Parental and professional beliefs about the function of self-harm in young people

This thesis was completed as part of the academic requirements for the degree of Doctorate in Clinical Psychology. The research was based on the author’s prior clinical experience of supporting people who self-harmed. Self-harm is seemingly on the rise among young people, and support is often provided by parents or professionals. Chapter 1 of this thesis is a review of the literature exploring parental beliefs about the functions of self-harm. Using a systematic search, 8 papers were found and evaluated using a structured appraisal tool, the Critical Appraisal Skills Programme (CASP). Most papers were of good quality. Synthesis of the findings indicated that parents hold a range of views about self-harm, with some misconceptions identified. Parents should be provided with accurate information on self-harm to ensure they are in the best position to support their children. Parents would also benefit from being provided with support for the feelings evoked by discovery of their child’s self-harm. Chapter 2 is an empirical study using Q-methodology to explore Child and Adolescent Mental Health Service (CAMHS) staff beliefs about why young people self-harm. Twenty-five staff members from a range of professions completed Q-sorts, where they ranked 65 statements about self-harm in terms of relative agreement and disagreement. A large overlap in beliefs was found between all staff. Beyond this, two distinct accounts were identified; ‘self-harm is a private experience used for coping’ and ‘self-harm seeks connection with others’. Overall, CAMHS staff appear knowledgeable about self-harm. Future studies could aim to use Q-methodology with other populations such as alternative staff groups or young people who self-harm to explore their beliefs. Chapter 3 is an executive summary of the empirical paper, written in a more accessible style. This paper is aimed to be disseminated amongst CAMHS staff in the NHS Trusts where the research was undertaken.