When between friends, I've found that it hasn't worked. My friend once made me promise on her life that I wouldn't cut again. I broke it and felt really horrible about it, and I didn't feel able to talk to her about it either. So no, I woulnd't really say they worked... in an institutional setting it will probably be even worse, because then you're dealing with people who don't know or understand you. But it's the rules and I don't think it would be in your benefit to fight against them.