title: Self-harm and the positive risk taking approach. Can being able to think about the possibility of harm reduce the frequency of actual harm?
abstract: BACKGROUND
  This article presents the results of an audit of self-harming across three women's units over a period of 6 years. All three units use a positive risk-taking approach to self-harm whereby the risk that this behaviour presents is considered in an effort to reduce actual harm.
  
  
  OBJECTIVE
  To explore patterns and frequency of self-harm across three units within a women's service.
  
  
  METHODS
  Incidents of deliberate self-harm were collected from incident forms completed across the units from 2004 to 2009.
  
  
  RESULTS
  Frequency graphs show a reduction of self-harm over the course of admission, and parametric analyses show that there was a significant difference in the frequency of self-harm during the first and last 3 months of admission.
  
  
  CONCLUSIONS
  These results are discussed within a psychoanalytical framework, with particular reference to relational security and the value of positive risk-taking.
authors.affiliation: Women's Service, Secure and Forensic Services, The Firs, Hellingly, Hailsham, East Sussex, BN27 4EP, UK. sarah.birch@sussexpartnership.nhs.uk
authors.forename: Sarah
authors.initials: S
authors.lastname: Birch
authors.forename: Samantha
authors.initials: S
authors.lastname: Cole
authors.forename: Kate
authors.initials: K
authors.lastname: Hunt
authors.forename: Blossom
authors.initials: B
authors.lastname: Edwards
authors.forename: Emma
authors.initials: E
authors.lastname: Reaney
mesh_terms: D000328:Adult; D001883:Borderline Personality Disorder / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D040261:Harm Reduction; D006801:Humans; D007297:Inpatients; D008875:Middle Aged; D016728:Self-Injurious Behavior / Q000517:prevention & control / Q000534:rehabilitation*; D013808:Therapeutic Community; D016896:Treatment Outcome; D006113:United Kingdom; D016387:Women's Health