Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Mar;98(1):133-148.
doi: 10.1111/papt.12567. Epub 2024 Dec 19.

"It's like I used to share a room with self-injury, but now it lives next door": Exploring experiences of naturalistic improvement in non-suicidal self-injury

E Hudson  1   2 , S Hartley  1   3 , P J Taylor  1
Affiliations

"It's like I used to share a room with self-injury, but now it lives next door": Exploring experiences of naturalistic improvement in non-suicidal self-injury

E Hudson et al. Psychol Psychother. 2025 Mar.

Abstract

Background: Many people who engage in non-suicidal self-injury (NSSI) do not access support from health services, and evidence regarding the effectiveness of interventions is mixed. Despite this, NSSI prevalence rates decrease from adolescence into adulthood. Little is known about what helps alleviate difficulties with NSSI beyond psychological or medical intervention. This study sought to understand factors influencing naturalistic improvements in NSSI.

Methods: Semi-structured interviews were conducted over video call with 16 participants who believed their difficulties with NSSI had improved due to factors not attributed to psychological or medical intervention. Interviews were audio recorded and transcribed verbatim for analysis.

Results: A reflexive thematic analysis revealed four main themes. Increased insight into NSSI experiences promoted self-compassion and self-acceptance and enabled participants to reflect on the conflicting role of NSSI. Safe and supportive relationships helped alleviate loneliness, and developing alternative coping strategies enhanced feelings of control over self-injury. Creating a life guided by personal values promoted independence, choice, and self-esteem.

Conclusions: The findings of the study highlight several internal and external naturalistic processes deemed meaningful in improving difficulties with NSSI. Clinical implications include the importance of developing and embedding these approaches within services and interventions to improve outcomes for individuals who self-injure while promoting a person-centred approach.

Keywords: NSSI; qualitative; recovery; self‐injury.

PubMed Disclaimer

Conflict of interest statement

None.

Similar articles

See all similar articles

References

    1. American Psychiatric Association . (2013). Diagnostic and statistical manual of mental disorders: DSM‐5 (Vol. 5). American psychiatric association.
    1. Andover, M. S. (2012). Advances in conceptualization and treatment of nonsuicidal self‐ injury (NSSI): Introduction to the special issue. Journal of Cognitive Psychotherapy, 26(4), 283–286. 10.1891/0889-8391.26.4.283 - DOI - PMC - PubMed
    1. Ayton, A. , Rasool, H. , & Cottrell, D. (2003). Deliberate self‐harm in children and adolescents: Association with social deprivation. European Child & Adolescent Psychiatry, 12, 303–307. 10.1007/s00787-003-0344-0 - DOI - PubMed
    1. Bentley, K. H. , Nock, M. K. , & Barlow, D. H. (2014). The four‐function model of nonsuicidal self‐injury: Key directions for future research. Clinical Psychological Science, 2(5), 638–656. 10.1177/2167702613514563 - DOI
    1. Best, M. W. , Law, H. , Pyle, M. , & Morrison, A. P. (2020). Relationships between psychiatric symptoms, functioning and personal recovery in psychosis. Schizophrenia Research, 223, 112–118. 10.1016/j.schres.2020.06.026 - DOI - PubMed