Staff emotional reactions to self-harm : the role of self-efficacy, attitudes, attributions and empathy

Abstract

Approximately 150,000 people annually present to hospital following self-harm (Hawton, Fagg, Simkin, Bale & Bond, 1997). However, self-harming behaviours remain poorly understood (Huband & Tantam, 2000). This literature review focuses on staffs emotional experience of working with people who self-harm. It has been documented that emotions evoked in staff include panic, hopelessness, anger and even hate, which makes a consistent, therapeutic response difficult to achieve (Allen, 1995). Despite this acknowledgment there has been little systematic study of how clinicians perceive and emotionally respond to clients who self-harm. There is a clear need to explore those factors which may help to explain emotional reactions to self-harm in order to guide staff training and support and optimise care provision to this client group. Literature Review Goals and Search Strategy This literature review aims to address several key issues. Firstly and primarily, to investigate the clinical relevance of staff reactions to self-harm, i.e. to what extent may staff reactions influence the care provided to this client group? This involves finding evidence for possible negative attitudes and reactions in professionals who care for people whom self-harm. Secondly, the review outlines some theoretical frameworks in order to understand staff reactions. Lastly, it will be argued that there is a need to study staff emotional reactions to self-harm and to investigate how these in turn may relate to the attributions and attitudes staff hold.

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