Counsellors' perspectives on self-harm and the role of the therapeutic relationship for working with clients who self-harm

Maggie Long; Mary Jenkins

doi:10.1080/14733140903474293

Counsellors' perspectives on self-harm and the role of the therapeutic relationship for working with clients who self-harm

Maggie Long, Mary Jenkins

Faculty of Arts, Humanities & Social Sciences

Research output: Contribution to journal › Article › peer-review

19 Citations (Scopus)

Abstract

Aims: To gain insight into counsellors’ experiences of and ideas about self-harm, and to develop understanding of relational depth when working with clients who self-harm. Method: A qualitative exploration of counsellors’ perspectives on working with people who self-harm. The research proposal gained approval from the University Ethics Committee. Data were collected from a sample of counsellors who have experience of working with people who self-harm (n8) using tape-recorded interviews. Grounded Theory was used for analysis. Findings: Two major categories emerged from the findings: (i) the activity of self-harm; (ii) the therapeutic relationship with people who self-harm. These categories and sub-categories were integrated to form the core category. Implications: Counsellors have a valuable role to play in the lives of people who self-harm, by embodying confidentiality and so facilitating a sense of trust, by opening minds through acceptance, and by expanding knowledge through participation in research. Conclusions: In order to effectively accompany clients from a life of self-harm to a life of self-healing, counsellors must be aware of and responsive to the many concepts underpinning the emergent categories of the research.

Original language	English
Pages (from-to)	192-200
Journal	Counselling and Psychotherapy Research
Volume	10
Issue number	3
DOIs	https://doi.org/10.1080/14733140903474293
Publication status	Published (in print/issue) - Sept 2010

Bibliographical note

Reference text: Anderson, M., & Standen, P.J. (2007). Attitudes towards suicide
among nurses and doctors working with children and young
people who self-harm. Journal of Psychiatric and Mental Health
Nursing, 14 (5), 470477.
British Association for Counselling and Psychotherapy (2007).
Ethical framework. Retrieved November 4, 2007, from http://
www.bacp.co.uk/ethical_framework
DHSSPS(NI) (2008). Draft suicide prevention strategy to protect
life a shared vision. Belfast: DHSSPS(NI).
Favazza, A. (1996). Bodies under siege: self-mutilation and body
modification in culture and psychiatry. Baltimore, MD: John
Hopkins University Press.
Fox, C., & Hawton, K. (2004). Deliberate self-harm in adolescence.
London, UK: Jessica Kingsley Publishers.
Freud, S. (1930). Civilisation and its discontents. New York: W.W.
Norton.
Gratz, K., Conrad, S., & Roemer, L. (2002). Risk factors for
deliberate self-harm among college students. American Journal
of Orthopsychiatry, 72 (1), 128140.
Harris, J. (2000). Self-harm: cutting the bad out of me. Qualitative
Health Research, 10, 164173.
Hawton, K., Bale, L., Casey, D., Shepherd, A., Simkin, S., &
Harris, L. (2006). Monitoring deliberate self-harm presentations
to general hospitals. The Journal of Crisis Intervention and
Suicide Prevention, 27 (4), 157163.
Huband, N., & Tantam, D. (2004). Repeated self-wounding:
women’s recollection of pathways to cutting and of the value of
different interventions. Psychology and Psychotherapy: Theory,
Research and Practice, 77, 413428.
Hume, M., & Platt, S. (2007). Appropriate interventions for
the prevention and management of self-harm: a qualitative
exploration of service-users’ views. BMC Public Health, 7 (9),
19.
McMyler, C., & Pryjmachuk, S. (2008). Do ‘no-suicide’ contracts
work? Journal of Psychiatric and Mental Health Nursing, 15 (6),
512522.
Mearns, D., & Thorne, B. (2007). Person-centred counselling in
action. London, UK: Sage.
Menninger, K. (1938). Man against himself. New York: Harcourt
Brace.
Mental Health Foundation (2006). Truth hurts: report of the
National inquiry into self-harm among young people. London,
UK: Mental Health Foundation.
Rogers, C. (1967). On becoming a person. London, UK: Constable.
SANE (2008). Understanding self-harm. Retrieved May 5, 2009,
from http://www.sane.org.uk/Research/SelfHarmIntro
Schoppmann, S., Schrock, R., Schnepp, W., & Buscher, A.
(2007). ‘‘Then I just showed her my arms . . .’’ Bodily Sensations
in moments of alienation related to self-injurious behaviour.
A hermeneutic phenomenological study. Journal of
Psychiatric and Mental Health Nursing, 14 (6), 587597.
Sinclair, J., & Green, J. (2005). Understanding resolution of
deliberate self-harm: qualitative interview study of patients’
experiences. British Medical Journal, 330, 19.
Strauss, A., & Corbin, J. (1998). Basics of qualitative research:
techniques and procedures for developing Grounded Theory.
London, UK: Sage.
Turp, M. (2003). Hidden self-harm: narratives from psychotherapy.
London; UK: Jessica Kingsley Publishers.
Turp, M. (2007). Self-harm by omission: a question of skin
containment. Psychodynamic Practice, 13 (3), 229244.
Walsh, B.W., & Rosen, P.M. (1988). Self-mutilation: theory,
research and treatment. New York: The Guilford Press.
Ystgaard, M., Arensman, E., Hawton, K., Madge, N., van
Heeringen, K., Hewitt, A., Jan de Wilde, E., De Leo, D., &
Fekete, S. (2009). Deliberate self-harm in adolescents:
comparison between those who receive helf following selfharm
and those who do not. Journal of Adolescene, 32 (4),
875891.

Keywords

self-harm
self-injury
counsellor perspective
therapeutic relationship

Access to Document

10.1080/14733140903474293

Cite this

@article{f47f60d1cf1145bd8d9f275921c19b32,

title = "Counsellors' perspectives on self-harm and the role of the therapeutic relationship for working with clients who self-harm",

abstract = "Aims: To gain insight into counsellors{\textquoteright} experiences of and ideas about self-harm, and to develop understanding of relational depth when working with clients who self-harm. Method: A qualitative exploration of counsellors{\textquoteright} perspectives on working with people who self-harm. The research proposal gained approval from the University Ethics Committee. Data were collected from a sample of counsellors who have experience of working with people who self-harm (n8) using tape-recorded interviews. Grounded Theory was used for analysis. Findings: Two major categories emerged from the findings: (i) the activity of self-harm; (ii) the therapeutic relationship with people who self-harm. These categories and sub-categories were integrated to form the core category. Implications: Counsellors have a valuable role to play in the lives of people who self-harm, by embodying confidentiality and so facilitating a sense of trust, by opening minds through acceptance, and by expanding knowledge through participation in research. Conclusions: In order to effectively accompany clients from a life of self-harm to a life of self-healing, counsellors must be aware of and responsive to the many concepts underpinning the emergent categories of the research.",

keywords = "self-harm, self-injury, counsellor perspective, therapeutic relationship",

author = "Maggie Long and Mary Jenkins",

note = "Reference text: Anderson, M., & Standen, P.J. (2007). Attitudes towards suicide among nurses and doctors working with children and young people who self-harm. Journal of Psychiatric and Mental Health Nursing, 14 (5), 470477. British Association for Counselling and Psychotherapy (2007). Ethical framework. Retrieved November 4, 2007, from http:// www.bacp.co.uk/ethical_framework DHSSPS(NI) (2008). Draft suicide prevention strategy to protect life a shared vision. Belfast: DHSSPS(NI). Favazza, A. (1996). Bodies under siege: self-mutilation and body modification in culture and psychiatry. Baltimore, MD: John Hopkins University Press. Fox, C., & Hawton, K. (2004). Deliberate self-harm in adolescence. London, UK: Jessica Kingsley Publishers. Freud, S. (1930). Civilisation and its discontents. New York: W.W. Norton. Gratz, K., Conrad, S., & Roemer, L. (2002). Risk factors for deliberate self-harm among college students. American Journal of Orthopsychiatry, 72 (1), 128140. Harris, J. (2000). Self-harm: cutting the bad out of me. Qualitative Health Research, 10, 164173. Hawton, K., Bale, L., Casey, D., Shepherd, A., Simkin, S., & Harris, L. (2006). Monitoring deliberate self-harm presentations to general hospitals. The Journal of Crisis Intervention and Suicide Prevention, 27 (4), 157163. Huband, N., & Tantam, D. (2004). Repeated self-wounding: women{\textquoteright}s recollection of pathways to cutting and of the value of different interventions. Psychology and Psychotherapy: Theory, Research and Practice, 77, 413428. Hume, M., & Platt, S. (2007). Appropriate interventions for the prevention and management of self-harm: a qualitative exploration of service-users{\textquoteright} views. BMC Public Health, 7 (9), 19. McMyler, C., & Pryjmachuk, S. (2008). Do {\textquoteleft}no-suicide{\textquoteright} contracts work? Journal of Psychiatric and Mental Health Nursing, 15 (6), 512522. Mearns, D., & Thorne, B. (2007). Person-centred counselling in action. London, UK: Sage. Menninger, K. (1938). Man against himself. New York: Harcourt Brace. Mental Health Foundation (2006). Truth hurts: report of the National inquiry into self-harm among young people. London, UK: Mental Health Foundation. Rogers, C. (1967). On becoming a person. London, UK: Constable. SANE (2008). Understanding self-harm. Retrieved May 5, 2009, from http://www.sane.org.uk/Research/SelfHarmIntro Schoppmann, S., Schrock, R., Schnepp, W., & Buscher, A. (2007). {\textquoteleft}{\textquoteleft}Then I just showed her my arms . . .{\textquoteright}{\textquoteright} Bodily Sensations in moments of alienation related to self-injurious behaviour. A hermeneutic phenomenological study. Journal of Psychiatric and Mental Health Nursing, 14 (6), 587597. Sinclair, J., & Green, J. (2005). Understanding resolution of deliberate self-harm: qualitative interview study of patients{\textquoteright} experiences. British Medical Journal, 330, 19. Strauss, A., & Corbin, J. (1998). Basics of qualitative research: techniques and procedures for developing Grounded Theory. London, UK: Sage. Turp, M. (2003). Hidden self-harm: narratives from psychotherapy. London; UK: Jessica Kingsley Publishers. Turp, M. (2007). Self-harm by omission: a question of skin containment. Psychodynamic Practice, 13 (3), 229244. Walsh, B.W., & Rosen, P.M. (1988). Self-mutilation: theory, research and treatment. New York: The Guilford Press. Ystgaard, M., Arensman, E., Hawton, K., Madge, N., van Heeringen, K., Hewitt, A., Jan de Wilde, E., De Leo, D., & Fekete, S. (2009). Deliberate self-harm in adolescents: comparison between those who receive helf following selfharm and those who do not. Journal of Adolescene, 32 (4), 875891.",

year = "2010",

month = sep,

doi = "10.1080/14733140903474293",

language = "English",

volume = "10",

pages = "192--200",

journal = "Counselling and Psychotherapy Research",

issn = "1746-1405",

publisher = "John Wiley & Sons, Inc.",

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TY - JOUR

T1 - Counsellors' perspectives on self-harm and the role of the therapeutic relationship for working with clients who self-harm

AU - Long, Maggie

AU - Jenkins, Mary

N1 - Reference text: Anderson, M., & Standen, P.J. (2007). Attitudes towards suicide among nurses and doctors working with children and young people who self-harm. Journal of Psychiatric and Mental Health Nursing, 14 (5), 470477. British Association for Counselling and Psychotherapy (2007). Ethical framework. Retrieved November 4, 2007, from http:// www.bacp.co.uk/ethical_framework DHSSPS(NI) (2008). Draft suicide prevention strategy to protect life a shared vision. Belfast: DHSSPS(NI). Favazza, A. (1996). Bodies under siege: self-mutilation and body modification in culture and psychiatry. Baltimore, MD: John Hopkins University Press. Fox, C., & Hawton, K. (2004). Deliberate self-harm in adolescence. London, UK: Jessica Kingsley Publishers. Freud, S. (1930). Civilisation and its discontents. New York: W.W. Norton. Gratz, K., Conrad, S., & Roemer, L. (2002). Risk factors for deliberate self-harm among college students. American Journal of Orthopsychiatry, 72 (1), 128140. Harris, J. (2000). Self-harm: cutting the bad out of me. Qualitative Health Research, 10, 164173. Hawton, K., Bale, L., Casey, D., Shepherd, A., Simkin, S., & Harris, L. (2006). Monitoring deliberate self-harm presentations to general hospitals. The Journal of Crisis Intervention and Suicide Prevention, 27 (4), 157163. Huband, N., & Tantam, D. (2004). Repeated self-wounding: women’s recollection of pathways to cutting and of the value of different interventions. Psychology and Psychotherapy: Theory, Research and Practice, 77, 413428. Hume, M., & Platt, S. (2007). Appropriate interventions for the prevention and management of self-harm: a qualitative exploration of service-users’ views. BMC Public Health, 7 (9), 19. McMyler, C., & Pryjmachuk, S. (2008). Do ‘no-suicide’ contracts work? Journal of Psychiatric and Mental Health Nursing, 15 (6), 512522. Mearns, D., & Thorne, B. (2007). Person-centred counselling in action. London, UK: Sage. Menninger, K. (1938). Man against himself. New York: Harcourt Brace. Mental Health Foundation (2006). Truth hurts: report of the National inquiry into self-harm among young people. London, UK: Mental Health Foundation. Rogers, C. (1967). On becoming a person. London, UK: Constable. SANE (2008). Understanding self-harm. Retrieved May 5, 2009, from http://www.sane.org.uk/Research/SelfHarmIntro Schoppmann, S., Schrock, R., Schnepp, W., & Buscher, A. (2007). ‘‘Then I just showed her my arms . . .’’ Bodily Sensations in moments of alienation related to self-injurious behaviour. A hermeneutic phenomenological study. Journal of Psychiatric and Mental Health Nursing, 14 (6), 587597. Sinclair, J., & Green, J. (2005). Understanding resolution of deliberate self-harm: qualitative interview study of patients’ experiences. British Medical Journal, 330, 19. Strauss, A., & Corbin, J. (1998). Basics of qualitative research: techniques and procedures for developing Grounded Theory. London, UK: Sage. Turp, M. (2003). Hidden self-harm: narratives from psychotherapy. London; UK: Jessica Kingsley Publishers. Turp, M. (2007). Self-harm by omission: a question of skin containment. Psychodynamic Practice, 13 (3), 229244. Walsh, B.W., & Rosen, P.M. (1988). Self-mutilation: theory, research and treatment. New York: The Guilford Press. Ystgaard, M., Arensman, E., Hawton, K., Madge, N., van Heeringen, K., Hewitt, A., Jan de Wilde, E., De Leo, D., & Fekete, S. (2009). Deliberate self-harm in adolescents: comparison between those who receive helf following selfharm and those who do not. Journal of Adolescene, 32 (4), 875891.

PY - 2010/9

Y1 - 2010/9

N2 - Aims: To gain insight into counsellors’ experiences of and ideas about self-harm, and to develop understanding of relational depth when working with clients who self-harm. Method: A qualitative exploration of counsellors’ perspectives on working with people who self-harm. The research proposal gained approval from the University Ethics Committee. Data were collected from a sample of counsellors who have experience of working with people who self-harm (n8) using tape-recorded interviews. Grounded Theory was used for analysis. Findings: Two major categories emerged from the findings: (i) the activity of self-harm; (ii) the therapeutic relationship with people who self-harm. These categories and sub-categories were integrated to form the core category. Implications: Counsellors have a valuable role to play in the lives of people who self-harm, by embodying confidentiality and so facilitating a sense of trust, by opening minds through acceptance, and by expanding knowledge through participation in research. Conclusions: In order to effectively accompany clients from a life of self-harm to a life of self-healing, counsellors must be aware of and responsive to the many concepts underpinning the emergent categories of the research.

AB - Aims: To gain insight into counsellors’ experiences of and ideas about self-harm, and to develop understanding of relational depth when working with clients who self-harm. Method: A qualitative exploration of counsellors’ perspectives on working with people who self-harm. The research proposal gained approval from the University Ethics Committee. Data were collected from a sample of counsellors who have experience of working with people who self-harm (n8) using tape-recorded interviews. Grounded Theory was used for analysis. Findings: Two major categories emerged from the findings: (i) the activity of self-harm; (ii) the therapeutic relationship with people who self-harm. These categories and sub-categories were integrated to form the core category. Implications: Counsellors have a valuable role to play in the lives of people who self-harm, by embodying confidentiality and so facilitating a sense of trust, by opening minds through acceptance, and by expanding knowledge through participation in research. Conclusions: In order to effectively accompany clients from a life of self-harm to a life of self-healing, counsellors must be aware of and responsive to the many concepts underpinning the emergent categories of the research.

KW - self-harm

KW - self-injury

KW - counsellor perspective

KW - therapeutic relationship

U2 - 10.1080/14733140903474293

DO - 10.1080/14733140903474293

M3 - Article

SN - 1746-1405

VL - 10

SP - 192

EP - 200

JO - Counselling and Psychotherapy Research

JF - Counselling and Psychotherapy Research

IS - 3

ER -

Counsellors' perspectives on self-harm and the role of the therapeutic relationship for working with clients who self-harm

Abstract

Bibliographical note

Keywords

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