Residential Avoidant Restrictive Food Intake Disorder Treatment in Beautiful Malaysia
Self-Harm in Children, Teens and Adolescents
Self-harm or self-injury sometimes referred to as non-suicidal self-harm (NSSI) is a complex mental health presentation that often begins in the tween or teen years. Self-harm is an increasingly common and serious presentation and is seen in all sexes and genders.
It is important to know that not all young people who self-harm have the wish to end their life. However, many do and self-harm should never be considered as ‘just a phase’ or dismissed with ‘she/he doesn’t do it often’ or ‘it’s not that deep’. Self-harm is always a psychiatric or mental health need and is not a ‘normal’ part of growing up. Parents should always take advice from a Child and Adolescent Mental Health Specialist.
Recent research suggests that up to 30% of teenage girls and 10% of teenage boys will engage in self-harming behaviour. Young people who identify as non-binary are at increased risk of self-harm. Children and young people with other mental health concerns, including Borderline Personality Disorder, Eating Disorders, ADHD and Autistic Spectrum Disorders ,are at increased risk of self-harming more often and more severely.
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Treatment for Self-Harm
With a supportive, caring environment and a solid treatment programme, young people can recover from self-harm. Our Professional team have extensive training and supervision in NSSH. We take a personalised approach in developing tailored treatment plans and interventions to address each individual’s specific challenges. We use a range of treatment methods, including:
- Mentalization-Based Therapy (MBT)
- Enhanced Cognitive
- Behaviour Therapy (CBT-E)
- Family-Based Treatment (FBT)
- Interpersonal Therapy (IPT)
- Internal Family Systems Model (IFS)
- Eye Movement Desensitisation and Reprocessing (EMDR)
- Somatic Therapy
- Trauma and Tension Release Exercises (TRE)
- Art Therapy
Growing up feeling outside of the binary, in a CIS-favoured environment, or feeling excluded is associated with an increased risk of self-harm. At The Wave, we understand the importance of young people who identify as non-binary having access to treatment that meets their needs for acceptance and inclusion. Gender-affirming care is associated with greater outcomes of success and can always be guaranteed at The Wave.
Self-harm and eating disorders often go hand-in-hand. Whilst not every young person with an eating disorder will self-harm, there are many who have self-harm episodes or periods where self-harm becomes evident.
Self-harm and eating disorders both have an increased risk of additional serious mental health concerns and suicide and it is important to always take any episodes of self-harm or disordered eating seriously. Getting help from adolescent mental health professionals and early interventions is often the key to successful treatment.
The Wave has a highly specialised treatment program for young people living with eating disorders. Every member of The Wave treatment team is trained in the care and management of eating disorders and is experienced in treating complex cases with love, fun, and comfort.
Signs and Symptoms of Anorexia in Teens
Self-harm is deliberately acting in a way to cause harm to your body. Young people may do this to change the way they are feeling. Teens may self-harm when they are angry, sad, lonely, depressed, care-seeking or to show hopelessness. They may also self-harm because they have suicidal thoughts and feelings.
Some signs of self-harm in teenagers are:
- Cutting (with sharp objects such as razors, scissors, fingernails)
- Burning (with items such as lighters and cigarettes)
- Bruising (often from pinching)
- Picking skin and pulling hair
- Head banging
- Inserting objects into the throat or mouth to cause damage
- Removing teeth
- Excessive piercings
- Skin carving
- Drug and alcohol abuse
- Low self-esteem
Young people with eating disorders who self-harm may use cutting with sharp objects, often on the upper arms, thighs, or tummy area. Burning with cigarettes or lighters is often seen, together with intentional harm using prescription or over-the-counter medications.
self-harm can be frightening for parents, you can help by encouraging young people to respect their bodies and providing a non-judgemental space to talk.
There is no official test or standardised medical evaluation to diagnose self-harm. Diagnosis is based on a physical and psychological evaluation from a mental health professional. They may check for other mental health conditions that could be linked to self-injury, such as depression, eating disorders, post-traumatic stress disorder (PTSD) or personality disorders.
At The Wave, we use a range of thorough diagnostic approaches, informed by the DSM-5, to ascertain the presence of co-occurring mental health conditions. We understand the importance of identifying the root cause of self-harm. Our expert team will always provide a supportive and gentle environment while we find the appropriate treatment approach for our young people.
Treatment decisions at The Wave are made by our multidisciplinary team of treatment professionals. Every young person at The Wave has a Lead Psychiatrist, Medical Officer, Psychiatric Nurse, Primary Eating Disorder Therapist, Recovery Associate, Recovery Coach, Dietician, and team of Chefs. Treatment is overseen by The Wave Medical Director and Clinical Director.
Laying the Groundwork for a Bright Life After Recovery
The Seven Core Elements of Treatment
At The Wave, our treatment programs are built on seven elements, each designed to nurture young people in all areas of their personal development. Self-harm often stems from feelings of worthlessness, insecurity, and sadness, so our seven elements will focus on helping them rebuild their confidence, independence, and self-esteem. From clinical and medical treatments to activities and volunteering, we aim to equip all young people who walk through our doors with the tools and resources needed to overcome self-harm and lead a fulfilling life.
We complement our personalized treatment plans with a deep level of care and understanding. We take the time to listen to each young person’s hopes, fears, and future ambitions, creating a unique treatment approach just for them. On top of medical treatment, we also use a range of therapies to help young people get to the root of their self-harm and learn about their triggers. They’ll also learn how to develop healthy coping mechanisms in times of stress, ensuring that they don’t give in to old habits.
Some of our clinical treatment options include:
- Family therapy
- One-to-one therapy
- Expressive arts therapy
- Somatic therapy
- Self-love techniques
- Cognitive-behavioral therapy (CBT)
- Dialectical-behavioral therapy (DBT)
- Eye movement desensitisation and reprocessing (EMDR)
- Group therapy
No two people are the same, so why would you create a treatment plan that caters to everybody? At The Wave, this is something we understand and put into practice with our fully personalized treatment approach. Every case of self-harm is different and every person has different goals, dreams, and ambitions – that’s why we’ll always design our treatment programmes around their schedule, life, and their own personal experiences with trauma and self-harm.
Our medical staff may develop a treatment plan that includes medication depending on a young person’s individual circumstances and triggers. All medication is regularly reviewed and monitored by medical directors, and they’ll always be happy to answer any questions you may have. We know that taking medication can be daunting, so we’ll always be open and honest with you throughout the entire process.
As they move through their treatment plan and learn healthy coping mechanisms, the dose of medication they need may reduce. However, for some people, long-term medication may be the most effective course of action to control symptoms.
We firmly believe that no young person should be left behind, and that’s why one of our seven elements is education. Self-harm all too often interrupts important life-stages for young people, halting things like university and education in their tracks. At The Wave, we don’t see why young people shouldn’t work towards their future while recovering. As well as giving them purpose, it sets them up for their bright future.
Every young person has so much ahead of them, and we’re here to help them see their potential and realise their dreams. Alongside therapy and medical treatment, we provide a range of educational opportunities designed to bolster a young person’s confidence and skills for life outside of our clinic. Whatever their dream is, we’re here to help arm them with the tools needed to achieve it.
Some of the educational pathways we offer include:
- International GAP-year experiences
- Continuation of GCSEs and A-Levels
- Vocational courses (London School of Art, Royal Horticultural Society, Leith’s School of Cookery, and The British Horse Society)
Each young person will have their own personal learning plan (PLP) to help them stick to their goals and set the foundations for a solid future.
True recovery doesn’t happen through talking and support alone; it happens through action. At The Wave, we call this ‘living and learning recovery.’ It’s one of the reasons we’ve developed a global citizenship programme that gives our young people the chance to help out in the local community and become more aware of the world around them.
Self-harm can often rob young people of inspiration and purpose, making it difficult for them to look outside of themselves. With our global citizenship program, they’ll not only learn how to develop friendships and bonds, but they’ll also learn valuable skills like teamwork and the importance of helping others.
Volunteering opportunities will also give young people a chance to reconnect with something they care about. If they feel strongly for a particular cause, our programme will help them nurture that care into something meaningful and positive. Having something that they deeply care about can help re-develop that sense of purpose and give them something to keep busy with once they leave the clinic.
As well as clinical treatment, we also offer a range of alternative therapies to young people such as cooking, gardening, and dancing. At The Wave, we believe trying new activities and developing new hobbies is an important part of the treatment process. They give young people a chance to be creative, flex their skills, nurture their passions, and develop healthy coping mechanisms.
We combine a range of creative and holistic treatments into each of our young person’s treatment plans, including:
- Education on the food and body groups
- Mindful movement
- Tension, stress, and trauma release (TRE)
- Eating disorder informed yoga
- Education on nourishment and healthy eating
- Journalling and reflective writing
- Team sports and group challenges
As well as giving young people a chance to develop healthy habits for their life outside the clinic, our outside/inside approach will also help them release their emotions in productive, healthy ways instead of bottling it all up.
Cultivating a strong team spirit, sense of accomplishment, and fun into our treatment programmes is what sets our approach apart from others. We don’t just focus on medical and clinical treatment – we’re also keen to get our young people involved in fun challenges and experiences that will empower them and help them learn new life skills.
That’s why one of our seven core elements is experiences. All young people have the chance to take part in a range of experiences and exciting adventures, including:
- Dance and drama productions
- Fashion design
- Batik painting
- Horse riding
- Jungle adventures
- Rock climbing
Self-harming can often impact relationships and the way a young person approaches life. That’s why our ‘experiences’ element is designed to help bolster their confidence to try new things and give them a chance to develop team-building skills. These are all things they can take with them into their life after recovery, setting a solid foundation for a fulfilling life.
Self-harm doesn’t have to rob a young person of their potential. They’ve got so much ahead of them, and we’re keen to help them realise their dreams and ambitions, giving them the tools and resources to set the cogs into motion.
Our dedicated care team works with each young person to develop an ongoing plan that will help ease them back into everyday life and transition healthily. We know that leaving behind the security and familiarity of treatment can be a little daunting, but we’re here to help each young person develop a set of goals and plans to work towards their future with confidence.
Having some kind of purpose when they leave our clinic will help set them up for their future and limit the chances of them returning to old habits. With a renewed sense of hope and inspiration, they’ll be more likely to stick to their goals and go on to lead a fulfilling life.
Self-Harm therapies and treatment options
Recovering from self-harm
During a young person’s stay with us, they’ll experience a range of therapies and treatment options. Some of our most popular include:
During their stay at The Wave, each young person will meet regularly with a dedicated therapist. These sessions offer a safe space for young people to open up, share any issues that are troubling them, and identify the root of their condition. Young people are also encouraged to learn how to manage their feelings and develop healthy coping mechanisms and behavioural patterns to address and replace self-injury
At The Wave, we place a strong emphasis on team spirit and building relationships. Building a strong support network is important for both their time at The Wave, and the transition back into their communities at home. This is one reason that so many of our activities and therapies are focused on cultivating relationships.
Although many young people find it a little daunting to open up, group therapy is a great way to learn from others on a similar journey. Young people at The Wave often find that group therapy enables them to form long-lasting friendships with other people. Hearing from others who’ve struggled with self-harm shows our young people that they’re not alone and gives them the chance to hear how others cope with the condition. Group therapy also provides a greater sense of accountability, as everyone will have each other’s backs.
Eating Disorder-Informed Yoga
Self-harm and eating disorders are often co-occurring, and all treatment for self-harm at The Wave will be provided with the specialist care of treatment professionals trained in the care and management of eating disorders. Eating disorder-informed yoga is gentle and non-aerobic, making it ideal for those with anorexia who may have experienced malnutrition.
Eating disorder-informed yoga offers a gentle, controlled workout that focuses on the mind rather than just the body. During sessions, young people are guided through different movements, each designed to help them develop emotional awareness and trust in their bodies. It’s all about developing healthy habits that allow young people to regain ownership over their bodies, and reminding young people that they are in control.
Self-harm can affect the whole family, and it can sometimes be difficult for loved ones to fully understand what a young person is going through and why. Our family therapy sessions offer a safe space for everyone to open up, voice their feelings and concerns, and better understand one another.
At The Wave, we offer a range of alternative therapies to enhance wellness and promote healing from the inside out, from dance and art therapy to reiki and mindfulness. Natural healing treatments can relieve stress, calm the autonomic nervous system, and help people to manage negative emotions and those moments when they feel like slipping back into old habits.
Creative therapies like art, dance, and drama offer the chance to express emotions and let go of negative associations with food. These therapies also help many develop new skills and find joy in new hobbies that they can continue once they’ve left our clinic – ideal for channeling their energy into something creative.
Known as horticultural therapy, our gardening group programmes offer the opportunity to garden and tend to their own bed of flowers and plants. This ownership gives young people responsibility, empowering them to look after the seeds they’ve sown. Not only does this show them the power of care and compassion, but these skills can also be directly translated into how they look after themselves.
Flowers take time to grow, but they flourish with the right care and support, just like young people in recovery. We also offer young people the opportunity to plant fruits and vegetables, enabling them to be involved with food from the moment it’s planted.
During a young person’s stay at The Wave, they are given a personalised nutritional programme tailored to their specific needs. This ensures that those in recovery from an eating disorder in addition to self-harming get all the vitamins and minerals they need to stay strong and recover. We also offer a wide range of education on nutrition, food groups, and how nutrition affects the body.
Over time, young people in our care gradually learn to develop healthy and regular eating patterns and meal planning. We take everything at the individual’s own pace, helping them adjust to the changes smoothly.
Dialectical Behaviour Therapy (DBT)
Another form of talking therapy, DBT is similar to cognitive-behavioural therapy (CBT) and has been adapted for people who experience intense emotions and behaviours that negatively impact their mental or physical health.
When going through DBT, young people are encouraged to accept who they truly are and challenge any negative thoughts patterns which could motivate self-harm. Not only does this help them develop healthy coping mechanisms and identify triggers, but it also gives them the chance to reflect on their situation and better understand self-harm and why it’s cropped up in the first place.
Frequently asked questions
Self-harm is very common amongst teenagers and young people. The average age for self-harming is between twelve and fifteen, with recent studies showing that around one in every twelve teenagers engages in self-harming behaviours every day.
Mental illness is often passed down from family member to family member – something that’s often seen as hereditary. Though this isn’t always the case, it is common and certain disorders like depression are thought to increase the likelihood of self-harming.
Supporting a young person through this process can be complicated and challenging. The most important thing to remember is to remain open-minded and free of judgement. When someone self-harms, they’re not doing it for your attention – they’re using it as an outlet for their pain.
Let them know that you are there to support them and that you aren’t making assumptions about their condition. Try to listen and offer reassurance during difficult times.
Children and teenagers self-harm for a number of reasons. For some very young children, self-harm may mark a period of frustration and be short-lived. Teens who are proximity-seeking or care-seeking may self-harm in the hope of having their needs met. This can result from feeling unseen and unheard.
Young people who find it difficult to express their feelings may also be more at risk of self-harm. They may experience big emotions that feel too big to hold or feel numb and empty inside. There are many reasons that your teen may be self-harming and it is important to be supportive and gentle whilst finding the appropriate help.
Eating disorders such as anorexia nervosa, binge eating disorders, bulimia nervosa, or ARFID often occur alongside other psychiatric symptoms or disorders. For young people with eating disorders, engaging in other forms of self-destruction is common. For example, consuming dangerous substances to induce vomiting and withholding food to the point of pain are both co-occurring symptoms of self-harm and bulimia. Hair pulling is one form if self-harm that is more common in young people with disordered eating than in the general population.
According to a 2017 report by Stonewall, four out of every five young people who identify as TNB have self-harmed, while two in every five have attempted to end their life by suicide. These statistics highlight the urgent need for support and resources for TNB youth who may be struggling with mental health issues related to their gender identity.
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