Reviewed by Vinsent Franke, MBA, AMFT, CADC-II, RA, Founder of iRely Recovery. Updated September 2026.
Intro
Self-harm is not a character flaw. It is a survival behavior used to manage emotions that have become intolerable, and a better alternative is teachable.
iRely Recovery is a self-harm treatment center in Los Angeles providing DBT-based dual diagnosis care for non-suicidal self-injury (NSSI) and co-occurring addiction in a Joint Commission-accredited, ASAM 3.5 residential program.
Key Points
- NSSI is commonNAMI estimates about 2 million US cases a year, most often beginning in adolescence or young adulthood.
- DBT is the gold standardMultiple randomized trials show significant reductions in NSSI frequency and severity.
- Self-harm and addiction overlapBoth are driven by the same emotional dysregulation deficits.
- ASAM 3.5, PPO acceptedJoint Commission accredited. Call 818-351-1193 for a no-cost benefits check.
In Short
As a dedicated self-harm treatment center, iRely Recovery uses DBT, trauma-informed therapy, individualized safety planning and psychiatric support inside an ASAM 3.5 residential program. We treat NSSI alongside addiction and the underlying conditions that drive both. Most PPO plans accepted. Call 818-351-1193.
Crisis notice: If you or someone you know is in immediate danger, call 911 or go to the nearest emergency room. The 988 Suicide and Crisis Lifeline is available 24/7 by call or text.
What Is Non-Suicidal Self-Injury (NSSI)?
Quick answer: Non-suicidal self-injury (NSSI) is deliberate self-harm without suicidal intent, most commonly cutting, burning or hitting. It works as an emotional regulation strategy, not manipulation or attention-seeking, and it responds to evidence-based treatment, particularly DBT.
NSSI is deliberate, direct damage to one’s own body tissue without suicidal intent. The DSM-5 lists it as a condition for further study, recognizing its clinical significance while distinguishing it from suicidal behavior, though the two can co-occur.
Why It Works Short Term
It produces a physical sensation that interrupts overwhelming emotion, triggers the body’s pain response, or provides a sense of control and release when life feels unmanageable.
Why It Overlaps With Substance Use
NSSI and substance use often serve the identical function: fast, accessible, ultimately self-destructive ways to manage emotional pain. Treatment must address the shared function.
How Self-Harm and Addiction Connect
Quick answer: Self-harm and substance use disorder co-occur in more than 50 percent of clinical populations because both regulate the same emotional states: intense negative affect, dissociation and unbearable tension. Integrated treatment addresses these shared drivers.
The same states that drive self-harm, including emptiness, self-loathing and unbearable tension, also drive substance use. When one behavior is removed without addressing the underlying deficit, the other often escalates. A person may reduce self-harm in a structured setting and increase substance use after discharge, or stop using and immediately intensify self-harm.
Integrated treatment teaches new skills before removing the old behaviors and builds a life with alternative sources of relief, connection and meaning.
Forms of Self-Harm We Treat
Quick answer: We address all forms of NSSI, including cutting, burning, impact self-injury, self-harm through dangerous substance use, and body-focused repetitive behaviors. Each presentation is assessed individually.
Cutting
The most commonly reported form, usually secretive and accompanied by intense shame that reinforces the cycle. Our environment addresses both the behavior and the shame.
Burning
Heat-related self-injury produces a sensation that interrupts overwhelming emotion. We assess the specific function it serves for each person.
Hitting and Impact
Striking the body or hard surfaces, more common in trauma-related contexts, and often needing attention to dissociation and trauma.
Substance Use as Self-Harm
Deliberately using at dangerous doses or in dangerous contexts to express self-directed rage or hopelessness. It needs careful assessment.
Body-Focused Repetitive Behaviors
Skin picking and hair pulling are assessed individually and treated within our model when they serve a tension-relief function.
Signs That Self-Harm May Be Part of the Picture
Quick answer: Signs include unexplained cuts or burns, long sleeves in warm weather, withdrawal after emotional events, and substance use that escalates during crises. Saying physical pain is easier to manage than emotional pain needs clinical attention.
- Unexplained cuts, burns, bruises or scars, particularly on arms, legs or abdomen
- Wearing long sleeves or coverings in warm weather
- Withdrawing from others after emotional events or conflicts
- Saying that physical pain makes emotional pain easier to manage
- Substance use that escalates during emotional crises
- Statements of intense self-blame, self-disgust or self-hatred
- Psychiatric hospitalizations or crisis contacts without long-term resolution
- Increasing risk-taking or deliberately dangerous substance use
DBT for Self-Harm and Addiction
Quick answer: DBT is the gold-standard treatment for self-harm, with multiple randomized trials showing significant reductions in NSSI frequency and severity. Developed by Dr. Marsha Linehan, it teaches mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness.
DBT is the clinical anchor of our program. Dr. Marsha Linehan, who has openly shared her own history of self-harm, built it specifically for the emotional dysregulation that NSSI and addiction share.
Safety Planning
An individualized plan identifies warning signs, coping strategies and support contacts for moments of acute distress. It is not a contract demanding immediate elimination of self-harm, and it starts on day one.
Skills for Regulation and Tolerance
Crisis survival skills such as TIPP and ACCEPTS give concrete, evidence-based alternatives that address the same physiological and emotional states self-harm relieves, without damaging the body.
Chain Analysis
We map the exact sequence of events, thoughts, emotions and sensations behind a self-harm or substance use episode, then identify where a different response could go. This is how DBT produces lasting change.
What to Expect in Our Program
Quick answer: Care starts with a comprehensive intake covering self-harm history, psychiatric diagnoses and safety. Safety planning begins day one, followed by daily DBT skills groups, twice-weekly individual therapy and psychiatric support over a 30 to 90 day residential stay.
Step 1: Assess and Stabilize
A thorough intake covers self-harm history, current diagnoses and safety, done without judgment and at a pace that does not retraumatize.
Step 2: Plan for Safety
Your primary therapist helps you identify personal warning signs and build coping strategies and support contacts. The plan is updated as you progress.
Step 3: Build Skills
DBT skills groups five days a week, individual therapy at least twice weekly, psychiatric care and yoga, breathwork and somatic practices.
Step 4: Step Down
Most clients stay 30 to 90 days before moving to PHP or IOP, where DBT practice continues in daily life. Your discharge plan is built with your team.
Additional Treatment Modalities
Quick answer: Beyond DBT, we offer trauma-informed individual therapy, psychiatric medication management, group therapy, somatic and mindfulness practices and family therapy, all in one coordinated plan.
Trauma-Informed Therapy
Many self-harm presentations have trauma at their root. Trauma work is paced on a foundation of skills and safety, alongside our PTSD program.
Medication Management
Medication does not target NSSI directly, but co-occurring depression, BPD, bipolar disorder, anxiety and PTSD respond well to it.
Group and Peer Support
A community that understands the shame and secrecy of self-harm without requiring it to be hidden, interrupting the isolation cycle.
Somatic and Mindfulness Practices
Yoga, breathwork and body-oriented mindfulness rebuild a non-adversarial relationship with the body and the capacity to tolerate discomfort.
Family Therapy
Families often respond with fear, anger or punishment that increases shame. Sessions help loved ones understand NSSI and support recovery.
Residential Level of Care: ASAM 3.5
Quick answer: iRely Recovery operates at ASAM Level 3.5, the highest level of non-hospital residential care, with Joint Commission accreditation and DHCS License #191516AP. It provides the environmental safety and structure most appropriate for self-harm with co-occurring addiction.
Our facility provides 24-hour supervised care in a structured therapeutic environment, giving both the environmental safety and the clinical intensity needed for meaningful change. Afterward, clients step down to our Partial Hospitalization Program (PHP) or Intensive Outpatient Program (IOP) to continue DBT skills work in real-world practice, with our care coordination team supporting each transition. We also offer grief and loss treatment for people whose self-harm is tied to loss.
Why Choose iRely Recovery
Quick answer: We offer DBT-specialist therapists, ASAM 3.5 residential certification, Joint Commission accreditation and an integrated approach that treats NSSI and addiction at the same time, serving clients across Los Angeles and those who travel for specialized care.
DBT Specialist Team
Safety planning, chain analysis and DBT crisis survival skills are core tools our therapists use every day, not supplemental offerings.
Safe Residential Structure
Our ASAM 3.5 setting removes access to common means of self-harm. That is the beginning, the space where your nervous system can start building lasting skills.
No Shame, No Judgment
Our team receives self-harm disclosures without shock or moralizing. Shame maintains secrecy, and secrecy maintains self-harm.
Integrated Dual Diagnosis
Self-harm and addiction are two responses to the same emotional experience, treated in one coordinated plan.
Serving Greater Los Angeles
Located in Sherwood Forest at 17524 Napa St, serving the metro area and those who travel for care. Call 818-351-1193.
Frequently Asked Questions
Is self-harm a suicide attempt?
No. Non-suicidal self-injury (NSSI) is clinically distinct from suicidal behavior, defined by the absence of suicidal intent. NSSI serves an emotional regulation function, not an escape function. However, NSSI is a significant risk factor for eventual suicidal behavior and warrants thorough clinical assessment. If someone is expressing intent to die or making a suicide attempt, call 911 or go to the nearest emergency room. The 988 Suicide and Crisis Lifeline is available 24/7 by call or text.
Why do people hurt themselves?
The most common function of NSSI is emotional regulation. Self-harm interrupts unbearable emotional states, provides a sense of control, or converts emotional pain into a more manageable form. Other documented functions include self-punishment, communicating distress to others and relief from dissociation. Understanding the specific function self-harm serves for each person is central to treatment, because effective alternatives must address the same function.
What treatment works best for self-harm?
Dialectical Behavior Therapy (DBT) has the strongest and most consistent evidence base for reducing self-harm frequency and severity. Multiple randomized controlled trials show significant reductions in NSSI with DBT for BPD and non-BPD presentations alike. Residential treatment at ASAM Level 3.5 provides the clinical intensity and environmental safety most appropriate for self-harm with co-occurring addiction.
How do I talk to someone about self-harm?
Approach with curiosity rather than alarm or judgment. Ask directly but gently, and listen without immediately problem-solving or threatening consequences. The goal of the first conversation is connection, not resolution. Our admissions team is available to speak with families and loved ones trying to support someone who self-harms. Call 818-351-1193.
Can self-harm treatment and addiction treatment happen at the same time?
Yes, and integrated treatment is the clinical standard. Addressing self-harm without addressing addiction, or the reverse, frequently results in one behavior escalating when the other is removed. Integrated dual diagnosis treatment addresses the shared emotional regulation deficits that both behaviors serve and builds skills across the full emotional regulation system.
Does insurance cover self-harm treatment?
Most PPO insurance plans cover dual diagnosis residential treatment for self-harm and co-occurring addiction under mental health parity laws. Coverage details vary by plan. Our admissions team offers no-cost benefits verification so you understand what your plan covers before you make any decisions. Call 818-351-1193.
Begin Self-Harm and Addiction Treatment at Our Los Angeles Center Today
For Individuals and Families
If self-harm is part of your picture, or someone you love, alongside substance use, you deserve treatment that addresses both without judgment. Our admissions team can answer your questions, verify insurance benefits and walk you through what care at iRely Recovery looks like. Call 818-351-1193 or reach out through our online form.
For Healthcare Providers
iRely Recovery accepts referrals for patients with NSSI and co-occurring substance use disorder. We work collaboratively with referring providers and provide clinical updates throughout the episode of care. To discuss a referral or clinical case, call 818-351-1193.
