Individuals’ experiences of adolescent self-harm

Adolescent self-harm has been recognised as an international healthcare concern. Given the challenge that self-harm presents for adolescents and professionals, this thesis aimed to provide a more in-depth understanding of the experiences of adolescents who self-harm and the professionals working with them. Chapter one is a systematic review investigating qualitative research exploring adolescents’ experiences of self-harm. Twelve studies were identified through electronic database and manual searches. Building on the individual studies, the Thematic Synthesis identified the paradoxical nature of self-harm: Control (self-harming to gain control yet experiencing self-harm as uncontrollable), Purpose (self-harm as a form of selfpreservation or self-punishment), and Others (stigmatising and helpful responses). Policy and clinical implications concerning increased education regarding self-harm and the paradoxes are discussed. Limitations and research recommendations are also considered. Chapter two is a qualitative research study that used Interpretative Phenomenological Analysis to explore the lived experiences of nurses who work with adolescents who self-harm within community Child and Adolescent Mental Health Services (CAMHS). Ten nurses participated in semi-structured interviews. The analysis led to the identification of two superordinate themes, each with two subthemes. The findings suggest that CAMHS nurses experience a range of personal and professional conflicts in their work with adolescents who self-harm, and the systems around them. All nurses described a process of development, learning to manage the conflicts and emotions they experience, as well as gaining confidence and understanding through experience. Policy and clinical implications are considered, including supervision and training to understand and manage these conflicts. Limitations and research recommendations are also discussed. Chapter three is a reflective account of the author’s experience of conducting this research. The author discusses the value of reflective practice, and reflexivity within the research process, and their position as a researcher and ‘partial insider’. The author reflects on their experiences and personal and professional development, and how these paralleled the experiences described by the research participants