Post on 28-Dec-2015
transcript
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What is There to Gain?Understanding Adolescent
Self-Mutilation
Sheena Smith2009 MSW Colloquium May 5, 2009Baylor School of Social Work
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Overview
Objectives
Statistics
Characteristics
Story
Intervention
Frameworks
Ethics
Questions and Discussion
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Objectives Identify key characteristics of self-mutilating teens
Discuss the purpose behind the behaviors
Explore prevention and intervention techniques
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What are Self-Mutilating Behaviors? Interchangeable terms
Self-mutilation Self-injury Self-harm Self-abuse Cutting
Definition of self-injury “Self-injury is characterized as any sort of self-harm that
involves inflicting injury or pain on one's own body.”
Source: Simpson, 2001
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United States Statistics 1 in 5 of U.S. teens self-injure
Highest among teenage females
All races and social classes involved
29 is the average age to stop self-injuring
90% grew up in homes where family problems were ignored and communication was lacking
50% were sexually or physically abused
Frequently associated with additional disorders
50% attempt suicide
Source: http://www.answers.com/topic/self-mutilation
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Characteristics of Self-Mutilation
Torment of different feelings and trauma
Rarely life-threatening
Not part of group rituals or trends
Impulsive-not planned actions
More difficult to stop and more severe with time
Often takes place for years before disclosure
Source: Levenkron, 2006
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Connections to Mental Health Mental and Emotional Desperation
Not recognized disorder in DSM IV
Associated as feature of larger disorders
Neurological Impairments
Medication is not enough
Source: Levenkron, 2006
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Nature vs. Nurture Nature
Effects from birth to age 6-9 Developmental junctures Influence of biologically associated disorders
Nurture Parenting approach Dysfunctional family life Childhood trauma
Source: Levenkron, 2006
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Why Self-Mutilation?
Coping mechanism
Inexpressible rage, emotion, chaos
Dissociation, numbness vs. pain and blood
Release of endorphins
Drown out/divert attention
Intangible emotions are made tangible
Self-punishment
Source: Levenkron, 2006
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What they have to say… “Self-injury is a sign of distress, not madness. We should be congratulated
on having found a way of surviving.” -Cory Anderson
“The great art of life is sensation, to feel that we exist, even in pain.” -Lord Byron
“My skin sheds the tears that I can’t cry.” -Anonymous
Source: http://www.youtube.com/watch?v=tRw8iN11oww&feature=related
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Shila’s Story
Is this an example of nurture or nature?
What actions and feelings led to the behaviors of Shila?
Source: Levenkron, 2006
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The Helping Process Identify team of professionals
Locate support networks
Allow time and patience
Seek behavioral change
Address the scars
Source: Levenkron, 2006
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Social Work Techniques Prepatory empathy
Validation of thoughts and feelings
Positive ideas and strengths
Monitoring and accountability
Conflict and confrontation role-playing
Source: Levenkron, 2006
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Quote
“Routine discussions of the injuries and deciding what to do about
them increases trust, begins to integrate the personality’s sense of
relationship to another person, and replaces self-mutilation with
Attachment.”
Source: Levenkron, 2006,183
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Frameworks
Family Systems Theory
Psychotherapy
Nurturant-Authoritative Therapy
Functional Approach
Solution-Focused
Strengths Perspective
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Remember! Self-injury has a purpose and function
Self-reflection, supervision, and debriefing are necessary
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Ethical Considerations NASW ethics used in intervention
Dignity and worth of a person
Importance of human relationships
Ethical Challenges
Confidentiality
Cultural, religious beliefs
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ReferencesDuperouzel, H., Moores, P. (2009). The good, the bad and the ugly: Experiences of self-injury [Electronic version]. Learning
Disability Practice, 12, 21-23.
Fish, R., Duperouzel, H. (2008). Just another day dealing with woulds: Self-injury and staff-client relationships [Electronic version]. Learning Disability Practice, 11, 12-15.
Hilt, L., Cha, C. Nolen-Hoeksema, S., (2008). Nonsuicidal self-injury in young adolescent girls: Moderators of the distress-function relationship [Electronic version]. Journal of Consulting and Clinical Psychology, 76, 63-71.
Klonsky, E. (2008). Identifying clinically distinct subgroups of self-injurers among young adults: A latent class analysis [Electronic version]. Journal of Consulting and Clinical Psychology, 76, 22-27.
Levenkron, S. (2006). Cutting: Understanding and overcoming self-mutilation. New York: W.W. Norton and Company, Inc.
Nock, M. (2009). Why do people hurt themselves?: New insights into the nature and functions of self-injury [Electronic version]. Current Directions in Psychological Science, 18, 78-83.
Simpson, C. (2001). Self-mutilation. ERIC/CASS Digest, ERIC Clearinghouse on Elementary and Early Childhood Education. Retrieved April 23, 2009, from http://www.athealth.com/Consumer/disorders/selfmutilation.html
Wedge. (2009). Self injury: Self-expression inside out [Electric version]. Healthcare Counseling and Psychotherapy Journal, 9, 22-25.
Psyke.org. Self-injury Information and Support. Retrieved April 28, 2009 from http://www.psyke.org/articles/