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“I can’t escape my scars, even if I do get better”: A qualitative exploration of how adolescents talk about their self-harm and self-harm scars during cognitive behavioural therapy for depression

Kristen, A; Lecchi, T; Loades, ME; Midgley, N; (2024) “I can’t escape my scars, even if I do get better”: A qualitative exploration of how adolescents talk about their self-harm and self-harm scars during cognitive behavioural therapy for depression. Clinical Child Psychology and Psychiatry 10.1177/13591045241241348. (In press). Green open access

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Abstract

Emerging evidence indicates that perceptions of self-harm behaviours and self-harm scars may thwart recovery from depression, yet limited research has explored adolescent accounts of their self-harm and scars during therapy. This study sought to explore how adolescents describe their self-harm behaviours and scars during Cognitive Behavioural Therapy (CBT) and explore the sociocultural discourses that may influence these descriptions. The participants were six female adolescents (aged 14-17 years old) with clinical depression, who were engaging in self-harm. All participants accessed CBT as part of clinical trial evaluating three psychological treatments for major depressive disorder in Child and Adolescent Mental Health Services. Audio-taped CBT sessions were analyzed using discourse analysis. Within CBT sessions, adolescents drew upon stigma discourses in talking about their self-harm. Adolescent also described their self-harm scars as shameful and stigmatizing, and as "proof" of the legitimacy of their depression. It is important for CBT practitioners to understand the context of sociocultural discourses around self-harm behaviours and self-harm scars, which are reflected in how adolescents with depression describe these within therapy and may serve to maintain distress. The study indicates that awareness of use of language and intersecting sociocultural discourses can inform CBT practice.

Type: Article
Title: “I can’t escape my scars, even if I do get better”: A qualitative exploration of how adolescents talk about their self-harm and self-harm scars during cognitive behavioural therapy for depression
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1177/13591045241241348
Publisher version: https://doi.org/10.1177/13591045241241348
Language: English
Additional information: This work is licensed under a Creative Commons Attribution 4.0 International (CC BY 4.0) License.
Keywords: Adolescence, cognitive-behavioural therapy, discourse, self-harm, stigma
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
URI: https://discovery-pp.ucl.ac.uk/id/eprint/10190123
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