What to Do When Your Teen Is Self-Harming … A Parent's Guide
Finding out your child is hurting themselves is devastating. Whether you discovered cuts, found hidden blades, or they told you themselves, you're likely feeling shock, fear, and confusion. Know that you're not alone – about 15-20% of teens engage in some form of self-harm.
When parents call me or Rebekah and say that their child is struggling with their mental health, one of the first questions we ask them is, “Are they self-harming?” It’s so very common. However, the good news is that once we help these kids and they learn better coping skills, they most often stop the behavior altogether.
Why Do Teens Self-Harm?
When your kid is self-harming, it doesn’t mean that they have suicidal tendencies or that they want to die. For the majority of kids, cutting is just an attempt to feel better, to cope with emotional pain that feels unbearable. Teens self-harm for some of the following reasons:
A way to feel in control when everything else feels chaotic
Making emotional pain physical so that it feels more manageable
A way to feel something when depression makes them numb
Communication when they don’t know how to express their pain
Self-punishment when they are feeling shame or guilt
What Makes Teens So Vulnerable to Self-Harm
Adolescence creates a perfect storm of risk factors:
Developing brains: The parts responsible for emotional regulation are still being formed (and won’t be complete until their mid-twenties), so teens’ emotions feel more intense to them
Everything feels permanent: Without life experience, teens can't see past current pain
Intense social pressure: Peer relationships become everything, amplified by social media
Mental health issues emerge: Depression, anxiety, and trauma often surface during these years.
Academic pressure: The stakes around grades and future success feel impossibly high
How to Speak To Your Teen About Self-Harm
Before You Start: Process Your Own Emotions
Your teen needs you to be calm and collected, even if you feel overwhelmed by your own emotions around your child’s struggles. Speak to your own therapist to learn how to best support your child.
Setting the Stage
Whatever you do, don't ambush your kid with: "I need to have an important conversation with you, that’s going to take about 45 minutes. Would you like to walk and talk or sit in your bedroom?" You might as well say … I’m going to talk to you about this in a prison cell for an eternity.
Your child will need to feel safe in the conversation, not ambushed or trapped. Give them time to prepare, and more importantly, set a time limit of a few minutes.
Opening Lines That Work
"I'm concerned about you."
"I want you to know I'm here if you want to talk."
"How can I best support you right now?"
Questions to Guide the Conversation
The most important thing is that you express curiosity over judgement!
Questions that reflect curiosity – ask these:
"My biggest concern is supporting you. How can I do that?"
"Help me understand self-harm. How does it make you feel better?"
"What time of day are you struggling most?"
"How well are you sleeping?"
"Would seeing a therapist be something you'd be open to?"
"At your worst moments, how bad are your feelings? Could you give me a rating out of
Questions that reflect judgment – DO NOT ask these:
"If you don't stop, I'll punish you."
"Lots of people go through bad stuff and don't cut."
"Tell me where you're hiding your blades."
"Why do you want to kill yourself?"
"There must be something wrong with you."
“I think you're doing this for attention."
How to End the Conversation
"This isn't the last time I want us to talk. I'll check in with you in a few days, and I'm always here if you need me sooner. The most important thing is that I love you, and there's nothing we can't get through together."
Building Better Coping Strategies
Work together on healthier alternatives:
Physical alternatives: Ice cubes, hot/cold showers, intense exercise, stress balls
Emotional expression: Journaling, art, music, talking to trusted people
Mindfulness: Deep breathing, grounding exercises (name 5 things you see, 4 you hear, etc.)
Problem-solving: Breaking big problems into smaller pieces, improving communication skills
When to Seek Professional Help
If your teen is self-harming, it's time for professional help. Look for therapists specializing in adolescents with experience in:
Dialectical Behavior Therapy (DBT)
Cognitive Behavioral Therapy (CBT)
Family therapy
Don't wait for things to get worse. Early intervention makes a huge difference.
Creating Support at Home
Stay connected: Keep having check-in conversations
Reduce judgment: Criticism will make them less likely to come to you
Address safety: Work together to remove/safely store items used for self-harm
Focus on positives: Help them reconnect with things that used to bring joy
Take care of yourself: You can't help them if you're not okay (think of the airlines’ safety instructions: “Put your oxygen mask on first.”)
Questions Parents Ask Me Most Often
Is self-harm a suicide attempt?
In most cases, no. Self-harm and suicide attempts are different behaviors with different intentions. Most teens who self-harm are trying to manage unbearable emotional pain, not end their lives. The cutting is the coping strategy, however unhealthy.
But the two are not unrelated. Teens who self-harm are at higher risk for suicide than teens who don't, which is part of why this behavior needs professional attention even when your child tells you they don't want to die. Believe them when they say it. Take it seriously anyway.
Should I take my teen to the hospital?
Sometimes, yes. Take your teen to the emergency room if a wound needs medical attention you cannot provide at home, if they are expressing suicidal thoughts with any intent or plan, or if the situation is escalating and you do not feel able to keep them safe.
If none of those apply (surface-level injury, no suicidal intent, an established treatment relationship), an urgent call to their therapist is usually the right next step. The hospital is an important resource for crisis. It is not the right setting for ongoing self-harm treatment.
If you are unsure, call 988 and ask. That is exactly what they are there for.
How do I find a therapist for self-harm?
Start with your child's pediatrician. They often have a short list of clinicians they trust. Contact us: we have these resources. Your child's school counselor is another strong source, since they usually know which local therapists are good with adolescents.
When you call to set up an intake, ask three things: Do you have experience with adolescent self-harm? Are you trained in DBT or CBT? How do you involve parents in treatment? A therapist who hesitates on any of those questions is not the right fit.
My teen promised they had stopped, and I just found evidence they haven't. What do I do?
Recovery from self-harm isn't linear. Lapses are common, and a lapse doesn't mean treatment is failing or that your child is lying to you about wanting to stop. Approach the conversation the same way you approached the first one: curiosity, not confrontation. "I noticed something. I'm not angry. Help me understand what was going on for you." Then loop in their therapist.
Should I be checking their body for marks?
This is one of the hardest questions parents bring me, because the impulse is so understandable. But routine body checks tend to do more harm than good. They turn the parent-child relationship into surveillance, which is the opposite of the trust your teen needs in order to come to you when they are struggling. Bring your concerns to the treatment team instead. A good therapist can build appropriate safety check-ins into the treatment plan.
Do I need to tell their school?
In most cases, yes (at least the school counselor or nurse). Schools can support your child's emotional needs during the day and adjust academic pressure when it's appropriate. You don't need to tell every teacher. One confidential conversation with the right person at the school is usually enough.
What do I tell their siblings?
Siblings almost always know something is wrong, even when they haven't been told what. Age-appropriate honesty is better than secrecy. Something like: "Your sister is going through a hard time. She is getting help. You might notice some changes at home while we work on this." Then ask them how they're doing, and keep asking. (If you haven't read The Glass Siblings, this is a good moment to.)
My teen refuses to go to therapy. How do I get them to go?
Start by getting curious about the refusal. Some teens have had bad experiences with previous therapists. Some are afraid of what might come up. Some don't believe anything will help. Each of those refusals has a different answer. Where you can, involve your teen in choosing the therapist (gender, specialty, even a brief meet-and-greet call) so the decision feels collaborative rather than imposed.
Is it okay that I'm angry?
Yes. You can be devastated and frightened and angry all at once, sometimes in the same hour. What matters is where you bring those feelings. Bring them to your own therapist, your partner, a trusted friend. Do not bring them to your teen. They cannot hold the weight of your fear on top of their own pain.
Will the scars fade?
Most do, over time. Some do not. There are dermatological options that can help with the appearance of scarring later, when your child is ready to think about that. For now, the scars matter less than what they represent: a child who was hurting and did not have a better way to cope. The path forward is the better way.
How long until things get better?
There is no honest answer to this question that is also a satisfying one. With good treatment, most teens see meaningful progress within months rather than years. But "better" is not a finish line. It is a slow accumulation of skills, of trust, of evidence that your child can get through a hard feeling without hurting themselves. Stay in it with them.
Crossbridge Consulting Can Connect you to resources if your child is self harming
Resources and professionals understand what you're going through. Please reach out to us if you need assistance locating these.
If you’ve gotten your child help, and they continue to self-harm, contact us. Your child may need more support than outpatient therapy can provide. Your child’s safety is paramount!
Cutting can be life-threatening. It may be a sign of severe emotional trauma that can eventually lead to suicide. We will put you in touch with programs that have experience in understanding and treating the underlying cause of cutting and other self-harmful behaviors.
Let’s Talk: We are here to support you!
In crisis? Contact 988 (Suicide & Crisis Lifeline) by phone or text, or go to your nearest emergency room. Help is available.
