One moment you're covered in blood and next it's what’s for tea? An interpretative phenomenological analysis of residential care staff's experiences of managing self-harm with looked after children

Young people in care have been found to have a higher incidence of self-harming behaviours. However, despite research findings that managing self-harm can be stressful for carers, there has been a dearth of literature which has specifically examined residential carers' experiences of this. Therefore, the current study used an interpretative phenomenological approach to explore the experiences of residential carers in relation to self-harm. Three superordinate themes emerged from the study, each with a number of subordinate themes. 'Surviving' illustrated how managing self-harm can be a difficult experience for residential carers and therefore they need a number of coping strategies to draw upon to manage. 'We're out here alone' represented participants' feelings around being held individually responsible for managing acts of self-harm and also feeling as though outside agencies were inadequate or slow to respond to the young people’s needs. 'Losing control' reflected when coping strategies failed, and participants were left feeling uncontained. It also demonstrated the potential negative consequences on their life outside of work. Recommendations are discussed for future practice, including regular staff supervision, team consultation, training and shared risk planning.