Adolescent Self-Harm Support Program

A physician-led, family-inclusive service for adolescents who are engaging in self-harm, including cutting. This program integrates evidence-informed approaches with somatic practices and Presence Therapy to help teens develop safer ways of coping—without requiring them to talk through their pain before they’re ready.

Who This Program Serves

This program is designed for adolescents (typically ages 12–18) who are engaging in self-harm behaviours such as cutting, and their families. It serves:

• Teens who feel overwhelmed by emotions they can’t yet name or manage
• Families seeking a structured, compassionate clinical pathway
• Referring physicians looking for an OHIP-covered option that goes beyond medication alone
• Adolescents who haven’t responded to conventional talk therapy

The program welcomes teens who may not be comfortable with traditional verbal therapy. Non-talk options are available at every phase, including grounding, breathwork, gentle movement, and art or music journaling.

Our Approach

Self-harm in adolescents is often an attempt to manage emotional pain that feels unbearable. Rather than treating the behaviour as the primary problem, this program addresses the underlying dysregulation—helping teens reconnect with their bodies and develop the capacity to tolerate difficult emotions safely.

The program combines three evidence-informed modalities:

• Dialectical Behaviour Therapy for Adolescents (DBT-A) — Structured skills training in mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness
• Somatic and Experiential Practices — Body awareness, micro-movements, breathwork, sensory anchoring, and expressive therapeutic arts
• Presence Therapy — Dr. Yu’s approach to recognizing thoughts as conditioned, involuntary events and re-anchoring in sensory experience rather than mental loops

At its core, the program helps adolescents learn that they can observe what they feel without being consumed by it.

The 7-Phase Clinical Program

Each adolescent progresses through a structured sequence of care, adapted to their pace and readiness. Phases may overlap, and the clinical team adjusts intensity based on ongoing assessment.

Phase 1: Intake & Mapping

Comprehensive safety assessment, personal and family history review, and collaborative goal-setting with the teen and parent(s). This phase establishes the therapeutic relationship and maps the context around the self-harm behaviours—what triggers them, what function they serve, and what supports already exist.

Phase 2: Stabilization & Grounding

The immediate priority is safety. This phase focuses on somatic resourcing, breathwork, sensory anchoring, and crisis planning. The teen learns to identify early warning signs and access grounding techniques before the urge to self-harm escalates.

Phase 3: Skills Foundation (DBT-A Informed)

Structured skills training drawn from Dialectical Behaviour Therapy for Adolescents:

• Mindfulness — Observing thoughts and sensations without judgment
• Distress Tolerance — Surviving emotional crises without making them worse
• Emotion Regulation — Understanding and reducing the intensity of painful emotions
• Interpersonal Effectiveness — Communicating needs and maintaining relationships during difficult moments

Phase 4: Somatic & Experiential Integration

Moving beyond cognitive skills into body-based work. This phase incorporates body awareness exercises, micro-movements, and expressive therapeutic practices. For adolescents who struggle with verbal expression, this phase often becomes a turning point—offering a way to process experience without having to put it into words.

Phase 5: Family Sessions

Self-harm doesn’t happen in isolation. Family sessions focus on co-regulation practice, communication pattern analysis, and collaborative problem-solving. Parents learn to recognize their teen’s distress signals and respond with grounding rather than escalation. The teen always participates; at least one parent or guardian is included, with both parents or guardians preferred.

Phase 6: Consolidation & Toolkit

Building a personalized set of grounding resources the teen can use independently. This includes home and school practice strategies, crisis protocols, and a toolkit of techniques that have proven effective during the program.

Phase 7: Maintenance & Boosters

Brief check-in sessions during developmental transitions (school changes, exam periods, family shifts). These sessions help prevent relapse and allow the clinical team to adjust strategies as the teen matures.

Clinical Team

Dr. Carlos Yu, MD

Family Physician and Presence Therapist. Lead clinician for the adolescent self-harm program. Over 35 years of clinical experience integrating conventional medicine with awareness-based therapeutic approaches.

Cherie Young

Therapeutic Assistant. Coordinates skill practice sessions and provides continuity of support between clinical appointments.

Family-Centred Model

This program recognizes that adolescent self-harm affects the entire family system. The family-centred model means:

• The teen always participates in their own care
• At least one parent or guardian is included—ideally both
• Family sessions address communication patterns, not blame
• Parents receive their own grounding tools to support their teen at home
• Custody and guardianship situations are accommodated with appropriate documentation

OHIP Coverage & Billing

All sessions in this program are billed to OHIP. There is no out-of-pocket cost for patients with valid Ontario health coverage.

Sessions are billed under family and group psychotherapy codes. For referring FHO (Family Health Organization) physicians: these services fall outside the basket and do not negatively impact access bonuses or shadow billing arrangements.

Referral Process

Referrals are accepted from family physicians, paediatricians, psychiatrists, and other regulated healthcare providers.

1. Submit referrals for the adolescent (mandatory) and a minimum of one parent or guardian (both preferred)
2. Indicate custody/guardianship status with supporting documentation where applicable
3. Include a brief clinical note describing the presenting concern and relevant history
4. Fax completed forms to 905-683-0690

After referral, the clinical team will contact the family to schedule an intake assessment.

Contact

For questions about the program or to discuss whether a patient may be appropriate for referral:

• Phone: 905-683-0690
• Fax: 905-683-0690
• Email: ajaxharwoodclinic@gmail.com
• Location: 88 Harwood Avenue South, Ajax, ON L1S 2H6

If you or someone you know is in immediate danger, call 911 or go to your nearest emergency department.