Investigating the Effective Factors in the Formation of Deliberate Self-harm in Adolescence: Mental Health Professionals’ Viewpoints

Objective: This study aims to investigate the issues related to the formation and persistence of deliberate self-harm behavior in adolescents from Iranian mental health professionals’ viewpoints.  Methods: The present qualitative study used semi-structured interviews to record the experiences of 9 mental health professionals with work experience in deliberate self-harm behavior in adolescence. The participants were selected via the purposive sampling method. The Sterling content analysis method was used to analyze the transcription of the interviews. Results: The semantic units of the interview were classified into 32 initial codes. The extracted sub-themes were as follows: A rejection of new identities, repression, the disintegration of social identity, materialism, economic poverty, unresolved parental conflicts, the lack of authority, the ambivalency between boundaries and freedom, shame, and guilt, blame, fear of harm, liberation, self-care, escape mechanism, and replacement, affect regulation, coping with self-disintegration and self-esteem, relationship conflicts with adults and peers, identity creation, identity disorder, boundless mental structure, lack of self-confidence, and distorted self-perception. The following four themes were categorized as subcategories of transformational injuries: Traumatic society, vulnerable family, interpersonal impact, and interpersonal effectiveness. Conclusion: Mental health specialists considered deliberate self-harm traumatic; however, they deem it for eliminating negative emotions and controlling the internal and external world of adolescents. Furthermore, they consider this behavior a reaction to cultural conflicts, cultural materialism, and the disintegration of identity and role during adolescence in families not being capable to facilitate low-risk transformation for adolescents because of economic and psychological factors.