A strategic assessment of deliberate self-harm

This paper describes how patients are interviewed in the context of a general hospital after they have been involved in an episode of self-harm. The interview schedule is structured upon the principles of brief therapy, and uses the 'neutral' approach of the Milan Team (Weakland 1974; Palazzoli et al. 1980). The schedule provides information for referring on and has proved to be 'therapeutic' in itself. The method of interviewing has been used in other hospital contexts with families where a member has been referred 'in a crisis' threatening, or indicating suicidal behaviour. It is suggested that the identification of who is involved systemically is of paramount importance, and that this may not involve 'the family' but significant others in the social network. The important systemic involvement of the general practitioner is recognized.