Using photo-elicitation to understand reasons for repeated self-harm: a qualitative study

Background: Reasons for self-harm are not well understood. One of the reasons for this is that first hand accounts are usually elicited using traditional interview and questionnaire methods. This study aims to explore the acceptability of using an approach (photo-elicitation) that does not rely on solely verbal or written techniques, and to make a preliminary assessment of whether people can usefully employ images to support a discussion about the reasons why they self-harm.

Method: Interviews with eight participants using photo elicitation, a method in which photographs produced by the participant are used as a stimulus and guide within the interview.

Results: Participants responded positively to using images to support a discussion about their self harm and readily incorporated images in the interview. Four main themes were identified representing negative and positive or adaptive purposes of self-harm: self-harm as a response to distress, self harm to achieve mastery, self-harm as protective and self-harm as a language or form of communication.

Conclusions: Employing this novel approach was useful in broadening our understanding of self harm