Yeah, a lot do avoid it. Some think that talking about it will reinforce the behavior. Others just aren't comfortable with it, or don't know what to say. As a therapist myself, I have had other therapists ask if I would assist with a self-injuring client or have that case transferred to me because they weren't comfortable with it. As a client in therapy, the first therapist I told about cutting myself (before I knew what it was or that anyone else ever did that) showed no reaction at all at the time and then threw it in my face a few weeks later by saying that the way I had said it was suspicious. Others never addressed it at all (I was reluctant to bring it up again), or wouldn't spend much time talking about it if I did bring it up. My last therapist has a history of SI herself, and she wouldn't let me talk about SI much either, saying that I was hiding behind symptoms and avoiding what was real.

None of the therapists I went to practiced DBT. DBT therapists are trained to focus on SI or other destructive or therapy-interfering behaviors as top priority if they have occurred, and not to allow the client to discuss other things until after a thorough analysis of the SI behavior, why the client chose to do it, and what they could have done instead. Since DBT clients are supposed to present a diary card at the beginning of each session, the client is always expected to report SI and other destructive behaviors so that they can be addressed.

I don't think that avoiding talking about SI is helpful, and I can see how being required to address it could be a lot more effective for extinguishing the behavior, even though that could be really annoying too. I think that the important thing is to understand the emotions and motivations behind SI, and not to focus on the actual SI itself. And also to find ways to cope with emotions and distress in healthier ways.