Question
What are common signs that may indicate a client is engaging in self-harming behaviors?
Answer
Common signs of self-harm can include visible but unexplained injuries, such as cuts, bruises, or bandages, especially when the injuries are located on areas typically kept private or hidden, like the upper thighs or forearms. A pattern of wearing long sleeves or clothing that is inconsistent with the weather, such as covering up during warm conditions, may also be cause for concern. However, it is important to consider environmental factors like indoor temperatures. Another red flag arises when a client offers explanations for injuries that seem inconsistent with the physical evidence, such as saying they "ran into a wall" when the injury appears to be from a sharp object.
In addition to observing these physical signs, clinicians should remain attentive to reports from family members indicating that certain areas of the client’s body have not been visible for extended periods. Consistent or repeated concealment of specific body parts can be a behavioral indicator of self-injury. These observations should prompt gentle and supportive inquiry rather than immediate assumptions or confrontation to better understand what is happening.
This Ask the Expert is an edited excerpt from the course, 'Assessing and Treating Non-Suicidal Self-injury,' presented by Patrice Berry, PsyD, LCP.