Smith-Gowling, Claire and Hodge, Suzanne and Knowles, Susan (2016) Towards an understanding of the self-harming behaviours of vulnerable young people. PhD thesis, Lancaster University.
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Abstract
Relatively little is known about the factors associated with young people’s engagement in self-harm. Given the existing vulnerabilities associated with being lookedafter, the first section of this thesis aimed to examine and synthesise the empirical literature investigating the psychosocial risk factors associated with self-harm and suicide among looked-after children (LAC). Systematic appraisal of fourteen studies highlighted several demographic, socio-environmental and psychological factors thought to place LAC at an increased risk of self-harm and suicidal behaviour. The findings have significant implications for intake assessment, treatment planning, service delivery, and staff training to address the complex emotional and behavioural needs of LAC. Given the potential risk that exposure to the self-harm of others might have on engagement in self-harm, the second section of this thesis aimed to explore, using Interpretative Phenomenological Analysis (IPA), how adolescents made sense of the selfharm of others, and how, if at all, the self-harm of others influenced their own behaviour and well-being. Eight young people, resident at one of two adolescent inpatient units, were interviewed and five themes emerged from the interview data: ‘Exposure to self-harm’, ‘An unpleasant environment’, ‘Helper vs helped’, ‘Separation from the attention seekers’, and ‘Competing for authenticity’. Self-harm prevention efforts aimed towards reducing the social transmission and stigma surrounding self-harm were discussed. The final section of the thesis adopts a critical and reflective stance to consider the decision-making processes regarding the thesis topic including the rationale for the study and the chosen methodology, and the practical and procedural challenges encountered during the course of the research, such as ethics approval processes and recruitment difficulties. The appraisal then goes onto review the researchers’ clinical reflections on the applications of the thesis findings, and the impact of the research on her journey through doctoral training.