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Self-Harming Daughter

Question:

My stepdaughter began cutting herself and taking large amounts of Benadryl about six to eight months ago. My wife and I were unaware of this until she was a few months into this practice. We rushed her to the hospital, and she started psychiatric treatment.

When it became clear that she was continuing to harm herself, we took her to a clinic that handles this type of disorder. She stayed there for eight weeks. During her stay, she was placed on suicide watch three times. My wife was very nervous about bringing her home, but she had to begin the new school year.

She has been home for two weeks, and it appears that her old, harmful habits are returning. She has already snuck out of the house past midnight, returning at 5 a.m. This situation is putting a huge strain on the family and our marriage.

My stepdaughter is aware that we have looked into other facilities for possible placement if her behavior does not improve. But she makes my wife feel guilty, saying we are placing her in treatment just to get her out of the way. This is not true. We just want her to be healthy and to have a normal childhood. We have sought the help of local counselors and child psychiatrists. How long do we do this before sending her away? We are concerned about her friendships and her safety.
 

Answer:

This information is included in our Guide to Harmful Behaviors. Click here to see the rest of the guide.

Dealing with a teenager who uses self-harm as a coping skill is difficult. She was taught new coping skills while she was in the hospital. So now we encourage you to focus on her behaviors: sneaking out, hanging out with inappropriate friends and trying to make her mother feel guilty. 

Sit her down and make your rules and expectations very clear. Include everything from her curfew to her choice of friends, chores, being respectful, etc. Let her know that if she does not follow the rules and meet your expectations, she will not earn privileges (cell phone, computer, iPod, free time with friends, etc.)

It sounds like she does not respect your authority and is manipulative (the guilt trips, for example). She needs to earn a large consequence for sneaking out of the house. If this happens again, we encourage you to call the police and report her as a runaway. Let her know that she lost all trust with you and her mother and that it is up to her to earn that trust back. She earns this trust by reporting her whereabouts, being in bed when you check on her at night and by following all of the rules.

Talk with her counselor and psychiatrist to see if they recommend out-of-home placement, as this is often the last resort for parents dealing with child/teenager behavior problems. Give her the opportunity to turn her behavior around, but let her know that sending her to a group home is an option if her bad behavior escalates. We also encourage you and your wife to seek individual and couple’s counseling to help you deal with the current situation with your daughter. It is important that you not allow her behaviors to affect you or your relationship.
 

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