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Working Therapeutically with People Who Self Injure and Self-Harm

Andrew Reeves

27 Jun 2022


Self-injury and self-harm are common presentations in mental health services but are often responded to through a ‘risk-management’ lens through the mitigation of risk. Rather, self-injury and self-harm represent complex emotional and psychological processes that often speak of trauma. While there are some ‘top-level’ ways of understanding why people might hurt themselves, an exploration of the meaning for individuals is much more important, and the therapeutic relationship provides a compelling space for that to happen. However, working with self-injury and self-harm presents several practice challenges: managing confidentiality and the requirements of the therapeutic contract; organisational policy and the degree of risk tolerance; personal responses on behalf of the practitioner; safety planning; and ensuring a client’s capacity to work with the demands of therapy. This session aims to explore these issues and consider how practitioners might truly engage with harm in a way that facilitates positive change.

The event will be equivalent to 5.1/2hrs of CPD.


This workshop will:
• Consider what is meant by the terms ‘self-injury’ and ‘self-harm’: their differences and similarities and the consequence of conflating the two
• Look at how self-injury and self-harm might present different therapeutic challenges, and opportunities
• Consider what is meant by ‘risk’ and how we can work effectively with risk in a therapeutic context
• Explore what is meant by a safety plan and how one might be developed through a therapeutic, rather than procedural context
• Discuss professional responsibilities in managing risk and confidentiality.

Learning Objectives

You will learn:
• How to explore self-injury and self-harm with clients in a way that facilitates their understanding and ownership of the process of change
• What your own responses are to risk and how to work effectively with risk in a therapeutic context
• Different ways of working with self-injury and self-harm, drawing on a pluralistic framework of collaboration and integration in practice
• How to support yourself in the work to ensure practitioner wellbeing and safety

Training Modalities

This session will include didactic delivery, group discussions, video and reflective learning opportunities.

Key References

Babiker, G. and Arnold, L. (1993). The Language of Injury: Comprehending Self-Mutilation. Oxford: Wiley
Long, M. (2022). A Psychosocial Understanding of Self-Injury and Trauma. Buckingham: Oxford University Press
Royal College of Psychiatrists. (2021). Self-Harm and Suicide in Adults: CR229. - - accessed January 2022
University of Manchester. (2022). National Confidential Inquiry into Suicide and Safety in Mental Health - - accessed January 2022

About the presenter

Andrew has worked as a counsellor and social worker in a variety of settings for over 30 years. He has worked in a full range of settings, including child protection, with vulnerable adults, mental health crisis services, as a senior practitioner in a university student support service, with schools, colleges, the third sector and in independent practice. He has written extensively about working with risk in therapeutic settings and has trained more than 15,000 practitioners internationally around this area. He was previous Editor-in-Chief of Counselling and Psychotherapy Research journal, past-Chair of the British Association for Counselling and Psychotherapy and now sits on several Advisory roles, including for the Charlie Waller Trust, CALM and community mental health services. He is current Chair of the Steering Group for pluralistic practice and is committed to supporting therapeutic services attend to issues of social injustice and advocacy.

Who should attend

This webinar is specifically focused on understanding and working with self-injury and self-harm from a therapeutic perspective but will be of interest to anyone who works with people with such presentations.

Low Intensity clinical contact hours survey - BABCP Low Intensity Special Interest Group

Please click below if you are interested in contributing to the survey.


The BACP Low Intensity SIG are interested in the impact of clinical contact hours on Low Intensity/Wellbeing Practitioner wellbeing. This questionnaire contains six multi-choice questions and a free text box for you to share your experiences. The answers to these questions will help the BABCP SIG plan how to meet CPD topics and other developments within the SIG.  The SIG hope to produce a write up of the answers to this questionnaire to be shared with SIG members and to be used in training.

View Survey

This FREE conference is for Psychological Wellbeing Practitioners working in Talking Therapies for Anxiety and Depression services and is brought to you by Bespoke Mental Health in collaboration with the NHS England Talking Therapies National PWP Leads Network

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