The most helpful behavior management options for treating adolescents who harm themselves or others include Dialectical Behavior Therapy (DBT) , Mentalization-Based Therapy (MBT) , Cognitive Behavioral Therapy (CBT)-based approaches , and family-focused interventions. These therapies emphasize skill-building in emotion regulation, distress tolerance, interpersonal effectiveness, mindfulness, and improving family communication and support. Key points from evidence-based treatments are:

• Dialectical Behavior Therapy (DBT) is among the strongest supported treatments, specifically adapted for adolescents (DBT-A). It helps teens develop coping skills to manage intense emotions and replace self-harm with healthier behaviors, also involving family in skills training to provide a validating home environment. DBT has been shown to reduce both non-suicidal self-injury (NSSI) and suicide attempts in adolescents.

• Mentalization-Based Therapy (MBT) aims to improve adolescents' understanding of their own and others' emotions and motivations, helping regulate impulsive and harmful behaviors. It is usually longer term, involving individual and family sessions, and has demonstrated reductions in self-harm and improvements in emotional functioning.

• Cognitive Behavioral Therapy (CBT) helps adolescents reframe distressing thoughts and develop problem-solving skills. While direct evidence for CBT alone on self-harm is less consistent, integrated CBT elements such as problem-solving therapy are foundational to many effective approaches.

• Family Interventions such as Multisystemic Therapy (MST) and family skills training are critical to address systemic and environmental factors, improve communication, and support adolescents' skill use at home.

• Additional supportive strategies include normalizing feelings without judgment, grounding techniques for dissociative states, anxiety reduction, developing social support networks, and patience in the gradual healing process.

Pharmacological treatments have no specific approval for self-harm itself but may be used adjunctively when there are underlying mood or anxiety disorders.

In sum, behavioral therapies focusing on emotion regulation, interpersonal skills, and family involvement—especially DBT and MBT—are the most helpful management options for adolescents who harm themselves or others.