Some young people find it possible to utilise less harmful techniques to provide the function sought from self-injury. The following are examples that may be considered with a young person, particularly during the care planning process.

Alternatives to self-injury

• physical activity eg: running, punching bag
• relaxation eg: controlled breathing
• stamping on empty cans, throwing rocks into water
•  carrying a safe object eg: teddy bear, rock, item of clothing
•  squeeze ice cubes between fingers until they go numb
•  yell, scream, sing loudly
•  write about or draw the thoughts, feelings
•  eat a chilli, or something really hot
•  snap wrist with a rubber band
•  visualisation of self-injury or alternatively a ‘safe’ space
•  apply Vapour Rub or Deep Heat under nose
•  talk to someone

Many of these ideas are consistent with the DBT approach to distress tolerance.