Investigating the understanding and management of self-harm in a children's residential therapeutic community

The definition of self-harm has been widely debated and has expanded from the traditional idea of habitual cutting to more abstract versions, such as self-harm by inadequate self-care (Hunter, 2011). There is sparse research on self-harm involving young children, with the focus predominantly upon adolescents. This small-scale, work-based study explores the understanding and management of self-harm within a therapeutic residential community caring for children aged 5-12. A mixed-methods design was used, combining quantitative analysis of secondary data of self-harm with qualitative data derived from professional discussions with community directors and semi-structured interviews with care staff. Results reflected the variance in defining self-harm and how semantics such as 'intent', 'level' or 'risk' are based on subjective interpretation and may vary between children and contexts. Such fluidity in terms can make self-harm a challenging subject to understand, compounded by the idea that self-harm is often seen as a taboo subject. The study concludes that identifying self-harming behaviour relies on the therapeutic relationship, and responses to this should be tailored to the child’s individual needs. The value of staff communication, training and support were highlighted as recommendations for future practice.