The first step in diagnosing the problem is a psychiatric evaluation, which will likely include a mental status examination and patient history. In addition to looking for signs of mental disorders that can accompany cutting (e.g., borderline personality disorder), if possible it is useful for the mental health professional to identify and assess the following:

• What function cutting serves for the self-injurer
• The intent behind past cutting
• Thoughts that contribute to cutting
• Intended or unintended consequences that reinforce cutting

A physical examination may also be included, with particular attention paid to areas of the body where self-injury has occurred.

The next step is a recommended course of treatment. The treatment approach will depend on any accompanying conditions or underlying issues. Possible treatment methods for cutting include:

• Medication. The type of medication used will depend on the accompanying disorder. For instance, treatment for cutting associated with depression may involve antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs).
  
  
• Psychotherapy. The treatment of mental and emotional disorders using a variety of psychological techniques. Psychotherapy can be performed in one-on-one, family or group settings. The type of psychotherapy chosen depends upon the nature of the underlying mental disorder. Specific psychotherapy techniques include:
  
  
• • Cognitive behavioral therapy, which addresses a person’s thoughts in relation to their actions.
    
    
  • Dialectical behavior therapy, which focuses on coping skills, managing emotional trauma and tolerating distress. Both dialectical and cognitive behavioral therapies may help self-injurers to identify any possible underlying cause and better manage self-destructive thoughts and behaviors.
    
    
  • Interpersonal therapy, which focuses on human relationships. This type of therapy can help self-injurers develop better social skills to help decrease the likelihood of emotional and physical isolation from others.
    
    
• Contracts, journals, behavior logs. These tools track thought and behavior patterns and can help the self-injurer regain self-control.

Whether or not to hospitalize an individual who engages in cutting should be carefully evaluated. At times, it may be felt that the individual does not appreciate the severity of the problem and family members may need to hospitalize (commit) the person against his or her will. However, hospitalizing a person immediately after cutting may come at a time when the patient is actually feeling her or his best and is actually less likely to engage in additional self-harm.

Before making the decision to hospitalize, it is important to identify whether the cutting was an act of nonsuicidal self-injury or an actual suicide attempt. A comprehensive psychiatric evaluation can help in making this decision.