk self-harm Therefore, this study aims to explore the health impact of experiencing a family member's high-risk self-harm. Methods: Participants represented family members of consecutive cases of self-harm, who were recruited from the Suicide Support and Information System: A Case-Control Study (SSIS-ACE). Qualitative interviews were conducted with nine participants whose family member presented to a large tertiary hospital in Ireland with high-risk self-harm. Interpretative Phenomenological Analysis Results: Qualitative findings indicated four superordinate themes in relation to experiences following a family member's presentation to hospital following an episode of high-risk selfharm (1) implications for health and wellbeing; (2) process of meaning-making; (3) feelings of responsibility and (4) challenges with support network. Conclusion: Participants consistently experienced adverse health impacts including vomiting, hypertension and depression. The findings imply that caring for their own and their family members' wellbeing, together with challenges with accessing health services underscores the importance of family members being proactively contacted by healthcare professionals to alleviate these detrimental health effects.
Trials, 2015
Self-harm is common in the community with a lifetime prevalence of 13 %. It is associated with an elevated risk of overall mortality and suicide. People who harm themselves are high users of public services. Estimates of the 1-year risk of repetition vary between 5 and 15 % per year. Currently, limited evidence exists on the effectiveness of clinical interventions for young people who engage in self-harm. Recent reviews have failed to demonstrate any effect on reducing repetition of self-harm among adolescents receiving a range of treatment approaches. Family factors are particularly important risk factors associated with fatal and non-fatal self-harm among children and adolescents. Family therapy focuses on the relationships, roles and communication patterns between family members, but there have been relatively few studies of specifically family-focused interventions with this population. The Self-Harm Intervention: Family Therapy (SHIFT) Trial was funded by the National Institute...
International Journal of Environmental Research and Public Health, 2021
Suicide is a serious global public health problem and the third leading cause of death in those 15–35 years old. Self-harm is the major predictor of future suicide attempts and completed suicide yet remains poorly understood. There is limited evidence on effective interventions for adolescents who present with self-harm. To identify and develop acceptable preventive and therapeutic interventions it is essential to understand the factors that contribute to self-harm and suicide in young people, in the context of their emotions, interpersonal difficulties, available support and prevention strategies. This qualitative study aimed at exploring the lived experiences of adolescents presenting with self-harm and their views about potential prevention strategies. Semi-structured interviews with 16 adolescents (12–18 years) presenting with a self-harm episode in a public hospital in Pakistan. A topic guide was developed to facilitate the interviews. The following themes emerged using the fra...
International Journal of Qualitative Studies on Health and Well-being, 2010
The aim of the study was to discover and describe lived experiences of professional care and caregivers among parents of adults who self-harm. Narrative interviews were conducted with six parents of daughters with self-harming behaviours and analysed using a phenomenological hermeneutic approach. The meanings of the parents' narratives of their lived experiences of professional care and caregivers were interpreted as their being involved in 'limit situations' comparable to hostage dramas. Several meaningful themes contributed to this interpretation: being trapped in a situation with no escape; being in the prisoner's dock; groping in the dark; and finding glimmers of hope. Parents of daughters who were in care because of self-harming often felt obliged to pay an emotional ransom, which included feelings of being accused, being 'broken', being confused, and feeling lost. Moments of peace occurred as welcome breaks offering a short time of rest for the parents. Situations that were understood by the parents and solved in a peaceful way were experienced as a respite and inspired parents with hope for their daughters' recovery.