Sharing, carrying, and tolerating the pain–A meta-synthesis of clinicians’ experiences from working with adolescents who self-harm

Abstract

Objective: This study aims to review and synthesise qualitative studies of the subjective experiences of clinicians working with adolescents (11–18 years of age) who self-harm. Method: We conducted a systematic literature search and included 14 studies in a meta-synthesis, applying Noblit and Hare’s (1988) [Meta-ethnography–synthesizing qualitative studies. SAGE Publications] seven analytical steps for meta-ethnography. Results: The meta-synthesis resulted in three meta-themes that narrate a process of the emotional experiences of being in a professional relationship with adolescents who self-harm: (1) “Sharing the pain–The relationship as a vehicle to help, understand, and protect”; (2) “Carrying the pain–Self-harm evokes strong feelings”; and (3) “Tolerating the pain–To show a way out”. Conclusion: Working with self-harm may represent a challenging balance for clinicians between exploring the pain in the therapeutic relationship, while also managing their own ability to tolerate the difficult emotions in this work.