Objective To explore the therapeutic effect of family participation combined with transcranial magnetic therapy on adolescents with depressive disorder and non-suicidal self-injury （NSSI）. Methods From January 2020 to December 2023， 100 adolescents with depressive disorder and NSSI admitted to the Department of Psychological Rehabilitation of Sinopharm North Hospital of Inner Mongolia Autonomous Region were selected as participants. Patients were randomly divided into a study group and a control group using a random number table method， with 50 cases in each group. Both groups were orally administered with sertraline hydrochloride tablets， and control group received transcranial magnetic therapy on this basis， while study group received treatment in combination with family participation on the basis of control group. The total effective rate， family function， psychological resilience， and improvement of NSSI were compared between two groups of patients before and after treatment. Results After treatment， the total effective rate of study group was 94.00% （47/50）， which was higher than control group's 80.00% （40/50）， and the difference was statistically significant （χ2 =4.332， P＜ 0.05）. The psychological resilience scores of both groups of patients after treatment were higher than before treatment， and the psychological resilience scores of study group after treatment were higher than those of control group， with statistical differences （t=3.243， 3.120， 3.201； all P ＜ 0.05）. The difference in strength and optimism of the two groups of patients before and after treatment was statistically significant （Z=-3.095， -2.475； P＜ 0.05）. The incidence of NSSI and addiction score in both groups of patients after treatment were lower than before treatment， while the self-control score was higher than before treatment， and the addiction score in study group was lower than those in control group after treatment， while the self-control score was higher than that in control group， and the differences were statistically significant （all P＜0.05）. There was a statistically significant difference in addiction and self-control score between the two groups before and after treatment （Z=3.693， -4.350； P ＜ 0.05）. After treatment， the family function scores of both groups were lower than before treatment， and the family function scores of study group were lower than those of control group after treatment， with statistical differences （t=7.177， 2.098， 5.157， 5.740， 3.334， 7.432， 3.906； all P ＜ 0.05）. The difference in problem-solving， role， emotional response， behavioral control， emotional intervention， and overall function between two groups of patients before and after treatment was statistically significant （Z/t=-3.874， 3.986， 3.873， -3.226， 2.720， 3.670； P＜ 0.05）. During the treatment process， there was no statistically significant difference in the incidence of adverse reactions between the two groups ［study group 6.00%（3/50） vs control group 8.00%（4/50）］ （χ2 =0.154， P＞ 0.05）. Conclusions Family participation combined with transcranial magnetic therapy is beneficial for leveraging the family function of adolescents with depressive disorder and NSSI， enhancing their psychological resilience， and improving NSSI.