Residential Youth Care Workers’ Perceptions of Self-Harm and Interventions

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O’Rielly, Tanya
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Mount Saint Vincent University
This qualitative research examined the perceptions of eight youth care workers regarding self-harm in youth. The types of self-harm encountered, the differences in self- harm between typically developing youth and youth with disabilities, and effective interventions in dealing with self-harm were addressed. The progression of youth care workers and their understanding and treatment of youth who self-harm were also examined. The types of self-harm found in the research included compulsive self-injurious behaviour, stereotypic self-injurious behaviour, and impulsive self-injurious behaviour. Three forms of self-harm emerged that were difficult to classify as they had not been previously discussed in the literature; 1) tattooing, 2) cutting off oxygen with a belt (strangulation), and 3) placing fingers in the wheels of a wheelchair (breaking bones). Low self-esteem, emotional pain, sadness, and inner turmoil were identified as characteristics common to both youth with disabilities and those who are typically developing. Behavioural disorders were also identified for both groups of youth. Differences between youth who self-harm according to whether they are typically developing or have special needs were as follows. Typically developing youth were perceived to have psychological disorders, while youth with special needs were believed to have cognitive disorders. The participants perceived the actual disability to be the root cause of self-harm for the youth with special needs. Hypersensitivity to the environment, limited verbal skills with a concomitant inability to express themselves, loneliness, and craving attention were also attributed to youth with disabilities. In contrast, typically developing youth were perceived as engaging in self-harm due to a specific intent or explicit purpose. This purpose was to release stress, and to replace their emotional stress by acute pain. Typically developing youth were also perceived as engaging in self-harm for acute attention seeking. The youth care workers reported a number of supportive interventions that they used with youth who self-harm. These included medication supplemented by emotional support, using “safe areas”, taking away objects used in self-harm, confidence boosting, and positive reinforcement. Verbal redirection and extensive discussion regarding self-harm were found to be effective with typically developing youth, while physical redirection was used more extensively for youth with special needs. Youth care workers had received limited training in self-harm prior to their employment. They described the dichotomous feelings of being intrigued and shocked, while also having feelings of sadness and pity, when they first encountered self-harm. Due to both their lack of training in self-harm and lack of agency policy, the participants felt confusion and uncertainty in how to deal with self-harm. Findings from this research are discussed within the context of confusion and uncertainty of youth care workers in understanding self-harm, interventions found to be effective in dealing with self-harm and the need for training and professional development on self-harm for youth care workers.
Limited training in self-harm , Self-harm , Qualitative Research , Youth