Family Therapy for NSSI

Over the past few decades, an increasing number of researchers have studied the treatment of nonsuicidal self-injury (NSSI) in adolescent and adult samples in both clinical and nonclinical settings. Various scholars have emphasized the importance of a motivated family, satisfactory attachment relationships, and family support in obtaining a desirable NSSI treatment outcome. Also, several forms of family-based/systemic therapies, hereinafter identified as family therapy (FT), have shown relative efficacy for the treatment of NSSI (and broader self-injurious thoughts and behaviors). Therefore, the current chapter presents an overview of the available methods and evidence for using family-based approaches (e.g., attachment-based family therapy, emotionally focused family therapy) to treat NSSI. The chapter includes guidelines for FT based on both common elements for psychotherapy (e.g., countertransference) and FT elements (e.g., addressing attachment ruptures and supporting parents or caregivers suffering from secondary stress). Challenges and future directions for clinical practice and research on FT and NSSI are discussed in the concluding paragraph, stressing the need for more tailored interventions and critical view on outcome measurements.