Examining therapeutic approaches towards injurious behaviours in adolescents: Perspectives on influence, efficacy & prevention

Abstract

This qualitative research investigates professional perspectives on adolescent non- suicidal self-injury (NSSI) and outward-directed injurious (ODI) behaviours through in-depth interviews with twelve professionals across mental health, education, and social services in New Zealand. Utilising thematic analysis, the study reveals insights into how these behaviours represent interconnected manifestations of underlying emotional regulation challenges shaped by individual vulnerabilities, relationship dynamics, and systemic factors. Four key themes emerged: The Duality of Aggressive Expression, Environmental and Developmental Influences, Building Therapeutic Connections, and System Complexities and Bridge-Building. The research extends theoretical understanding by examining how risk factors influence behavioural expression, highlighting the connection between neurodevelopmental differences, trauma histories, and family dynamics. By challenging traditional conceptual frameworks, the study identifies significant gaps between evidence- based interventions and real-world implementation, ultimately offering recommendations for more integrated treatment protocols, enhanced professional support systems, and comprehensive care pathways for vulnerable youth.