Self-injurious behaviour: what do we know and where are we going?

Self-injurious behaviour can become an intransigent difficulty, reduce people's quality of life and lead to hospital admissions or other restrictive outcomes (such as the wearing of protective devices to prevent serious injury). Over the last 15 years there have been some important developments in the treatment of severe self-injury, but the evidence is that these are making little impact on most people's lives. The reasons why this might be are discussed, and it is proposed that it is time for a radical new approach to interventions for self-injurious behaviour.