A teenage girl is in CBT to help treat self-harm.

Here’s How CBT Can Help Treat Self-Harm

Cognitive behavioral therapy (CBT) aims to address the underlying thoughts, emotions, and behaviors that contribute to self-harm.


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Trigger warning: Self-harm, suicide. If you’re experiencing suicidal thoughts or are in danger of harming yourself, this is a mental health emergency. Contact The Suicide & Crisis Lifeline 24/7 by calling or texting 988.

How CBT treats self-harm

Cognitive behavioral therapy (CBT) can be effective in treating self-harm by helping people identify the thoughts, emotions, and situations that lead to their harmful behaviors. By working with a mental health professional, people can learn to challenge and reframe negative thought patterns, develop healthier coping strategies, and build resilience to manage difficult emotions. Through CBT, people can also acquire skills for problem-solving and communication, which can help them navigate challenging situations and relationships without resorting to self-harm. The goal of CBT in treating self-harm is to empower people to understand and manage their emotions in a healthier way, ultimately reducing the frequency and severity of their harmful behaviors.

Skills taught in CBT for self-harm

Skills taught in CBT for self-harm include:

Identifying triggers

This skill teaches people to recognize the thoughts, emotions, and situations that lead to self-harm behaviors. People can develop strategies to cope with and manage these difficult situations by understanding their triggers.

Building distress tolerance

CBT helps people learn how to manage intense or painful emotions without resorting to self-harm. Techniques such as deep breathing, grounding exercises, and mindfulness can help people ride out an intense emotion without acting on it destructively.

Challenging negative thoughts

CBT teaches people to recognize and question the negative beliefs and self-defeating thoughts that underlie self-harm behaviors. By challenging these thoughts, people can develop more realistic and constructive ways of thinking about themselves and their experiences.

Developing coping skills

People are taught practical skills to help them manage their emotional distress, such as problem-solving, assertiveness, and healthy communication. People can respond to challenges more adaptively and productively by developing this healthy coping mechanism.

Increasing self-awareness

CBT helps people become more aware of their emotions, thoughts, and behaviors, allowing them to better understand the patterns and triggers that lead to self-harm. By increasing self-awareness, people can make more informed choices about how to respond to difficult situations.

Building a support network

A mental health professional can help people identify and strengthen their social support systems, whether through friends, family, support groups, or community resources. A strong support network can provide important resources and encouragement to help people resist the urge to engage in self-harm.

Benefits of CBT for self-harm

Research has shown that CBT can have significant long-term benefits for people struggling with self-harm. By addressing underlying thought patterns and behaviors, people can learn to use a healthy coping mechanism and develop a more resilient mindset, leading to a reduction in instances of self-harm over time. CBT can also help people build a support network and improve their overall emotional well-being, ultimately leading to a long-term decrease in self-harm behaviors.

How quickly does CBT work for self-harm?

Research suggests that CBT can be effective in reducing self-harm behaviors in people. Some people may begin to see improvements in their self-harm tendencies after just a few weeks of CBT sessions. People who engage in CBT can learn coping skills and strategies to manage their emotional distress and responses to triggers, leading to a decrease in self-harm behaviors over time. However, the speed of progress can vary from person to person, and it is essential to continue with therapy and practice learned techniques for long-term success.

How is medication used to treat self-harm?

Medication is commonly used to help manage the underlying psychological issues that may lead a person to engage in self-harm. Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants, are often prescribed to help reduce symptoms of depression and anxiety, which are commonly associated with self-harm behaviors. Mood stabilizers like lithium and antipsychotic medications may also be used to help regulate mood and decrease impulsive behaviors. Additionally, anti-anxiety drugs, such as benzodiazepines, may be used to help manage symptoms of anxiety that contribute to self-harm urges. It is important for a person to work closely with a healthcare provider to determine the most appropriate medication regimen for their individual needs.

Other types of treatment for self-harm

Dialectical behavior therapy (DBT)

This therapy focuses on developing coping skills, regulating emotions, and improving relationships to help people manage self-harm behaviors.

Art therapy

Using creative expression through art, people can explore their emotions, thoughts, and triggers related to self-harm in a supportive and nonverbal way.

Mindfulness-based stress reduction (MBSR)

This therapy involves practicing mindfulness meditation and yoga to increase awareness of thoughts and feelings, allowing people to manage distress better and reduce self-harm impulses.

Animal-assisted therapy

Interacting with therapy animals can provide emotional support, reduce anxiety, and increase feelings of connectedness, which can help in decreasing self-harm behaviors.

Equine therapy

Working with horses can promote emotional self-awareness, trust-building, and communication skills, which can be beneficial for people struggling with self-harm.

IOP for self-harm

Intensive outpatient programming (IOP) is used to treat self-harm when a person requires more support and structure than traditional outpatient therapy can provide. IOP typically involves more frequent therapy sessions, often meeting several times a week, and may include group therapy to provide additional support from peers. This level of care allows the person to continue living at home while receiving the necessary treatment and support. IOP often incorporates a variety of therapeutic approaches, such as cognitive behavioral therapy (CBT), to address the underlying issues contributing to the person’s self-harm behaviors and to develop healthier coping strategies.

Treatment for self-harm at Charlie Health 

If a young person in your life is struggling with self-harm, Charlie Health is here to help. Charlie Health offers a virtual Intensive Outpatient Program (IOP) that provides more than once-weekly mental health treatment for young people and families dealing with serious mental health conditions, including self-harm. Our expert clinicians incorporate CBT into individual counseling, family therapy, and group sessions. With this kind of holistic treatment, managing self-harm is possible. Fill out the form below or give us a call to start healing today.

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