Self-harming behaviour: from lay perceptions to clinical practice

Self-harm is a complex phenomena that occurs in many different settings. Multi-factorial explanations predominate in the literature and accounts of treatment reflect this diversity, ranging through psychobiological and psycho-social theories.This study aims to identify, describe and interpret some of the accounts and understandings of self-harm from a cross section of the general population and then relate this to clinical practice. Q Methodology is used to explore various competing viewpoints of lay people in understanding and treating people who self-harm. Eight different accounts were produced from the Explanation Q-sort. All but the Biological account described self-harm as a coping strategy, utilized in response to feelings of helplessness following social interaction and were therefore psycho-social in nature. There were four treatment/policy viewpoints that were all psycho-social in nature. These were influenced by humanistic and cognitive types of therapy and were united by the importance of empathy, positive regard and empowerment. These viewpoints are fully explored in this study. Common themes and factors connecting the explanations and treatment Q-sorts are discussed. These findings are then discussed in terms of their implications to current working practice and further initiatives and research projects.