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Alternatives to Self-Harm: Coping Strategies for Adolescents


Dealing with negative emotions and traumatic situations isn't easy – especially for teenagers.

Teens are halfway between adults and children. They're still learning to live in their own skin while managing to cope with new situations and experiences.

Why are teens and self-harm so connected?

Accessibility probably has a lot to do with it.

Adults don't always cope with negative emotions in healthy ways either – sometimes they turn to alcohol and drugs, lash out, or resort to self-destructive behaviors.

However, teens don't have the same resources as adults, so they often resort to self-harm as an outlet for overwhelming stress.

That's why it's so important to develop coping skills and find an alternative to self-harm.

Teens and Self-Harm: What Qualifies?

Movies would have you believe that when it comes to teens and self-harm, you need to look out for one specific type: arm cutting.

The truth is: there are several types of self-harm and some people may do a better job at disguising their symptoms than others.

It's important to know what qualifies as self-harm.

In many cases, a teen may not necessarily intend to harm themselves. Instead, the action acts as a compulsive behavior to soothe anxiety or provide an endorphin rush similar to drugs and alcohol.

  • Cutting with sharp objects
  • Pinching or scratching with fingernails or other objects
  • Ripping, picking, or tearing the skin – including the face, cuticles, scalp, or chest
  • Compulsive hair-pulling
  • Rubbing sharp objects on the skin
  • Picking scabs or interfering with healing
  • Carving or burning letters or symbols into the skin
  • Impact such as punching or bashing objects
  • Nail biting to the point of bleeding or injury

As you can see, self-harm takes many forms: anything that involves intentional mutilation qualifies as self-harm.

Identifying Self-Harm in Teens

Most parents already know to look out for deliberate self-harm such as cutting with razors or other objects. These parents may write-off chronic hair pulling or cuticle biting as a quirk or compulsive behavior the teen will eventually outgrow.

It's important to take all types of intentional mutilation seriously so a teen can develop self-harm coping skills. Identifying and treating the psychological force behind the self-harm are crucial.

Without taking action, even minor self-harm can manifest into other self-destructive actions such as substance use disorder as well as severe anxiety or depression. Self-harm can also result in scarring, infections, and other unintended consequences.

As mentioned above, a teen may not intend to harm themselves. In these cases, they may pull their hair or pick scabs openly without trying to hide the action.

Look at your teen's behavior objectively.

In other cases, the teen may be ashamed or feel guilty. Here are some warning signs you may want to watch out for:

  • A recent traumatic event such as a fight or emotional abuse
  • Injuries they can't or won't explain
  • Distancing themselves from friends and family members
  • Withdrawing from social activities
  • Feelings of guilt and worthlessness
  • Feelings of anxiousness, stress, or worry
  • High levels of pressure from school or family responsibilities
  • Other mental health conditions such as depression, substance use, or anxiety
  • Drug or alcohol abuse

Sometimes it's normal for teens to withdraw or pull away from previously close relationships with parents. Find an adult they (and you) can trust to engage in supportive conversations about their mental wellbeing, relationships, and activity.

Building Self-Harm Coping Strategies

Building self-harm coping strategies starts with identifying and treating the root cause of the harm: why are they harming themselves in the first place?

From there, teens will learn to understand psychological triggers, their thought process, and how their response to stress eventually translates into physical harm.

Each person is unique. Self-harm help should provide a personalized approach catered to your teen's specific mental health struggle.

A comprehensive treatment plan may include:

  • Identifying when self-harm happens and why
  • Avoiding situations that make the teen want to engage in self-harm
  • Managing stress, negative emotions, and overwhelming thoughts
  • Acknowledging that not all thoughts need to become actions
  • Cognitive behavioral therapy to address thoughts and actions while developing self-harm coping strategies
  • Medication for anxiety, depression, bipolar disorder, obsessive compulsive disorder, and other mental health conditions
  • One-on-one therapy
  • Group therapy

The goal of any treatment plan is to address underlying psychological issues and develop healthy self-harm coping skills.

Finding an Alternative to Self-Harm

A big part of building self-harm coping skills is finding an alternative to the self-harm itself.

This is much easier said than done.


Finding an alternative often results in a person simply replacing one harmful action with another. That's why developing coping skills and understanding the cognitive process is so crucial: to avoid all harmful actions.

Nonetheless, teens still need to find a way to occupy their mind and hands when the urge to self-harm strikes. Here are some healthy alternatives to self-harm:

  1. Re-organizing your room or workplace.
  2. Ripping up pieces of paper or break plastic bottles
  3. Kickboxing and high-impact physical activity
  4. Playing a computer game
  5. Self-pampering such as a bath or massage
  6. Playing with animals
  7. Doing something nice for someone else
  8. Cooking or baking something delicious
  9. Talking to someone you trust
  10. Beginning a task you've been putting off
  11. Blowing up and popping balloons

Self-Harm Help for Teens at San Antonio Behavioral

At San Antonio Behavioral Healthcare Hospital, we provide personalized mental health services for teens in either an inpatient or partial hospitalization setting.

Our programs are designed for adolescents between the ages of 9 and 17 who struggle with mental health conditions such as self-harm, substance abuse, and other psychological disorders.

We provide a structured and safe environment to help teens reduce symptoms by developing healthy self-harm coping skills. If you or a loved one are struggling with mental health issues or in need of learning self-harm coping strategies, contact San Antonio Behavioral Healthcare Hospital today or call at 210-541-5350.