Transcript TEEN SELF-INJURY by Henry O’Brien, School Psychologist

ADOLESCENT SELF-INJURY by
Henry O’Brien, School
Psychologist
AGENDA
GENERAL INFORMATION REGARDING SELFINJURY
VIEW “CUT: THE MOVIE” (56 MINUTES)
Role of Parents Contd.
 Parents…what you need to know
 If you believe your child is suicidal, IMMEDIATELY
contact your therapist, if you have one or call 911
 Self-injury is a strong risk for suicide
 Take suicidal statements seriously
Definition of Self-Injury
 Deliberate self-inflicted harm resulting in tissue
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damage without the conscious intent of suicide
Behaviors include (but are not limited to):
Cutting, scratching
Burning
Interfering with the healing of wounds
Hitting or biting oneself
Head banging
Hair pulling
Incidence & Onset
 4% in the general population
 = numbers of males and females (though more
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females present for treatment)
Typical onset: puberty
though can be seen in young children and adults
Often lasts 5-10 years
But can last longer without treatment
Background Factors
 Found in = numbers in all ethnic groups
 Nearly 50% report physical/sexual abuse (At least 50%
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have NOT reporting abuse)
Many report that they were discouraged from expressing
emotion, particularly anger and sadness
Feelings of emptiness, over/under stimulated
Unable to express feelings
Lonely, fearful of intimate relationships or adult
responsibility
Feeling invalidated/disconnected from parents
Behavior Patterns
 Cutting arm/legs most common practice
 May attempt to conceal injuries (long sleeves/pants)
 Often make excuses
 Significant # also struggle with eating
disorders/substance/alcohol abuse
 Big difference between self decorating (tattoos/piercings)
and self harm
 Teens who self harm are seeking relief from emotional
distress
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Warning Signs
 Unexplained, frequent injuries including cuts and
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bruises
Wearing of long pants/sleeves in warm weather
Low self-esteem
Overwhelmed by feelings
Inability to function at home, school or work
Inability to maintain stable relationships
Dangers
 Can become desperate about lack of self-control and
addictive-like nature of acts
 May lead to true suicidal attempts
 Self-injury may cause more harm than intended. Can
result in medical complications or death
 Eating disorders/AODA intensifies threat to overall
health and quality of life
Purpose of Self-Injury
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Feelings of Emptiness
Over/under stimulated
Unable to express feelings
Lonely
Not understood by others
Fearful of intimate relationships and adult responsibilities
Way to cope with or relieve painful/hard to express feelings
Relief is temporary
Self-destructive cycle often develops without treatment
Wanting to fit in
Feeling emotionally dead inside
Self harm feels alive and confirms existence
Coping strategy
Therapies
 Cognitive Behavior Therapy
 Gestalt Therapy
 Reality Therapy
 Client-Centered Therapy
 Steven Levenkron/Audio Discussion of Therapies
Role of Parents
 Parents…what you need to know
 2. Some parents find it hard to deal with their own emotional response..
 Don’t minimize the problem (assuming that he/she is just doing it “for
attention”
 Know that self-injury is never a healthy coping strategy. It is an indication
that the child is having trouble coping with stressful issues and emotions.
 Some teens are more open with a professional than their parent
 Don’t overreact…result could be more hiding of behavior
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Role of Parents Contd.
 Parents…what you need to know
 Injuring is a coping strategy and not the problem
itself
 Instead of focusing on behavior understand that the
child needs help to identify and express emotional
issues verbally
Resources
 Whitlock, J. L., Powers, J. L., & Eckenrode, J. (2006). The
virtual cutting edge: The internet and adolescent self-injury.
Developmental Psychology, 42(3), 407-417.
doi:10.1037/0012-1649.42.3.407
 Plante, L. G. (2007). Bleeding to ease the pain: Cutting, self-
injury, and the adolescent search for self. Westport, CT, US:
Praeger Publishers/Greenwood Publishing Group. Retrieved
from
http://search.proquest.com/docview/621696309?accountid=
34899
Resources Contd.
 Hodgson, S. (2004). Cutting through the silence: A
sociological construction of self-injury. Sociological Inquiry,
74(2), 162-179. doi:10.1111/j.1475-682X.2004.00085.x
 Nock, M. K., & Deliberto, T. L. (2009). In Galanter C. A.,
Jensen P. S. (Eds.), Cutting helps me feel better: Nonsuicidal
self-injury. Arlington, VA, US: American Psychiatric
Publishing, Inc. Retrieved from
http://search.proquest.com/docview/621924292?accountid=
34899
Student Case Study
 Name: Donna
 Gender: Female
 Age: 15 yrs 8 months
 Lives with biological mother/only child
 Academic Standing:
 Gpa: 1.9
 FAIR Results: 49
 FCAT Results: Level 1 in Reading, Math & Writing
 Not completing assignments regularly.
Case Study Contd.
 Special Education:
 SLD & EBD
 2009 AND 2011: Spent time in intense behavior
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modification program.
Does not keep relationships for long.
Evaluations:
CDI & RCMAS/ BOTH SIGNIFICANT
DSM-IV DIAGNOSIS:309.28
Mixed Anxiety and Depressed Mood