Professionals’ perceptions of people who self-harm
: a systematic review comparing attitudes of professionals supporting people with and without learning disabilities who self-harm

Student thesis: Master's ThesisMaster of Science (MSc)


Background: National Institute for Health and Care Excellence (NICE, 2013) guidelines state that professionals supporting people who self-harm should demonstrate compassion, respect and dignity, and the organisation they work for should ensure they are adequately trained to provide such support. This systematic review considers the evidence for professionals’ attitudes towards people who self-harm, with a comparative focus between professionals supporting people with and without learning disabilities.

Method: Electronic databases were searched to find relevant research since 2000, references were hand-checked for further studies. Narrative synthesis was utilised to identify themes and describe the findings.

Results: Thirty studies (31 articles) were identified; four studies were conducted with professionals supporting people with learning disabilities, the other 27 studies were with professionals supporting people without learning disabilities. Attitudes were found to be largely sympathetic, but there was evidence of punitive and judgemental attitudes and a repeated concern raised across the sectors about inadequate training and support. Professionals supporting people with learning disabilities were found to have some attitudes that mirrored the behavioural and biological theories dominating theory and practice (that self-harm is the result of operant learning or associated with a biological condition or concern). However, they also tended to have a more relational approach, which was more reflective of the NICE (2013) recommendations.

Conclusion: Adequate training for staff supporting people who self-harm remains a priority that is largely not being met. Support and supervision for staff to increase resilience and equip them to sustain compassionate attitudes towards people who self-harm is also a necessity. These require appropriate resourcing. Professionals supporting people with learning disabilities who self-harm were found to have some differing attitudes, including a greater emphasis on relationship; these differences are worth exploring further.
Date of Award11 Dec 2019
Original languageEnglish
Awarding Institution
  • University of Bristol
SupervisorSandra Dowling (Supervisor) & Pauline Heslop (Supervisor)


  • learning disabilities, self-harm, attitudes, professionals

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