Deliberate self-harm is an important public health concern impacting children and adolescents. Although once considered rare, an increasing number of children and adolescents engage in deliberate self-harm or self-mutilating behaviors, including hitting, cutting, burning, hair-pulling, skin picking, and other behaviors intended to create injury. While self-harming behaviors are frightening to others, underlining reasons for the behavior is typically to ease emotional distress. This course will explore the reasons children and adolescents engage in self-harming behaviors and review some of the underlying causes that have been identified. The course will also explore signs and risk factors seen with deliberate self-harm, as well as the most effective treatment approaches.