I nanny for a family of 7, the oldest being a 16 year old girl. She is an EXTREME perfectionist and it really has started to concern me. I have seen little bits of evidence that she may be hurting herself and finally asked to see her arms that she had been hiding, they are completely cut up. She claims to have a story for the cuts that I do not believe (she fell off her bike, cat scratched her, etc)

What do people with experience with this suggest? Therapy? Pediatrician? Both? Anything else that may help?