Written by- Twinkle Garg, Registered Psychologist

Self-harm often emerges when adolescents feel overwhelmed by emotions they don’t know how to handle. It can serve as a coping mechanism by offering temporary relief from emotional distress, allowing the teen to feel a sense of control, or acting as a distraction from painful thoughts. For some, it is a way to express internal pain that feels too difficult to verbalise. While the behaviour may seem alarming, it is usually a sign that a young person is struggling with emotional regulation rather than an attempt to seek attention.

How can you identify signs of self-harm and open conversations with teens?

Identifying self-harm can be challenging because many adolescents go to great lengths to hide their injuries. They may feel ashamed, afraid of being judged, or worried about upsetting their family. This makes it especially important for parents and caregivers to pay attention to both physical and emotional cues.

Common physical signs may include:

• Unexplained cuts, scratches, bruises, or burns
• Marks that appear repeatedly, in similar patterns
• Wearing long sleeves or pants even in hot weather
• Avoiding activities where their skin may be exposed, such as swimming or sports

Behavioural and emotional signs can be more subtle. Teens may:

• Withdraw from friends and family
• Spend long periods alone, especially in bathrooms or bedrooms
• Show sudden changes in mood, such as irritability, sadness, or emotional numbness
• Become secretive about their routines or belongings
• Express feelings of hopelessness, worthlessness, or being overwhelmed

These behaviours don’t necessarily confirm self-harm but they do indicate a young person may be struggling and needs gentle support.

When you’re ready to start a conversation, approach with warmth and curiosity rather than fear or accusation. A confrontational tone can cause a teen to shut down. Instead, focus on what you’ve noticed and how you feel. You might say:

• “I’ve noticed you seem really overwhelmed lately, and I’m worried about you.”
• “You don’t have to talk if you’re not ready, but I’m here for you whenever you need me.”
• “It looks like you’ve been carrying a lot on your own. How can I support you?”

The aim is not to demand answers, but to create a safe, calm space where your teen feels heard and valued. Reassure them that they are not in trouble and that you want to understand what they’re going through. If the teen opens up, listen quietly without interrupting or trying to “fix” things immediately.

Opening the door to compassionate conversation is often the first step toward helping a young person access appropriate mental health support and begin their healing journey.

What is the role of therapy in addressing the underlying causes and providing healthier coping tools?

Therapy offers adolescents a structured, supportive environment to explore the reasons behind their self-harming behaviours. A psychologist can help identify underlying issues such as anxiety, depression, trauma, bullying, or perfectionistic pressures. Approaches like Cognitive Behavioural Therapy (CBT) and Dialectical Behaviour Therapy (DBT) teach essential skills for emotional regulation, distress tolerance, and healthier coping strategies. Therapy empowers young people with tools to manage their feelings safely and fosters long-term resilience.

Next steps:

At Spencer Health, our team is deeply committed to providing early, compassionate, and evidence-based mental health support for young people. We offer comprehensive adolescent therapy services, along with specialised assessments for Autism and ADHD. Our multidisciplinary team: consisting of psychologists, speech therapists, and paediatricians works collaboratively to ensure each young person receives holistic care tailored to their unique needs.

If you’d like to learn more about our assessment pathways or therapy services, please feel free to contact us at enquiries@spencerhealth.com.au. Early support can make a significant difference in a young person’s emotional development, mental health, and overall quality of life. At Spencer Health, we are here to walk alongside families every step of the way.