Not all coping skills work for all reasons teens self-harm. A teen who self-harms to release overwhelming emotion needs strategies that discharge intensity. A teen who self-harms to feel something through numbness needs strategies that safely generate sensation and reconnection. Handing a generic list of "healthy coping skills" to a teen without matching the skill to the need is one of the most common reasons replacement strategies fail.

The categories below are organized by the function the self-harm is serving. If you are unsure which function applies to your teen, see our resource page: Why Teens Self-Harm. These strategies are most effective when chosen and practiced together with your teen's therapist, who can tailor them to your teen's specific needs.

When the Urge Is About Releasing Overwhelming Emotion

These strategies work by safely discharging the intense emotional energy that self-harm would otherwise release:

• Intense physical exercise — sprinting, jumping jacks, a hard run, dancing to loud music. The goal is to move the built-up energy out of the body.
• Physical release that doesn't cause harm — punching or screaming into a pillow, tearing up paper or old magazines, wringing out a towel, squeezing a stress ball as hard as possible.
• Paced breathing — slow, extended exhales (breathing out for longer than you breathe in) activate the body's calming system and bring down emotional arousal.
• Writing out the emotion in raw, unfiltered language — not journaling for insight, but venting on paper. The paper can be torn up or thrown away afterward.
• Turning the volume down on the environment — moving to a quieter space, dimming lights, reducing sensory input while the wave passes.

When the Urge Is About Feeling Something Through Numbness

These strategies safely generate sensation or emotional activation that breaks through disconnection and helps a teen feel grounded in their body again:

• Strong but harmless sensory input — a sour candy, a piece of strong mint, smelling something vivid like citrus or peppermint. Intense (not painful) sensation can interrupt dissociation.
• Grounding through the senses — the 5-4-3-2-1 technique (naming five things you can see, four you can hear, three you can touch, and so on) pulls attention back into the present.
• Touching textured objects — a rough blanket, tree bark, a smooth stone, cool running water over the hands. Tactile input reconnects the body without harm.
• Vigorous physical movement — dancing, running, stretching. Motion produces sensation and re-engages the body.
• Warm, comforting sensation — holding a warm mug, a heated blanket, a warm shower. Warmth is a strong, safe signal that reaches through the numbness.

When the Urge Is About Self-Punishment

These strategies interrupt the self-blame cycle and redirect toward self-compassion. This is often the hardest function to replace because the teen believes they deserve the pain:

• Writing a letter to themselves from the perspective of someone who loves them — a friend, a grandparent, a therapist. The exercise externalizes compassion.
• Reading or listening to something affirming — pre-selected quotes, voice memos from loved ones, or a list of things they are proud of, assembled during a calm moment.
• Challenging the thought directly: "What would I say to a friend who felt this way about themselves?" The answer is almost never "You deserve to be hurt."
• Physical self-care as a counter-action — taking a warm bath, applying lotion, wrapping themselves in a blanket. Treating the body with gentleness directly contradicts the punishment impulse.

When the Urge Is About Regaining Control

These strategies provide a sense of agency and mastery without self-injury:

• Organizing something — a drawer, a playlist, a workspace. Imposing order on a small area can reduce the sensation of chaos.
• Making a deliberate choice about something small — what to eat, what to wear, where to walk. Exercising agency in safe domains.
• Creating something — art, music, writing, cooking. Creation is an act of control that produces something rather than destroying something.
• Setting and completing a small, concrete goal — cleaning a room, finishing a task, solving a puzzle. The sense of completion counteracts helplessness.

When the Urge Is About Communicating Distress

These strategies help teens express pain directly rather than through their body:

• Texting or calling a trusted person from the safety plan: "I'm having a really hard time right now." Reaching out directly replaces the indirect communication of self-harm.
• Writing what they need and showing it to someone: "I need help. I don't know how to say it out loud."
• Using an emotion rating system with a parent — a simple 1–10 scale, a color system, or emoji cards. This gives language to distress without requiring articulation.
• Journaling the unsaid — writing what they wish they could tell someone, even if they never share it. Forming the words is itself a form of expression.

How to Build Your Teen's Personal Toolkit

The most effective approach is to sit with your teen during a calm moment — not during a crisis — and explore which strategies feel realistic to them, ideally with input from their therapist. No one else can choose the right coping skills for your teen. They need to select strategies that match their specific experience, test them in low-stakes situations, and build confidence that the strategy works before they need it under pressure.

Aim for a list of 5 to 10 options written down and accessible — on their phone, on an index card in their wallet, taped inside a drawer. The list should include at least one option for each function they experience. When the urge hits, decision-making capacity drops. A pre-made list removes the need to think of alternatives in the worst possible moment.

An Important Note

Coping skills manage the moment. They do not treat the cause. A teen who is successfully using a grounding or self-soothing skill instead of self-harming is making real progress — but they still need therapy to address the emotional pain that is generating the urge in the first place. These strategies work best as one element of a broader treatment plan developed with a qualified clinician, not as a standalone solution. If your teen's urges include thoughts of dying, or the self-harm is escalating, contact their therapist, call or text 988 (Suicide & Crisis Lifeline), or go to the nearest emergency department.

A coping skill that serves the same function as the self-harm is far more likely to work than a generic suggestion to "try deep breathing."

Sources: DBT-A distress tolerance skills (Linehan, Miller, Rathus); NICE guidance on self-harm management; Child Mind Institute; American Academy of Child and Adolescent Psychiatry.