Hopefully, you now have a better idea of where to find information on self-harm, the types of resources that are out there, and some of the treatments for self-harm. Below, we turn our attention to the specific ways in which you can go about finding help in your area, as well as some important things to keep in mind during this process.


This is an important step, because many therapists don’t actually have much experience or training in the treatment of self-harm. In fact, it’s unfortunate, but some therapists actually refuse to treat people who self-harm, or they might require that you stop self-harming before they will treat you. This is like saying, “Get rid of your problems, and then I’ll help you.” Most therapists aren’t like this, but it’s important to know that this does happen to some people.

If possible, one of the things to look for is a therapist who’s comfortable treating people who self-harm, and has a good amount of training and experience with this type of work. There are several different ways to seek out someone like this. For example, you can:
+ Contact a hospital psychiatry department and ask about treatment providers in your area.
+ Go to a mental health clinic and set up an informational meeting with a clinician.
+ Contact a university counseling or psychology clinic and ask for referral information.
+ Search your area, state, or provincial registry of psychologists or psychiatrists.
+ Get in touch with your area’s psychological association and ask for a referral directory, or ask how you might find treatment providers who can help you.
+ Search local university websites for psychology faculty members with expertise in self-harm or BPD, and ask if they know of any therapists in your area with expertise in self-harm.

Now, it’s not always easy to figure out whether the person you’re seeing has the background and training to help you. Because of this, you might have to take charge of this process by asking questions, such as the following:

+ Have you ever treated someone who self-harms before?
+ What kind of training or experience have you had in treating people who self-harm?
+ How well do people who self-harm do in treatment with you?
+ How do you feel about working with someone who self-harms?
+ Do you think you can help me?


As we mentioned above, a thorough psychological assessment is the first step in treatment. Without knowing what kinds of problems you’re dealing with, it’s hard for anyone to help you with self-harm. A psychological assessment can also help the clinician get a good sense of the other difficulties you might have, and this information can help determine the best kinds of treatments for you. Treating someone for
self-harm without a thorough assessment is like going to a new country and trying to find your way around without a map. You might find your way around eventually, but not before going in the wrong direction, getting lost, and so on. And, if you self-harm, you really can’t afford to have someone try to help you find your way without a good map.

So, how do you get a psychological assessment? Well, normally, this is done at the beginning of treatment, so once you’ve found someone to help you, this professional will often start out with an assessment. But, you might also be interested in simply getting an assessment to learn more information about yourself before you seek treatment. In that case, you might consider searching (using the strategies we mentioned above) for mental health professionals in your area and setting up an appointment for an assessment. We sometimes see people who are not interested in starting treatment right away but simply want to know exactly what diagnoses they have (if any) and what treatment options are available.
If you’re not sure whether you’re ready for therapy or if you can’t afford it, you might consider doing this as well, as a way of giving yourself a direction once you are ready.


The first step in taking an active role in your treatment is to determine the kind of treatment you want and the type of person you’d prefer to work with. Depending on your personal preferences, certain types of psychological therapies might be a better fit for you than others. For example, do you want a more active, problem-solving approach? If so, maybe CBT or DBT would be a better fit for you than psychodynamic therapy.

It’s also important to consider the characteristics you prefer in a therapist. Some people prefer to work with a therapist of a particular gender. Others prefer therapists who are older or younger than they are, and still others prefer to work with someone of a similar (or not) ethnic or racial background. Consider your personal preferences, and then decide whether the person with whom you’re meeting is a good fit for you.

Now, in some cases, you may not have much of a choice in the matter. For example, you may live in an area where there are very few treatment providers to choose from. Or, your insurance company may only cover the services of a few therapists. If this is the case, you may need to decide if you’re willing and able to be flexible regarding some of your preferences. If you do, however, have a couple of different options and, for whatever reason, aren’t comfortable with or interested in working with the person you’re meeting with, it’s perfectly acceptable to tell the professional about your preferences and ask for a referral.

The next, and perhaps most important, step in taking an active role in your treatment is to ask questions.

Excerpt from FREEDOM FROM SELF-HARM: Overcoming Self-Injury with Skills from DBT and Other Treatments (New Harbinger Publications)

Author's Bio: 

KIM L. GRATZ, PH.D., is research assistant professor in the department of psychology at the University of Maryland and director of the personal disorders division of its Center for Addictions, Personality, and Emotion Research (CAPER). Gratz has written numerous journal articles and book chapters on bipolar disorder, deliberate self-harm, and emotion regulation. Her research currently focuses on understanding the nature and consequences of emotional dysregulation and emotional avoidance in individuals who struggle with bipolar disorder and self-harm. Gratz is coauthor of The Borderline Personality Disorder Survival Guide.

ALEXANDER L. CHAPMAN, PH.D., is assistant professor and registered psychologist in the department of psychology at Simon Fraser University. He is director of the Centre for Applied Research on Emotions, where he conducts research on self-harm, borderline personality disorder, suicidal behavior, impulsivity, and emotions. Chapman has published several journal articles and book chapters and has given numerous professional presentations on borderline personality disorder, suicidal and self-harming behavior, dialectical behavior therapy, and impulsive behavior. In addition, he supervises students in their treatment of clients who self-harm and/or have bipolar disorder. Chapman is president of the Dialectical Behavior Therapy Centre of Vancouver, a center for the treatment of bipolar disorder, self-harm, and related problems. He is coauthor of The Borderline Personality Disorder Survival Guide.

Foreword writer Barent Walsh, Ph.D., is executive director of The Bridge, a nonprofit human service agency in Worcester, MA. He is an author, consultant, and trainer on the topic of self-injury.