Responding to young people who disclose self-harm : A discourse analysis of an on-line counselling service

Rowley, Philip and McDermott, Elizabeth and Hodge, Suzanne (2020) Responding to young people who disclose self-harm : A discourse analysis of an on-line counselling service. PhD thesis, Lancaster University.

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Abstract

There is a concerning prevalence of self-harm in young people and most young people who self-harm do not seek help. Little is known about what facilitates help-seeking in this population but evidence suggests that many do go on-line to talk about their experience. One-to-one internet ‘chat’ sessions with an adult counsellor are an increasingly accessible and popular form of help but this type of support is under-researched and the evidence base for its effectiveness is weak. Help-seeking for mental health problems is not a linear process and young people have to navigate complex interpersonal and intrapersonal barriers in order to take up a help-seeking position. Qualitative research that pays close attention to the dynamic negotiation of the help-seeking process between on-line counsellors and young people who disclose self-harm can increase our understanding of these complex and highly sensitive interactions. The aim of this study is to investigate how counsellors respond to disclosures of self-harm by using critical discursive psychology to analyse archived transcripts of 19 separate counselling interactions from an on-line counselling service for young people aged 18 or younger. The Foucauldian concepts of governmentality and pastoral power are used to explore on-line counselling sessions as a potential site for the regulation of risky behaviours and for encouraging young people to find safer ways of managing themselves. The tools of interpretative repertoires, ideological dilemmas and subject positions are utilised to examine some of the ways in which competing discourses of mental health are negotiated at the local interactional level. I identify three key interpretative repertoires (“opening up,” “the divided self” and “keeping yourself safe”) and analyse the ways in which these repertoires create different subject positions for the counsellors and young people. The analysis demonstrates that the pastoral power of the on-line counsellor does not act uniformly on the self-harming subject and suggests that tensions and contradictions in counselling interactions may lead to some help-seeking interactions getting stuck. I conclude that the ways in which these repertoires are negotiated can produce or shut down important help-seeking opportunities. This thesis is the first study to look at on-line youth counselling through a Foucauldian lens and adds to our understanding of how pastoral power operates through on-line sites of governmentality. The findings have important consequences for on-line counselling practices and, more broadly, for our understanding of youth help-seeking for self-harm.