Dating advice does she like me
The therapist has a duty on multiple levels to create an atmosphere of safety for the patient.
Sometimes patients will act in ways that are impulsive and dangerous, and it is the therapist’s duty to try to limit those behaviors as much as possible, not unlike a parent’s duty is also to limit a child’s impulsive behavior.
I don’t use this comparison lightly; therapy in some cases is equivalent to emotional re-parenting, and reigning in is necessary to promote the patient’s ultimate health, and not their momentary comfort.
The therapist has no way to know what constitutes safe self-injury and what doesn’t.
If the patient is new to the therapist and there is no track record, the therapist has no way of knowing if the patient is likely to be under or over representing the degree to which they are able to keep themselves safe.
Many people who self injure will report suicidal ideation and other signs that are consistent with an elevated suicide risk.
If you think about the situation from the perspective of a therapist, the temptation to report when someone tells you they are engaged in a risky and potentially lethal set of behaviors such as self-injury is very high.Homicidal intent is always a reportable issue, and so is suicidal intent.