How to reduce non-suicidal self-harm in adolescents?
Non-suicidal self-injury (NSI) refers to intentional self-harm —such as cutting, burning, or hitting oneself—without the intent to die. However, the lack of suicidal intent does not diminish the seriousness of these behaviors.
Several studies show that non-suicidal self-injury is associated with significant emotional distress and suffering , difficulties regulating emotions, and an increased risk of suicidal behavior in the future. Therefore, in recent years it has become one of the main mental health concerns in childhood and adolescence worldwide.
It is estimated that between 16% and 22% of adolescents in the general population have engaged in some form of self-harm during their lifetime. In clinical populations, this percentage can reach 50–80%, according to various published studies. Furthermore, even in the absence of explicit suicidal intent, data indicate that up to 70% of young people who self-harm have attempted suicide at some point. (Calvo et al., 2022)
When and why do non-suicidal self-harms appear?
Non-suicidal self-injury typically appears early, usually between the ages of 12 and 14 , and reaches its peak frequency in late adolescence and early adulthood. Recent studies have established its onset and peak expression during a key developmental stage encompassing the transition from childhood to adulthood, termed " Transition Age Youth (TAY)," which spans from ages 14-15 to 25-26. This is a crucial developmental stage, marked by significant emotional, social, and neurobiological changes , during which many skills related to emotional regulation, personal identity, and autonomy are consolidated.
But at the same time, it is a stage of high vulnerability for the onset and chronicity of mental health problems. When self-harm persists in this phase, it is associated with:
- Higher risk of chronic emotional distress.
- Difficulties in interpersonal relationships.
- Worse academic and social functioning.
- Higher likelihood of developing more complex mental disorders in adulthood
In this context, the primary function of these behaviors is understood as a strategy to alleviate intense emotional distress, reduce anxiety, or manage emotions that are difficult to tolerate. In the short term, they may generate a sense of relief, but in the medium and long term, they tend to perpetuate the problem, increase impulsivity, and reinforce unhealthy coping patterns.
What is the TaySH Program and what does it consist of?
The TaySH (Transition Age Youth Self-Harm) Program is a psychotherapeutic intervention developed by the Mental Health Service of the Vall d'Hebron University Hospital (HUVH) in Barcelona. It is a manualized, structured, and brief program specifically designed to address non-suicidal self-injury and emotional dysregulation in adolescents and young adults, on an individual, outpatient basis. Unlike other psychotherapeutic approaches, the TaySH Program treats non-suicidal self-injury as a core problem requiring specific intervention, not as a secondary symptom. (Calvo et al., 2021)
This program integrates strategies from two models with extensive scientific evidence in the treatment of self-harm: dialectical behavior therapy (DBT), especially effective in working with emotional regulation, discomfort tolerance and impulsive behaviors; and cognitive behavioral therapy (CBT), which helps to identify and modify maladaptive thoughts and behaviors.
Unlike other psychotherapeutic approaches, the TaySH Program treats non-suicidal self-injury as a core problem requiring specific intervention, not as a secondary symptom.
The TaySH Program is delivered in twelve weekly outpatient sessions , organized into four main modules with clearly defined therapeutic objectives, which include:
- Psychoeducation.
- Emotional regulation training.
- Learning alternatives to harm.
- Psychoeducational sessions with families.
The main points of this program are as follows:
- Understanding non-suicidal self-injury. In its first phase, the program focuses on psychoeducation. The goal is for the individual to understand what non-suicidal self-injury is, its function, and what factors trigger and maintain it. This phase is key to reducing guilt and stigma, and to increasing motivation for change.
- Identifying triggers and risk signs. This module focuses on the early detection of emotional distress and the recognition of warning signs that allow young people to intervene before self-harm occurs.
- Learning to regulate emotions. This is one of the program's central pillars: emotional regulation training. The goal is not to eliminate intense emotions, but to learn to manage them in a more adaptive way.
- Building alternatives to self-harm and consolidating changes. In the final phase of the program, the use of alternatives to self-harm is reinforced, and the generalization of learned skills to daily life is addressed.
The program also includes three psychoeducational sessions with families , aimed at better understanding non-suicidal self-harm, reducing punitive or invalidating responses, and learning how to support the individual more effectively. Family involvement is a key element in sustaining therapeutic changes outside the clinical setting.
Socio-educational intervention with young people who self-harm
Results of the first study conducted with the TaySH Program
Calvo et al. recently published (2025) the study: "The effectiveness of the TaySH (Transitional Age Young Self-Harm) Program in the management of Non-Suicidal Self-Harm (NSSI) in outpatient adolescents and young adults: A non-randomized controlled pilot study ." The study included 37 young people receiving outpatient care at the Mental Health Service of the Vall d'Hebron University Hospital in Barcelona, the majority of whom were female at birth (91.9%), with a mean age of 16.7 years. Of the total participants, 28 young people (75.7%) completed the program. The mean age of onset of self-harm was 13.4 years. 67.7% had made at least one previous suicide attempt, and 43.2% were receiving pharmacological treatment at the time of enrollment in the program.
The TaySH Program is designed to help teenagers and young adults understand what is happening to them, learn to manage their emotions, and find safer alternatives to self-harm.
Self-harm, along with various psychopathological variables, was assessed clinically and psychometrically before and after the intervention (pre- and post-TaySH Program assessment). After completing the twelve-week program, a highly significant reduction in non-suicidal self-harm was observed, decreasing from an average of 3.32 episodes per week before treatment (Pre-TaySH) to 0.29 episodes per week after treatment (Post-TaySH), representing a reduction of over 90% . In addition, the following was observed:
- Significant decrease in suicide risk indicators.
- Improved emotional regulation skills.
- Reduction of depressive and anxiety symptoms.
- Improvement of overall functioning and quality of life.
These preliminary results show clinically relevant changes after a relatively short treatment period , both in the clinical presentation and overall functioning of the participants. Its brief, structured format, adapted to the life stage in which the behavior develops, appears to facilitate adherence. Therefore, the TaySH Program could be considered an effective treatment specifically designed for a problem that, until recently, lacked clearly defined interventions in our clinical setting.
Mobile apps to prevent self-harm
This is a pilot study with a limited sample size and no randomization, so the results should be interpreted with caution. Therefore, larger studies with long-term follow-up and, ideally, comparisons with other interventions will be necessary to confirm the program's effectiveness.
However, the published results support the need for specific, evidence-based interventions to reduce non-suicidal self-harm, improve emotional well-being, and offer real alternatives to suffering. In this context, the TaySH Program can be a pioneering, early, and promising alternative .
Key aspects
- When a teenager self-harms, it is usually a sign that they are experiencing intense emotional distress and do not have other tools to manage it: non-suicidal self-harm is a sign of emotional suffering, not a cry for help.
- Self-harm may relieve discomfort in the short term, but it increases the medium and long term psychological clinical risk.
- Emotional regulation is one of the central pillars for reducing self-harming behaviors.
- Early intervention in youth during transition is key to preventing the malaise from becoming chronic.
- The TaySH Program is designed to help adolescents and young adults understand what is happening to them, learn to manage their emotions, and find safer alternatives to self-harm. It is a short, twelve-session, outpatient program that allows participants to maintain their school, social, and family life.
- The TaySH Program appears to reduce the frequency of non-suicidal self-injury in adolescents and young adults by more than 90%.
- In conclusion, the results of the study show that, with adequate support and specific intervention, it is possible to reduce self-harm, improve emotional well-being, and promote healthier development.
