Therapist's Self Harm protocol?

[soysauce]

There is no clear cut answer to my question online. (Oh, a pun...this thread is starting out great.)

In most cases from what I've read or heard from people first hand, is that their Therapist's went as far as reporting self harm to a parent(s) or legal guardian. Therapist's have a legal right, to keep everything confidential between them and the client except for cases where they believe, "There patient is a danger to themselves or others around them."
Self harm is a grey area, since only 10% of people who try ending there life through cutting succeed. And those are suicide stats. 18% of the population have harmed themselves intentionally at least once in there lives.

I won't digress too deeply into my situation, but to put it shortly. I've been struggling with self harm on and off for 11 years. I was 8 months clean but relapsed 2 months ago and now things have grown worst than they have in all the 11 years. This Friday will be my first appointment ever to see a Therapist. Mid 2017 was the first time I told my father about this.
My ex-boyfriend had wanted to send me to a Mental Institution, my sister wants me on Antidepressants, my father and I are both in agreement that we weren't very fond of those options. But- my father also doesn't want me to share that I self harm with my Therapist. I understand his views, I should get a feel for the Therapist before I go sharing such a thing.

I am at the point though, where I feel I am out of options. I need to talk to someone about everything that has gone on for 11 years, and if I don't soon, I fear the outcome.

Anyone know how a Therapist would react to a new client who Self Harms and more?

[ErickaUnlimited]

How they will react? It'll depend on the therapist, your past medical/psychiatric history and your age as well (minor/adult). Mostly, unless you appear to be in immediate danger to yourself or others, it'll just be something you two work on in one manner or another. If you're in immiate danger, then the ramifications can escalate (bringing in parents, instituionalization, medication...ect), but, again, that depends on a whole slew of factors.

Not really something I'll dive into about myself, but as a long-time self-harmer, don't keep it to yourself, regardless if you're worried about the outcome. These things are always better out in the open with a trusted therpist/psychiatrist than bottled up and left for you to deal with on your own. Talk to your therapist; they're adivse will be far better than anyone's here as they are trained in this field.

[OfficeSpider]

Is that the same as a psychologist?

[soysauce]

ErickaUnlimited님이 먼저 게시:

How they will react? It'll depend on the therapist, your past medical/psychiatric history and your age as well (minor/adult). Mostly, unless you appear to be in immediate danger to yourself or others, it'll just be something you two work on in one manner or another. If you're in immiate danger, then the ramifications can escalate (bringing in parents, instituionalization, medication...ect), but, again, that depends on a whole slew of factors.

Not really something I'll dive into about myself, but as a long-time self-harmer, don't keep it to yourself, regardless if you're worried about the outcome. These things are always better out in the open with a trusted therpist/psychiatrist than bottled up and left for you to deal with on your own. Talk to your therapist; they're adivse will be far better than anyone's here as they are trained in this field.

From someone who knows it first hand, I appreciate the well written and informed response. Telling people was a huge step for me, I'm glad to know it was a good step.

[BaerSLK]

Guitarizt님이 먼저 게시:

Anyone know how a Therapist would react to a new client who Self Harms and more?

ErickaUnlimited님이 먼저 게시:

How they will react? It'll depend on the therapist, your past medical/psychiatric history and your age as well

No, in this case is not much space for personal decisions, in case of self harm it is required to take the patient in an asylum for therapy in case of suicidal danger.
You can't chose any different, because if he/she kills himself by self harm and you know it as doctor, you get serious problems.

[ErickaUnlimited]

BaerSLK님이 먼저 게시:

Guitarizt님이 먼저 게시:

Anyone know how a Therapist would react to a new client who Self Harms and more?

ErickaUnlimited님이 먼저 게시:

How they will react? It'll depend on the therapist, your past medical/psychiatric history and your age as well

No, in this case is not much space for personal decisions, in case of self harm it is required to take the patient in an asylum for therapy in case of suicidal danger.
You can't chose any different, because if he/she kills himself by self harm and you know it as doctor, you get serious problems.

There's plenty of space for personal decision. Again, mandatory hospitalization depends on a variety of factors, many of which we don't know given the OP's write up and many we'll never know so offering sound advice to talk to his/her therapist is the best anyone can offer here.

Self-harm doesn't always mean immediate hospitalization, BaerSLK.

[-V-]

BaerSLK님이 먼저 게시:

Guitarizt님이 먼저 게시:

Anyone know how a Therapist would react to a new client who Self Harms and more?

ErickaUnlimited님이 먼저 게시:

How they will react? It'll depend on the therapist, your past medical/psychiatric history and your age as well

No, in this case is not much space for personal decisions, in case of self harm it is required to take the patient in an asylum for therapy in case of suicidal danger.
You can't chose any different, because if he/she kills himself by self harm and you know it as doctor, you get serious problems.

^^^^
Self-harm constitutes "a danger to one's self."

[Washell]

Guitarizt님이 먼저 게시:

Anyone know how a Therapist would react to a new client who Self Harms and more?

Your profile mentions you're in the US different states have different laws and even within states there differences between therapists/mental health care centers on how it's handled. You should google for a mental health forum in your area or state, and ask there if you want a sound answer.

That said, mandatory admissions are problematic (expensive, few beds available) everywhere and the threshold is sooner on the (too) far end than on admitting every teen/young adult for a few cuts.

In general, cutting is a coping strategy and therapist tend to be more interested in dealing with the underlying issues so you no longer feel the need to cut than deal with it directly, hence advice like,

so^1ph^7ia님이 먼저 게시:

Something which may surprise you a bit is that some therapists might say to always use clean blades when you are doing it.

They try to reduce the damage of the symptoms while dealing with the disease. I wouldn't hold back, giving them a full picture will only help your recovery progress faster.

-V-님이 먼저 게시:

Self-harm constitutes "a danger to one's self."

Be that as it may, it's such a common coping strategy, it's not doable to forcibly institutionalize all of them.

[-V-]

Washell님이 먼저 게시:

-V-님이 먼저 게시:

Self-harm constitutes "a danger to one's self."

Be that as it may, it's such a common coping strategy, it's not doable to forcibly institutionalize all of them.

Coping strategy? Yes.
Positive or Healthy coping strategy? No.

Doable to put them all away? No.
Profitable to put away as many as possible? Yes.

[HeartoftheTiger]

Speaking from experience, sometimes, there is a liability concern. So if there some definitive self-harm going on, people will have no choice but to report it. Some states will demand it. Local LEOs will chose to err on the side of caution. The ones here are pretty cool about it.

I've been escorted to an ER over some already-healed scabs (a few days' old), looked at and given a Q&A, then given the "all-clear" and the same LEO drove me back. The LEOs are the better option. (Ambalances *will* charge you, regardless of your financial status.)

On the few times where I had to be held, it depends on the places. There are some units in actual hospitals are almost like any other hospital floor (Outside of the locks and keypads to the exits, of course), ready access to a phone, a menu where you mark down what you want for the next day's meals, and a decent library. Some are almost like holding pens, just a few levels about the infirmery of your local county pen with the food slightly better then what's in an inner-city elementary school cafeteria. The local laws are absolute: three days. No one I know has been released under that time-frame, even AMA (Against Medical Advice).

[-V-]

so^1ph^7ia님이 먼저 게시:

-V-님이 먼저 게시:

^^^^
Self-harm constitutes "a danger to one's self."

The quote you are agreeing with seems to be saying that if you deliberately harm yourself in any way at all you will 100% be put into an "asylum", with no choice in the matter at all. This is simply not the case at all, at least where I am from.

It is the case where I am from, and the laws are very clear. Most "inpatient therapy" (not the asylum) is run by for-profit medical corporations that are very happy to hold as many sick or healthy people for as long as insurance will pay for them.

There are different degrees of danger to one's self. Going to a party and taking illegal substances could be considered a danger to one's self, but the government do not throw everyone who has ever done that into an "asylum" for "profit"

No, they send them to prison. Only rich people can go to inpatient therapy.

It really is not profitable to build holdings and keep people against their will, feed them 3 times a day AND give them medication/therapy sessions, which are both a part of being held in an institution. Not to mention paying the 24 hour staff to work there.

They get goverment subsidies for each patient, plus what insurance is paying them. It's plenty profitable, the 24hr staff are minimum wage no-training mental dropouts.

You may face being sectioned under the mental health acts if you seriously hurt yourself, or a genuine suicide attempt, some will even take multiple times, but again, you will not be put into an "asylum" for scratching yourself. It is usually offered first a voluntary stay if you do not respond much to medication and/or therapy and involuntary only when the "danger to one's self" is completely out of control.

Very different in my country, but I'm glad to see that yours is much smarter about how it treats people. Here in the US, people are just dollar signs.

[soysauce]

Thanks for all the input everyone. For the first time, I am seeking help. From all your experiences and knowledge, I can gain some insight of what kind of help there is to offer.

[Incredible HLK]

Honestly, you can always ask your therapist what the protocols are. If they can't prove you are currently doing anything or have thought about it, they can't take any action.

If asking your therapist is weird or creepy, ask the receptionist if they have any forms on it. Usually during your intake you'll sign something (or your parents will) that explains any obligations they have.

[ErickaUnlimited]

Guitarizt님이 먼저 게시:

Thanks for all the input everyone. For the first time, I am seeking help. From all your experiences and knowledge, I can gain some insight of what kind of help there is to offer.

Glad to hear it. Best of luck to you, OP.