Issues regarding the diagnosis and treatment of non-suicidal self-injury (NSSI) continue to be of increasing concern to practitioners in educational and mental health settings. Given this rising concern, it is important to note that the majority of research regarding self-injury has focused on the symptomology and treatment of Caucasian females; little work has been done regarding the prevalence, presentation and treatment of self-injury with other populations (Marchetto, 2006). This article provides a rationale for addressing gender, culture and other issues of diversity in relation to self-injurious behaviors, including analysis of the Youth Risk Behavior Survey to provide empirical evidence for why additional issues of diversity need to be addressed. Implications for clinical counseling practice are discussed.