Barriers and responses to the disclosure of non-suicidal self-injury: a thematic analysis

ABSTRACT

Non-suicidal self-injury (NSSI) is a prevalent behaviour among youth and young adults, yet little is known about their NSSI disclosure experiences. Disclosure of NSSI may have important implications for accessing treatment and eliciting support from family and friends; it may also highlight where efforts are needed to combat potential barriers (e.g. shame). This study sought to better understand the factors that facilitate and discourage NSSI disclosure in a sample of undergraduate students as well as gather a richer understanding of young adults’ experiences disclosing NSSI. To do this, a thematic analysis of interview transcripts with 17 students (16 women and 1 man) was conducted. Themes related to barriers to disclosure (shame, concern about others) and disclosure recipients’ responses (silence/avoidance, understanding) were explored. Results underscored the central role of shame in NSSI disclosures, both as an experience impacting the difficulty and likelihood of disclosure and as a potential consequence of receiving avoidant responses to disclosure. Among the clinical implications discussed is the import of initiatives to reduce NSSI stigma and foster supportive and understanding responses to NSSI disclosures.

KEYWORDS:

• Non-suicidal self-injury
• NSSI
• disclosure
• qualitative
• young adults
• youth

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Notes on contributors

Shaina A. Rosenrot

Shaina A. Rosenrot, PhD, C.Psych. is a clinical psychologist registered with the College of Psychologists of Ontario. She is currently a staff psychologist with the Eating Disorders Residential Program at Ontario Shores Centre for Mental Health Sciences and a school psychologist at the Toronto District School Board. Her doctoral dissertation focused on the experience of non-suicidal self-injury disclosure, including factors that promote and deter disclosure and the role of scarring from self-injury in the disclosure process. She has published articles on her research examining non-suicidal self-injury and has presented research at several national and international conferences.

Stephen P. Lewis

Stephen P. Lewis, PhD is an Associate Professor in the Department of Psychology at the University of Guelph. His areas of expertise are self-injury and youth mental health, on which he has published and presented widely. His research has been featured in national and international media outlets, including The New York Times, Time, USA Today, ABC, CBS, The Globe and Mail, and the BBC. Dr Lewis is co-author of the book Non-Suicidal Self-Injury, which is part of the Advances in Psychotherapy series by the Society of Clinical Psychology (APA Division 12). He is an invited member and current president of International Society for the Study of Self-Injury (ISSS).