We work with young people struggling with bullying at school or family relationships. School is a big issue for many while other triggers are childhood abuse, be it sexual, emotional or physical. It may be teenagers swallowing bleach, poisoning themselves with tablets, cutting themselves or strangulation attempts.

They come to us to prevent further self-harm and develop more positive coping strategies. Some may hide the fact that they are injuring themselves. Others self-harm to get attention but that doesn't mean they should be ignored. If someone is crying for help we need to listen. They need to look at how to ask for help in a more positive way.

The young people called their group Release after its first session - it describes what they feel when they self-harm. Tension builds up and they may feel physical release when they see the blood flowing, for instance; they are letting the pain out.

Release started in 2006 and the group is usually made up of eight young people aged between 13 and 19 who meet every week for ten weeks after school. Coming to the group is voluntary and they don't always turn up for every session. They work with at least two facilitators, mental health professionals or social workers. The young people share their experiences with each other. Confidentiality is vital and we screen to make sure that if two members come from the same school they will respect each other's confidences and be happy to work together.

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We do anxiety-management work, explore alternative coping strategies and work on relaxation techniques. We might put a map of a body on the floor so the group can think about how different parts of the body feel when we are stressed.

At first they are very guarded. The big change we notice is in self-esteem. We focus on building confidence and get them to fill in self-evaluation forms so that they can describe how they feel as they progress through the course. Trust develops quite quickly. Once they realise they are not the only ones to feel as they do, they change very quickly and some close friendships develop with the group, providing a safe haven for them.

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With surveys suggesting that one child in ten in every classroom self-harms, RAP was delighted to be awarded £7,500 from the Queen’s Nursing Institute this year, so that it can extend its work to two other Essex towns.

But RAP isn’t just about supporting the young people, says Sarah Brazier, a nurse who works with RAP’s group for parents, Families Learning about Self-Harm.

“Parents struggle with how they can support their child. A lot of them say they feel that they are walking on eggshells,” she says. “There is a lot of self-blame, although it may not have anything to do with family life.

“We support parents to improve their own social networks. One mum was afraid to mention it to her best friend. When she did tell her she discovered that her children were doing something similar.”

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