Before, During, After Map
Self-Harm and Loss (Ages 11–18), Grief, Separation, and Big Goodbyes
Loss can flood a young person with feelings they cannot yet name. This map helps carers and schools respond to self-harm safely, calmly, and consistently. If you think there is immediate danger, call 999.
Before the moment
Self-harm is often a coping strategy, not a “behaviour choice”. With loss, it can become a fast route to relief, control, or numbness.
What might be happening underneath?
- Grief that shows up as anger, emptiness, or “I do not care”, rather than tears.
- Separation pain, contact changes, placement moves, parental break ups, or a sudden goodbye.
- Shame and self blame, “It is my fault they left”, or “I ruin everything”.
- A nervous system stuck in threat, where pain feels easier than feelings.
- Loss of control, self-harm becomes something they can control when everything else feels unsteady.
Support that helps, home and school
- Create predictability around the loss, what is known, what is not known, what happens next, who will update them.
- Plan for “anniversary spikes”, birthdays, contact days, court dates, Mother’s Day, Father’s Day, funerals, and end of term.
- Offer language for feelings without forcing it, “Some people feel wobbly, angry, or numb after a loss”.
- Agree a shared safety plan with school, who notices, who checks in, where they can go, what happens if injuries are seen.
- Reduce secrecy, but protect dignity, private check ins, no public questions, no corridor interrogations.
- Take self-harm seriously without panicking, calm tone, steady boundaries, and consistent follow through.
- Limit access to means where you reasonably can, without turning the home into a police station.
- When there is a known trigger day, school can offer a quiet arrival, a time out pass, or a named adult check in.
- Use evidence based guidance for assessment and support plans, not improvised punishments.
Useful UK resources (buttons)
Gentle prompt
If this self-harm is a coping tool, what is it helping them cope with today, and how can we offer a safer alternative that still works for their body?
During the moment
In the moment, your job is safety and connection. Not interrogation, not consequences, not a moral debate about why.
What matters most right now?
- Check immediate safety calmly. If injuries are serious, get medical help, and do not delay.
- Use low language, “I am here”, “You are not in trouble”, “We will do this together”.
- Protect dignity, privacy, and warmth, especially around school staff responses.
- Separate self-harm from suicidal intent. Ask directly and calmly if they feel unsafe to stay alive, and escalate support if yes.
- Remove the audience, shame increases risk and can deepen the cycle.
Support that helps, home and school
- Offer “urge surfing”, wait 10 minutes together, then reassess. Repeat if needed.
- Offer body based alternatives that create sensation without injury, based on what the young person can tolerate.
- Try cold and sensory resets, hold an ice cube in a cloth, splash cold water, or a cold can against wrists.
- Try “coloured cordial ice” cubes (if appropriate), strong taste plus cold, sometimes helps shift the urge.
- Try safe pressure, squeezing a stress ball, ripping paper, pushing hands into a cushion, wall press, or star jumps.
- Try grounding scripts, “Name 5 things you see, 4 you feel, 3 you hear, 2 you smell, 1 you taste”.
- Offer a short “reset space” at school, with a named adult, water, and minimal questions, then return to learning when ready.
- If they are in a grief spike, name it gently, “This might be the loss talking”, and bring them back to the present.
- Make a clear next step, “We are going to sit, breathe, then decide together what help we need”.
- Follow school safeguarding policy, but keep your tone regulated, warm, and non-punitive.
Useful UK resources (buttons)
Gentle prompt
What does their body need right now, cold, pressure, movement, quiet, or connection, and how can school offer the same option without drama?
After the moment
Aftercare is where the long term change happens. Keep it practical, compassionate, and joined up between home, school, and health.
Repair first, then learning
- Reconnect before analysing. Snack, drink, quiet activity, or a short walk if they want it.
- Use a curious tone, “What was happening just before the urge?”, not “Why did you do that?”
- Praise any help seeking, “You showed me”, “You came to staff”, “You stayed with me for ten minutes”.
- Agree one tiny change for next time. Too many changes becomes another stressor.
- Do not remove all freedom as a default consequence. Restriction can increase distress and secrecy.
Support that helps, home and school
- Create or update a written plan, triggers, early signs, safe alternatives, who to contact, and what school will do.
- Share patterns, not graphic details, with the safeguarding lead at school, and agree what will be documented.
- Consider grief support where loss is central, and ask for specialist help if the loss was traumatic or complicated.
- Ensure any injuries are cared for medically and safely, without turning care into punishment.
- Ask school to plan the pinch points, unstructured times, toilets, corridors, end of day, and to reduce isolation opportunities.
- Escalate to health services when needed. NICE guidance highlights coordinated assessment and ongoing support.
- For looked after children, keep the social worker and relevant professionals in the loop, in line with safeguarding procedures.
- Keep language steady across adults, “We take this seriously, we will help you stay safe, we will not shame you”.
Useful UK resources (buttons)
Final message
With loss, healing often looks like wobbling, then returning. Your calm, consistent response, and the school’s calm, consistent response, is part of what makes the wobble survivable.
Case Studies
Two loss linked self-harm patterns, one for ages 11–14 and one for ages 15–18, with practical steps carers and schools can actually do.
Case study 1, Ages 11–14, Contact changed, then self-harm at school
- What it looks like: After contact is cancelled or changes, the young person is “fine”, then later scratches or cuts in the toilet, or tells a friend they cannot cope.
- What might be underneath: Separation grief plus shame, “I must not need them”, or “I am not wanted”, with big feelings arriving at school because school is where the structure is, and the feelings leak out.
- Before support: Carer and school share a “contact change plan”. On contact change days, school offers a named adult check in, a time out pass, and a quiet start to lessons.
- During support: Staff keep it private and calm. Safety check, first aid if needed, then a short regulated reset, water, breathing, feet on the floor, and no public consequences.
- After support: A short debrief with one question, “What was the moment it tipped?”, and one tool chosen for next time. Carer and DSL share patterns, then update the plan.
Case study 2, Ages 15–18, Bereavement spike, self-harm urges at night
- What it looks like: At bedtime, urges surge. The young person says they feel numb, then panicky, then they want pain. They may also say they do not want to die, they just want the feelings to stop.
- What might be underneath: Grief plus nighttime rumination. When the day quietens, memories and “what if” thoughts get loud. Self-harm becomes fast relief, and sometimes a way to feel real.
- Before support: Build a “night plan” together. Reduce isolation, keep doors open if agreed, predictable routine, and a list of pre chosen tools next to the bed.
- During support: Use body tools first, ice cube in a cloth, coloured cordial ice, cold water, strong mints, wall press, stress ball, ripping paper. Pair with “stay with me for 10 minutes”, and urge surfing.
- After support: A short “what helped” review in the morning, not at midnight. Consider grief support and clinical input where needed, and ensure school is aware of sleep and grief patterns.
Useful UK resources (buttons)
Gentle prompt
If loss is the spark, what is our “next 24 hours plan” at home and at school, so they do not have to hold it alone?
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What this pearl is all about
When children tip into full-blown distress – red-faced, fists clenched, or wailing – something important is happening inside their brains. Especially if there’s trauma in the mix. The rational part goes offline and the survival system takes over. Fight, flight… sometimes both at once. And in that state, calming down on their own is almost impossible.
That’s where you come in. By staying steady – calm body, calm voice – you become the anchor. It’s not glamorous, but it’s powerful. Your calm nervous system helps to steady theirs. Psychologists call it co-regulation. I call it being the anchor in their storm.
The tricky bit, of course, is regulating yourself first. Because their anger can be contagious. It’s very easy to catch it, to snap back. But if you can keep your cool – soften your tone, ground yourself – you transmit calm instead of panic.
And when you do that, you’re saying something profound without words: even at your worst, you’re still safe with me. Over time, those storms lose some of their terror. The child begins to believe it. They borrow your calm again and again, until eventually they start to grow some of their own.
What you could say in the moment
“I can see you’re feeling a really big storm inside right now. It’s okay – I’m right here with you, and you’re safe. Take some deep breaths with me. We will get through this together.”
(Said softly, perhaps while offering a reassuring hand on the shoulder if welcomed, conveying that you are not angry and will stay by the child’s side until the emotional waves settle.)
(Said softly, perhaps while offering a reassuring hand on the shoulder if welcomed, conveying that you are not angry and will stay by the child’s side until the emotional waves settle.)
What this pearl is all about
Children in foster care don’t usually lie in the way adults think of lying – not with the cold calculation of a fraudster in a Netflix documentary. More often it’s a kind of survival tactic, almost automatic. Trauma specialists even talk about it as a “fourth F.” You’ve heard of fight, flight, freeze… well, lying becomes another option. Not to get one over on you, but to dodge the sting of shame, or the dread of being punished, or simply the awful feeling of being powerless.
That’s where the Curiosity Lens comes in. Imagine putting on a pair of invisible glasses or holding up a magnifying glass. Instead of seeing the fib at face value, you start to see what’s underneath it – the fear of rejection, the nervous energy, the shame the child doesn’t know how to name. With PACE in mind – curiosity and acceptance especially – you suspend the moral outrage, the urge to shout “just tell me the truth,” and you lean in gently instead.
It’s not about catching them out. It’s about keeping the conversation alive. As one parenting guide wisely put it: stay exploratory, keep wondering aloud. If you shame them, they’ll close the door. If you stay curious, they might just leave it ajar.
And when you respond with genuine interest – “I wonder what made it hard to tell me…” – you send a message that’s bigger than any single lie: I’m not here to trap you, or humiliate you. I’m here to understand you. That, over time, is how trust grows. They learn you’ll meet their honesty with compassion, not punishment. And that changes everything.
What you could say in the moment
“Hmm, that’s an interesting story you’ve told me. I wonder if maybe it feels safer to say that than what really happened? If you’re worried about getting in trouble, you don’t have to be – you are safe with me. Whatever happened, we can sort it out together. Can you help me understand what’s going on?”
(This phrasing invites the child to explain, without outright accusing them of lying. It uses "I wonder" instead of "You’re lying", signalling curiosity. You might even playfully put on “magic truth glasses” with your fingers, if age-appropriate, to lighten the moment and show the child they’re not angry.)
(This phrasing invites the child to explain, without outright accusing them of lying. It uses "I wonder" instead of "You’re lying", signalling curiosity. You might even playfully put on “magic truth glasses” with your fingers, if age-appropriate, to lighten the moment and show the child they’re not angry.)
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What this pearl is all about
Many children in care carry a kind of hidden script in their heads. It says: I am bad. It’s my fault. They don’t usually say it out loud, but it’s there, humming away. It comes from years of early hurt, of being rejected again and again. Some even learn that if they show real feelings – sadness, anger, longing – it might lead to punishment, or worse, abandonment. So they tuck those feelings away, and the shame festers.
This is where the Acceptance Shield comes in. It’s less superhero cape, more everyday armour. You hold it up, deliberately and consistently, to protect the child from those shame-arrows. It means making a very clear distinction: I don’t always like your behaviour, but I always accept you.
In PACE terms, it’s acceptance and empathy working in tandem. You meet the child’s feelings as they are, even the messy ones. You empathise with the shame they’re drowning in. And practically, it means tempering your own response. No harsh telling-off. No thunderous disappointment. Instead: “You’re not a bad kid. I get why this happened. And I still care about you.”
Because here’s the thing: children watch closely for whether their inner world is safe with you. If you counter their self-criticism – “I’m stupid, I’m bad” – with calm, believable truths – “You’re good, you’re worthy” – you’re teaching them a new script. One where they’re not discarded for messing up. One where they’re covered.
And when you hold that shield day after day, the child starts to believe it. Their sense of self stitches back together. They start to grow resilience against shame and rejection. And in that, the bond between you becomes their secure base – something solid, at last, in a life that’s often felt shaky.
What you could say in the moment
“I know you feel really bad about this. It’s okay – we all make mistakes, but I want you to hear this: I’m not angry and I’m not leaving. I love you no matter what. Nothing will change that. Let’s figure out how to make it right together when you’re ready.”
(This script explicitly assures the child of your enduring acceptance. Phrases like “no matter what” and “nothing will change that” directly address fear of rejection. You might literally open your arms like a shield or put an arm around the child if appropriate, to physically reinforce the feeling of protection and safety.)
(This script explicitly assures the child of your enduring acceptance. Phrases like “no matter what” and “nothing will change that” directly address fear of rejection. You might literally open your arms like a shield or put an arm around the child if appropriate, to physically reinforce the feeling of protection and safety.)
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What this pearl is all about
Defiance in children can feel like a brick wall. They cross their arms, scowl, and say “No!” with the kind of finality usually reserved for magistrates. And you feel that surge of frustration rising – the urge to push back harder. But there’s another option.
The Playful Pause is about puncturing that tense balloon with a bit of silliness. A ridiculous face. A pretend dragon lurking in the room. A mock-serious “emergency” about socks refusing to cooperate. It sounds daft, and in a way it is. But daftness is often what works.
The magic of playfulness is that it pauses the power struggle. It shifts the dynamic from “me against you” to “me with you.” For a younger child, it might be full-on theatrics. For a teenager, maybe a raised eyebrow and a wry, self-deprecating joke. Either way, it says: I’m not your enemy. We can reset this together.
It doesn’t mean ignoring the behaviour. It just means you’re smart enough to know that humour can sneak past defences that sternness never will. And once you’ve both laughed, even a little, the wall crumbles. Suddenly there’s room to carry on. Together.
What you could say in the moment
In a mock-serious narrator voice: “Oh no... the Defiance Dragon has entered the room! It’s making us both all grumpy. Quick, I have an idea – I’ll make a funny face to scare it off… 😜 See, the dragon is laughing! Can you give it a try? [Child pulls a face] Hooray, we scared it away together!” (Both laugh, tension breaks) “Alright, shall we give (the task) another go now?”
In this playful script, you create a tiny imaginative game (“Defiance Dragon”) to externalise the child’s defiance as something we can team up against playfully. The exact script can vary widely by age (for a teenager, humour might be more understated, like you suddenly doing a goofy dance and saying “Ugh, what a morning – shall we hit reset and start over?” with a grin). The essence is to surprise the child out of the stuck position with levity. Your willingness to be a bit silly shows the child it’s safe to drop their guard. Once the child smiles or giggles, even briefly, the emotional climate shifts – we (you and the child) are connected again, and the task or issue can often be revisited with less resistance.
In this playful script, you create a tiny imaginative game (“Defiance Dragon”) to externalise the child’s defiance as something we can team up against playfully. The exact script can vary widely by age (for a teenager, humour might be more understated, like you suddenly doing a goofy dance and saying “Ugh, what a morning – shall we hit reset and start over?” with a grin). The essence is to surprise the child out of the stuck position with levity. Your willingness to be a bit silly shows the child it’s safe to drop their guard. Once the child smiles or giggles, even briefly, the emotional climate shifts – we (you and the child) are connected again, and the task or issue can often be revisited with less resistance.
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What this pearl is all about
When a child withdraws – shuts the bedroom door, curls up silent on the bed – it’s tempting to take it personally. To knock loudly, or to storm off yourself. But here’s the truth: often what’s happening is less about you and more about the child drowning in feelings they can’t quite put words to. Shame, sadness, fear.
The Empathy Bridge is about reaching across that gap. Not forcing them to talk, not demanding eye contact, but sending a quiet signal: I see you. I understand. And I’m here. Maybe it’s a few calm words through the door. Maybe it’s leaving a note or a favourite snack outside. Maybe it’s just sitting nearby, available.
The visual is a bridge of hearts or hands. You stand on your side, they on theirs. And you extend something across – empathy – so when they’re ready, they can walk back over. The bridge is patient. It doesn’t collapse if they don’t use it straight away.
This says to the child: Even if you push me away, I won’t give up on you. And in time, that’s how trust is built. They learn that silence won’t scare you off. That feelings won’t break the relationship. And that you are a steady presence on the far side of the cliff, always waiting, always ready to welcome them back.
What you could say in the moment
(You speak through the door or next to the withdrawn child, calmly and kindly): “I know it’s been a really upsetting day. If I were you, I might want to hide under the covers too. Just wanted to say I understand why you feel that way, and it’s alright. I’m here whenever you feel like talking or even if you just want a hug. Take your time – I’m not going anywhere.”
(In this script, you're naming and normalising the child’s likely feelings, showing empathy: “I’d feel the same if I were in your shoes.” There’s also an explicit assurance of presence: “I’m here… I’m not going anywhere,” which is crucial for a child worried about being given up on. The tone is gentle, not demanding a response. You might sit quietly nearby, or leave a soft toy or drawing materials as an invitation. The child then knows the bridge is there whenever they are ready to cross back into interaction. Even if the child doesn’t respond immediately, such messages sink in and over time the child will trust that the carer truly cares and empathises with them.)
(In this script, you're naming and normalising the child’s likely feelings, showing empathy: “I’d feel the same if I were in your shoes.” There’s also an explicit assurance of presence: “I’m here… I’m not going anywhere,” which is crucial for a child worried about being given up on. The tone is gentle, not demanding a response. You might sit quietly nearby, or leave a soft toy or drawing materials as an invitation. The child then knows the bridge is there whenever they are ready to cross back into interaction. Even if the child doesn’t respond immediately, such messages sink in and over time the child will trust that the carer truly cares and empathises with them.)
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