Therapists for Self-Harm

On this page you will find therapists who list narrative therapy among their approaches and who work with self-harm. Use the listings below to explore how individual clinicians describe their focus, approach, credentials and languages, and to identify practitioners you may wish to contact.

Understanding self-harm through a narrative lens

When you come to narrative therapy with experiences of self-harm, the starting point is not primarily a set of symptoms but the stories you carry about your life and yourself. Narrative therapy, developed in Australia and New Zealand in the 1980s by Michael White and David Epston, begins from the idea that people make sense of their lives through stories. Some of those stories - passed down through family, school, workplaces or culture - are thin and harsh, offering only narrow ways of seeing who you are and how you might cope. With self-harm, familiar stories often position the person as overwhelmed, broken, or defined by their behaviour. Narrative practitioners attend first to those stories, exploring how they formed, where they are sustained, and how they shape daily action.

Rather than trying to prove that a story is wrong, narrative work helps you separate the problem from your identity so that you can see it as a lived experience that relates to your circumstances, relationships and values. That separation makes room for curiosity about exceptions - moments when the story did not hold - and for the gradual construction of a different account of your life. This approach is relational and language-focused. Over time you and your therapist build a preferred story - a richer account of your commitments and capacities that fits the reality of your ordinary days.

How narrative therapy works with self-harm

Core practices and what they look like

A narrative approach uses several named practices to shift the way you and others talk about self-harm. Externalising is central - it involves talking about the difficulty as something that affects you, rather than something that is you. That change of grammar opens space to describe the problem's strategies, its history, and the contexts that maintain it. For example, instead of saying I am a cutter, you might begin to talk about the cutting as something that has influenced parts of your life. That makes it easier to ask how the behaviour has served you, when it shows up, and what it does to relationships.

Practitioners also use thin and rich description to move beyond one-line summaries. A thin description collapses a complex life into a label; rich description attends to details - the times, places, people and feelings surrounding particular moments. Gathering unique outcomes is a practice of noticing times when the problem did not take over - moments when you acted in line with your values or chose a different response. Those exceptions become seeds for re-authoring conversations, where you and your therapist begin to articulate an alternative narrative that aligns with your commitments and aspirations. Other practices you may encounter include re-membering conversations, outsider witnesses, and definitional ceremony - ways of inviting others to acknowledge and celebrate the preferred story as it grows.

It is important to remember that most therapists who list narrative therapy combine it with other approaches. The listing shows that a clinician works with a narrative approach among their methods, not that they follow only narrative practices. When you read a profile, consider asking how they balance narrative work with other methods and how that mix influences the focus of sessions.

What to expect in narrative sessions for self-harm

Early conversations - naming and separating

Your first conversations in a narrative frame are often slow and exploratory. The therapist will ask questions aimed at helping you tell the story you live by and at naming the problem in a way that separates it from who you are. Questions are likely to be open and curious - about the times the problem turned up, what it seems to do, and where it feels strongest. The pace is typically guided by your readiness to speak about painful events. Rather than focusing immediately on symptom reduction, the early work is about mapping the problem's influence and identifying moments that contradict the familiar story.

Later work - re-authoring and practice

As sessions progress, focus often shifts toward re-authoring. That may mean expanding descriptions of your values and commitments, experimenting with small actions that align with a preferred story, and bringing other people into definitional conversations when appropriate. A narrative session is conversational and reflective; questions invite you to notice the effects of different stories and to try out new ways of talking and acting. Because many clinicians combine narrative practices with other interventions, some sessions may include techniques from additional approaches. If you want narrative methods to be primary, it is reasonable to ask how much of the therapist's work uses narrative practices and what a typical session looks like in their hands.

Is a narrative approach the right fit for self-harm?

There is no way to tell in advance whether a particular approach will suit you. People are drawn to narrative work for different reasons. You might be attracted to it if you do not want to be reduced to a diagnosis, if you feel that stories passed down by family or culture no longer fit who you are, or if you are interested in shifting relationships and meanings rather than focusing only on skills or symptoms. Narrative therapy emphasizes agency, language and context, and it invites you to develop a story that better represents your commitments and resources.

Narrative work is distinct from approaches that focus mainly on thought content, behavioural skills, or insight into early relationships. For example, cognitive-behavioural approaches concentrate on identifying and modifying unhelpful thoughts and patterns, and skills-based approaches prioritise strategies for crisis management and emotion regulation. Psychodynamic approaches typically explore unconscious processes and past influences. Narrative therapy differs by foregrounding the stories that organise experience and by using specific practices - like externalising and re-authoring - to change those stories. Many clinicians integrate ideas and techniques from different traditions; when this happens, narrative practices may sit alongside skill-building or exploratory work.

How to choose a therapist who works narratively with self-harm

Questions to ask and practical considerations

When you are looking at listings, focus on how therapists describe their approach and experience. A helpful opening question is how much of their work uses narrative practices and what a typical session involves. Ask for examples of the kinds of questions they ask in early conversations and how they move from naming the problem to building a preferred story. Since a listing only indicates that someone includes narrative therapy among their approaches, do not assume a specific training background; it is reasonable to ask where they trained and what ongoing learning they do.

Also check practical details that relate to fit - the clinician's credentials and registration or licensure where you live, the languages they work in, and whether they have experience with issues similar to yours. You can evaluate fit in an initial conversation by noticing whether the therapist listens for the stories that matter to you, whether they are curious about exceptions to those stories, and whether you feel able to consider different ways of describing your life. For many people, the first conversation is itself a form of assessment - a chance to see how the approach feels in practice.

Working narratively online

Narrative therapy is conversational and language-focused, so it adapts well to video sessions. If you plan to work online, ask the therapist how they structure remote sessions and what platforms or practices they use to support connection and privacy. It is appropriate to verify registration or licensure for the region where you live and to ask how they manage crisis situations at a distance. Taking time to clarify these details before you start can make it easier to focus on the narrative work once you begin.

Whatever you choose, remember that therapy is a collaborative process. Many people find that trying one or two conversations is the best way to see whether an approach and a particular therapist are a good fit. Use the listings on this page to identify clinicians who list narrative therapy among their approaches, and ask directly about the role narrative practice plays in their work with self-harm.