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One thing you might want to know about in case you are like me in that hospitals are not for you - if you have a fresh cut within 24 hours of seeing your therapist and your therapist sees it it is considered grounds for involluntary commitment to a mental health ward or facility (other wise known as nut wards). whether or not your therapist will have to follow that protocal depends on your locations menntal health laws and guidelines. most here in the usa have no choice but to follow that and refer their clients that are actively a danger to themself and or others to the local ER. If they didn't its a potental loss of agency/building permits and therapy certification and or licensess The reason for this is because here in the USA being a danger to yourself and or others is a crime and mental health agencys can't have crimes being committed on the premises kind of thing, let alone law suits and so on should the persons self injury behavior result in the persons death and the therapist knew they were a danger to them self and or other and did not refer that person for possible involluntary commitment.

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I hope that everyone will talk to their own therapists about policies and procedures and how they handle this. There is so much more to it, and in my experience and training and readings, I have never been told of any cut and dry rule like this. Therapists are allowed to and expected to use their own judgement and do what they believe is in the patient's best interest. There is no rule that says you will be hospitalized if the therapist sees evidence of self-harm during a certain time-period (unless the particular agency you go to has such a rule).

I have shown fresh cuts to therapists and they might ask what was going on behind doing that, or just say "well, that doesn't look so bad." They have never even suggested hospitalizing me.

In my training we have covered self-injury a few times as it comes up, and we were taught to assess the danger - how badly the client is likely to hurt themselves. There is nothing automatic about it. Hospitalizing people who don't need it does more harm than good, and we recognize that. One of my instructors told us about a client who cut during a session. We discussed how to handle that, and nobody even suggested hospitalizing the client. It wasn't warranted and would have damaged the relationship irreparably.

It concerns me when I see advice that people be less than open with their therapists. It is hard enough to be honest about scary things like SI (whether that means self injury or suicidal ideation - this applies to both), without fear of a rule that the therapist will have to enforce. Therapists are there for you, to help you, and to do what is best for you, and while they do have a responsibility to protect you and others, they are able to use their own judgement in determining what danger is present and how to keep you safe.

I needed to clarify that because we need to be open and honest with our therapists. That is the only way they can help us.

Rap