Self-Harm Therapy for Teens and Adults

Understanding Self-Harm and Why It Happens

Self-harm, sometimes called non-suicidal self-injury (NSSI), refers to behaviors like cutting, burning, hitting, or scratching that are intended to manage overwhelming emotional pain rather than to end one's life. It is not the same as suicidal behavior, though the two can co-occur.

People who self-harm are not seeking attention. They have typically found a way to regulate emotional states that feel unmanageable, and the behavior works in the short term even as it creates serious risks over time. The most effective treatments for self-harm address emotion regulation directly, which is why Dialectical Behavior Therapy has the strongest evidence base for this population.

Evidence-Based Treatment for Self-Harm

Dialectical Behavior Therapy (DBT)

Dialectical Behavior Therapy is the most extensively researched treatment for self-harm and is considered the first-line intervention for clients who self-injure. DBT was originally developed by Dr. Marsha Linehan specifically to treat chronically suicidal and self-harming individuals, and it has the largest evidence base of any treatment for NSSI.

Comprehensive DBT includes:

• Individual therapy targeting self-harm urges and behaviors directly

• A weekly DBT skills training group covering emotion regulation, distress tolerance, mindfulness, and interpersonal effectiveness

• Phone coaching between sessions for real-time support during urges

• A therapist consultation team to ensure quality of care

Our clinicians provide the full, adherent DBT program, not a skills-only or adapted version. Research consistently shows that the complete DBT package produces better outcomes than individual components alone.

DBT for Teens Who Self-Harm

Adolescents who self-harm benefit from a version of DBT that includes the entire family. Our multi-family DBT program for teens involves parents and caregivers in skills training alongside their teen, reducing invalidation at home and building a shared language for emotional experiences. This approach, known as DBT-A, has strong evidence for reducing self-harm in adolescents.

When Self-Harm Co-Occurs With Other Conditions

Self-harm frequently co-occurs with Borderline Personality Disorder, eating disorders, PTSD, and depression. Our clinicians are trained to treat the full clinical picture. Clients who present with both self-harm and a trauma history may be candidates for DBT Prolonged Exposure, an integrated protocol that addresses both at the same time.

Who We Treat

We provide self-harm treatment for:

• Adolescents ages 12 and up

• Adults of all ages

• Clients with co-occurring BPD, eating disorders, PTSD, or depression

• Clients who have not responded to previous treatment

What to Expect When You Start Treatment

The first step is a comprehensive intake assessment. Your clinician will ask about the history and function of self-harm, any co-occurring conditions, previous treatment experiences, and your current level of safety. This assessment shapes an individualized treatment plan.

From there, most clients begin the full DBT program, which typically runs for six months to a year. Progress is tracked throughout, and your clinician will adjust the plan based on what is working.

Self-Harm Therapy in Tennessee and Florida

We see clients in person at our Franklin, TN office and our Palm Beach Gardens, FL office. Telehealth is available throughout Tennessee and Florida for clients who prefer remote sessions or live outside our in-person service areas.

You Do Not Have to Manage This Alone

If you or someone you love is struggling with self-harm, we are here to help. Contact EBT Collaborative to schedule a consultation with a clinician who specializes in this work.