The Role of Social Work Education in Addressing Self-Harm: A Qualitative Analysis of Social Work Student Experiences

Background and Purpose: Given the alarming prevalence of self-harming and suicidal behaviors, a majority of social workers will be required to address these perplexing behaviors at some point in their careers. Although social workers are required to obtain continuing education training in the area of suicide prevention, previous research suggests they often experience feelings of anxiety and uncertainty in response to self-harm. Gaps in social work education may lead social workers to experience these feelings of uncertainty and a loss of confidence when treating self-harming individuals. The paucity of research surrounding the process by which social work students learn to assess and treat individuals engaging in self-harming behaviors underscores the need for the present study given the high-risk nature of this population. Several studies have already explored gaps in social work education as it relates specifically to suicide assessment, treatment, and prevention. The present study sought to build upon those existing studies and extend their inquiry to include both suicidal behaviors and nonsuicidal self-injury due to the overlapping nature of these distinct constructs. Specifically, this study was conducted to understand the process whereby social work students learn how to assess and treat individuals engaging in self-harming behaviors.

Methods: Students enrolled in an MSW elective course on assessing and treating self-harm developed by the first author wrote five journal reflections over the course of the semester on their perspectives and experiences of learning how to address these complex behaviors. Upon completion of the course, they were invited to submit their journal reflections for analysis. Thematic analysis was used to evaluate 125 journal reflections from 25 MSW students to identify emerging themes. All journal reflections were initially coded by the first author. Codes and emerging themes were then reviewed through a peer debriefing process. All data were analyzed using ATLAS.ti software.

Results: The analysis procedures revealed 4 overarching themes from the students’ self-reflections: (1) decreased misconceptions regarding the nature of self-harm, (2) increased confidence in ability to effectively assess self-harming behaviors, (3) attainment of skills for implementing components of empirically-supported interventions that are relevant to self-harm, and (4) the importance of reflexivity and conscious use of self when working with clients.

Conclusions and Implications: These findings highlight the value and importance of incorporating coursework on assessing and treating self-harm into social work education curriculum. For social workers to have the knowledge, skills, and confidence necessary to address these behaviors, their training should start with targeted courses in their graduate education. Future research could focus on assessing what frameworks and skills were most important in preparing social work students to assess and treat self-harming individuals.