Find a Self-Harm Therapist

Understanding self-harm and how it can affect you

Self-harm is a term used to describe a range of behaviours where someone deliberately hurts themselves in response to overwhelming emotion, distress or as a way of coping with difficult memories or relationships. It can take many forms - cutting, burning, hitting, pulling hair, overdosing or engaging in risky behaviour - and it can be both physical and non-physical. For many people the act is a way of managing pain in the moment, communicating distress or feeling a sense of control. It is not simply attention-seeking and it often sits alongside feelings of shame, isolation, low mood or anxiety.

The effects of self-harm extend beyond the immediate physical injury. You might notice changes to your daily routine, difficulty at work or college, strained relationships and increasing secrecy about wounds. For some people repeated self-harm can heighten feelings of guilt and make it harder to seek help. Therapy offers a space to explore the reasons behind the behaviour, learn safer ways to manage distress and work toward longer term change.

Signs that you or someone you care about may benefit from therapy

You might be considering therapy if self-harm is occurring more frequently, if the urges feel harder to resist or if the behaviour is disrupting everyday life. Other signs include feeling unable to talk about what is happening, experiencing intense shame or guilt, withdrawing from friends and family, or using self-harm to manage overwhelming emotions rather than trying other coping strategies. If you find that self-harm is becoming a primary means of coping, or if it is making relationships and responsibilities more difficult, therapy can be a helpful step. If you are ever concerned about immediate danger to yourself, contact emergency services or attend your local A and E.

What to expect in therapy sessions for self-harm

When you begin therapy you will usually have an initial assessment where the therapist asks about your history, current difficulties and what you hope to change. This conversation helps to agree clear goals and to build a plan that fits your needs. A skilled therapist will explain their role, how they work and the limits of their duty to act if they believe there is an imminent risk to life. You should expect a collaborative approach where you and the therapist review risks, develop a personalised safety plan and agree practical steps to manage crises.

Sessions often focus on identifying triggers and the thoughts, feelings and situations that lead to self-harm. You will be supported to develop alternative coping strategies - such as grounding techniques, emotional regulation skills and problem solving - and to practise these between sessions. Therapy can also explore underlying issues such as trauma, loss, relationship patterns or identity concerns, depending on what feels most relevant to you. Progress may be gradual and the pace should be set by you, with the therapist offering structure, emotional support and practical tools.

Initial safety planning

Early in therapy the therapist may work with you to create a safety plan that lists warning signs, coping strategies, people to contact and local emergency resources. This plan is a practical tool to use when stress escalates and can give you options other than self-harm. You should feel able to review and update the plan as you learn what helps most.

Common therapeutic approaches used for self-harm

Several therapeutic models are commonly used to help people who self-harm. Cognitive Behavioural Therapy, or CBT, focuses on identifying unhelpful thoughts and behaviours and developing alternative ways of thinking and acting. CBT often teaches practical skills for emotion regulation and for reducing the urge to self-harm.

Dialectical Behaviour Therapy, DBT, is a structured approach that combines acceptance and change strategies. It emphasises skills in distress tolerance, emotion regulation and interpersonal effectiveness. DBT has specific techniques aimed at reducing self-harm and building a life worth living one step at a time.

Compassion-Focused Therapy helps you develop a kinder relationship with yourself. For many people who self-harm, shame and self-criticism are central, and learning to respond with compassion can reduce the need to punish oneself. Mentalisation-based therapy focuses on understanding your own and others' thoughts and feelings and can be useful where relationships and emotional regulation are closely linked with self-harm.

Acceptance and Commitment Therapy teaches you to notice thoughts and feelings without being driven by them, and to take action in line with your values. Psychodynamic approaches explore how past experiences shape current patterns, including the ways you relate to yourself and others. A therapist may draw on more than one of these approaches depending on your needs and preferences, and some people find group work or skills-based workshops helpful alongside individual therapy.

How online therapy works for self-harm support

Online therapy offers many people a practical route to specialist support, particularly if there are barriers to attending in-person appointments. You may have video sessions, telephone appointments or text-based contact depending on the therapist's service. The first online sessions often mirror face-to-face work - assessment, safety planning and agreement of goals - but with extra discussion about what to do in a crisis and who local emergency contacts are. Your therapist will ask for your location and an emergency contact to make sure you can access local help quickly if needed.

The online setting can be particularly useful if you want access to therapists who specialise in self-harm but are not near where you live. It also allows more flexible scheduling around work or study. On the other hand, some people prefer in-person sessions for hands-on emotional support, and online therapy may not be suitable if you are at very high risk. Talk openly with potential therapists about how they manage risk remotely and what adjustments they can offer to make sessions feel safe and effective for you.

Tips for choosing the right therapist for self-harm

Start by checking a therapist's professional registration and training. In the UK look for registration with recognised bodies such as BACP, HCPC or NCPS and ask about specific training in self-harm and in any therapeutic approaches you prefer. Experience with trauma-informed practice and ongoing clinical supervision are important indicators that the therapist keeps their practice up to date.

Consider practical questions alongside professional qualifications. Think about the therapy format you prefer, whether you need evening or weekend appointments and what you can afford. Read profiles to see how therapists describe their approach and values and whether their style feels like a good fit. It is reasonable to ask potential therapists about how they handle safety planning, what they do in a crisis and how they work with other professionals, such as your GP or local mental health services, if that becomes necessary.

Trust and rapport matter. Many therapists offer an initial consultation or brief call so you can get a sense of whether you feel understood and heard. If a therapist’s way of working does not feel right, it is okay to try someone else. Therapy is a personal relationship and finding the right match can make a real difference to your experience and progress.

Finding immediate support and next steps

If you are considering therapy, you might start by discussing options with your GP, seeking a referral, or contacting a local mental health service for guidance. When you are ready to contact a counsellor on this site, look at profiles for details of registration, therapeutic approach and availability. If you are in immediate danger, call 999 or go to your nearest A and E. Outside of immediate crisis, a qualified therapist can work with you to develop safer coping strategies, address underlying issues and support gradual recovery at a pace that suits you.

Reaching out for help is a significant step. Whether you choose online or face-to-face therapy, the right practitioner will listen without judgement, help you create practical plans for safer moments and support you to build alternatives to self-harm over time. Take your time to compare options, ask questions and choose someone who helps you feel understood and hopeful about change.