Self-injury is a dangerous and pervasive behavior problem among adolescents. Clinical trials testing the effectiveness of psychological treatments for this behavior problem among adolescents are lacking; however, several treatments have shown promise, such as those focused on teaching emotion regulation, distress tolerance, and interpersonal skills. The authors provide a case illustration of the use of dialectical behavior therapy, which is one of the most promising treatments for adolescent self-injury. They then discuss several important considerations in the treatment of self-injury, such as the use of strategies to increase treatment participation and the assessment of self-injury and related target behaviors over the course of treatment to determine its effectiveness and to manage risk of self-injury.