An understanding of adolescents who self-harm and their meaning-making of school.

Abstract

Rates of self-harm are constantly on the increase in adolescence compared to adulthood. It is important to understand why adolescents engage in self-harming behaviour. Adolescents who self-harm are at higher risk of a repeated episode and self-harm is a key risk factor in completed suicide. Only a few studies have directly explored adolescents’ views of their self-harm using their personal accounts. The present study employed a qualitative design using the Interpretative Phenomenological Analysis (APA) to explore the subjective experiences of twelve adolescents who self-harmed, and to gain understanding of how they assigned meaning to their experiences within the context of their school. Data were gathered via interviews, solicited diaries, photos and drawings elicitations. Session recordings of the participants formed the dataset. Data were transcribed, and from the analysis, five super-ordinate themes were developed: (1) Disconnected at home (2) Traumatic Pain leading to self-harm (3) Coping strategies at school (4) School connectedness and (5) Fostering resilience. Accounts highlighted the complex interplay between self-harm and depression across episodes of self-harm. Self-harm was a means of communicating distress as well as managing emotions. Encouragingly, many participants described being able to resist self-harm, often mirroring why the adolescents harmed themselves in the first place. Results indicated that participants reported adversities at home, butexperienced a high-level of connectedness to school, including peers and teachers, and this resulted in positive coping strategies. Several protective factors have been found to alleviate conditions, including resiliency building, leading to cessation of self-harm. Ultimately a recovery from self-harm model was developed. Findings were discussed in relation to the literature along with strengths, limitations, clinical implications and future research. Results suggest schools may benefit from improving their approach to preparing for students’ self-harming behaviours, by providing an environment that is conducive to the development of the students’ mental health.