One of the more controversial issues in working with people who self-injure is whether counselors should use no-harm contracts. Important therapeutic considerations include the efficacy of such contracts or agreements in preventing self-injury, the emotional and behavioral responses of clients, and the perceived protection these contracts or…

In this article, self-injurious behaviors are examined through the conceptual framework of relational cultural theory (RCT). As an emerging theoretical approach that takes into account the importance of relationships and relational goals, it is suggested that RCT be used in conjunction with mainstream approaches to treat self-injury.