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Anastasia Glacken

on 6 August 2014

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Transcript of Self-Harm

build a strong, healthy alliance with the student
listen and be empathetic
help the child to feel connected, heard, supported, and valued
focus on reducing the environmental factors that trigger self-harm
use CBT strategies where appropriate
teach self-monitoring
teach assertiveness techniques and build communication skills
break the pattern of circular negative thinking
empowerment - discover student's personal strengths
encourage students to communicate their feelings in many adaptive ways
help to increase self-respect, self-esteem and self acceptance
encourage involvement in areas of interest
encourage positive connections to community

What is Self-Harm?
Definition: Self-Harm consists of self-inflicted deliberately destructive acts resulting in tissue damage that are not intended as an act of suicide, are not widely socially acceptable, and are not due to autism or other developmental disorders.
What to look for
scars, cuts, bruises, and burns (arms, thighs, abdomen)
consistent / inappropriate use of clothing to cover scars
secretive behavior (bathroom / isolated areas)
general signs of depression, anxiety, or other mood changes
changes in relationship, communication, and school performance
possession of sharp implements
indications of extreme anger / sadness / pain
images of physical harm in class work, creative work
extreme risk-taking behavior that could result in inury
substance abuse
hair pulling
head banging
Most common is cutting (razors/knives/scissors/protractors)
Why students cut
contagion effect
movies and tv have drawn attention
websites: youtube, tumbler, chat rooms
celebrities going public with cutting
peers / behavior is imitated
an impulsive reaction to a distressing situation
a defense against what's going on in their lives,
gain control where they feel they have failed
a symptom for other psychological problems
Additional protocols
do not react in horror or discomfort
address medical needs as necessary
conduct risk assessment for suicide
connect and build relationship
don't be directive or judgemental
reassure there is nothing to be ashamed of
acknowledge their feelings
offer to listen
emphasize hope
emphasize help and treatment is available
assure them they are not in trouble
notify parents /follow school protocol
collaborate with parents/ school psychologist and/or social worker
explore possible referrals / additional resources (i.e. GP, MATC)
provide parent(s) with information explaining self-harm behaviors and how they may be supportive to their child

Counselling considerations
Limiting Contagion Effects and Triggers
Evaluate whether student has friends who self-harm
Evaluate if time is spent on websites or chat rooms devoted to self-harm
Do not "Contract for Safety"
Do not run workshops or group counseling for self-harm behaviors
initial age of onset - tweens and teens ages 9 -14
among grades 3 - 6 equal numbers between genders
middle school onward more prevalent in girls 2 - 1
accepted part of Goth/Emo culture
a way to cope with the effects of having been bullied
may have abusive history (sexual/physical/verbal)
absent or "too-busy" parent(s)
parental divorce
may present as a symptom for other issues
yet many are just "regular kids" experimenting, curious
Self-Harm behaviors
are complex bio-psychosocial phenomenon, separate and distinct from suicide
cognitive, affective, behavioral, biological, psychological and environmental behaviors combine to produce the behavior
the release of endorphins
the pain-killer effect
What«it looks like
small linear cuts, straight line often linear
words: fat, ugly, loser, stupid, lonely, love
wrists, arms, inner thighs, ankles, abdomen
Why we need to intervene
very addictive
over time may escalate
more often, more cuts each time, and deeper, longer cuts
can become the only method to cope
acts as a pain-killer literally numbing the child's emotional pain or brings them back from dissociation/numbing
very secretive behavior
feelings of accompanying shame and guilt can lead it to becoming a punishing behavior
children want help but are not able to seek it out
Self-Harm is not a problem that kids can simply outgrow
They often don't know how to stop
Kids have to decide they don't want to cut anymore
They need help to develop healthier ways of coping
The sooner we intervene, the better the chances for successful outcomes
«How to respond initially
it is an attention seeking behavior
histories of abuse almost always coincide
only occurs in females
a fad that students outgrow
can be controlled by the individual
only occurs in certain income / ethnic pop.
it is easy to seek help
they can stop if they really want to
kids know why they are cutting
The End

The End
thank you
Full transcript