SELF-INJURY Kellie Szerlag, M.Ed. School Psychology Intern University of Massachusetts, Boston What’s Happening: Adolescence • Time of transition and change. • Maturing bodies and minds • Combination of Thoughts/Feelings: center of attention, but alone in experiences. • Early Adolescence: world is more black and white. • Later Adolescence: better able to understand self. • Learning How to: • Establish and maintain relationships. • Define self and purpose. • Understand themselves and the world. Why discuss Self-Injury? • Nonsuicidal self-injury (NSSI): is a growing public health concern among adolescents. • Self-injury is often identified in schools What is Self-Injury? • Terms: self-harm, cutting, self-mutilation, & non- suicidal self-injury (NSSI) • NSSI: “the deliberate destruction of one’s own body tissue without the intent of death” (Taylor, Peterson, & Fischer, 2012). Self-Injury vs. Suicide Attempts • Self-injurers are typically not attempting suicide. • Connection to thoughts of suicide later in life. • Physically harmful and dangerous • Related to impulsiveness • Dysfunctional/Maladaptive coping strategy Most Common Forms of Self-Injury • Skin cutting • Burning People who Self-Injure might: • Pick or interfere with wound healing • Engage in behavior secretively • Bathrooms or other secluded areas. Identifying Self-injury • Frequent unexplained scars/burns • Non-dominant arms, forearms, hands • Can be anywhere on body • “Covering-up” with clothing • Constant wearing of wrist bands, long sleeves, multiple bracelets Who is at-risk? • Victims of abuse • Family Conflict • Mental illness • Higher rates among: • Females • LGBTQ Who is at Risk? • Impulsivity • Low self esteem • Low levels of resiliency • Poor problem-solving skills • Difficulty regulating emotions • Often related drug and alcohol abuse Adolescents who self-injure reported they do it to: • Self-soothe • Reduce severe distress • “Feel good” • Express negative feelings • Hopelessness, worthlessness, depression, anxiety or distress • Fight feelings of numbness • Feel a sense of control Why Adolescents Self-Injure • Belief: self-injury achieves emotional equilibrium when they can’t regulate or control emotions (self-soothe). • To relieve intolerable emotional pain • To communicate a deep sense of anguish. • A cry for help Self-Injury in Social Groups • Sometimes considered “contagious” among groups of friends. • Importance of protocols for dealing with self- injury in schools. • Parent involvement and communication with children. Protective Factors • Connectedness • Access to mental health services • Spiritual life • Stable families Roles of the School • Communication is important between school- home-outside clinician. • Support Staff and Medical Professionals • School should be involved in the reinforcement of coping strategies and communication skills. Responding to Self-Injury • Medical attention • Outside counseling or therapy • Have a strong support system, treatment can be long and tough for parents. • Support siblings Responding to Self-Injury • Understand self-injury as a way to cope or handle intense feelings. • Encourage them to share feelings through journaling or in art (drawing, painting, creating). • Remove tools • After-school activities or hobby/interest. • Community outreach Things to Avoid • Avoid statements that might cause guilt or shame • Try not to appear shocked by this behavior. • Avoid talking about their self-injury in front of friends or with other relatives. • Try to teach them what you think they should do • Avoid punishment for self-injurious behaviors. • Overprotecting might be harmful, but try to be aware of what’s going on. • Don’t blame yourself for your child’s behavior. Communication and Bonds as Protective Factors • Family connectedness is a protective factor. • Reduced likelihood of harmful or dangerous behaviors (e.g., drugs, alcohol, or sex, etc.) • Fewer mental health problems • Increased likelihood of making “right” choices and standing up for believes. • Predicts more constructive coping skills and social skills • Difficult topics are better discussed when connectedness and communication are in place. But my child pulls away… • Searching for own identity. • Time spent with family drops an estimated 21% • More times with friends, work, or dating relationships. • Does not mean there is not a secure bond or good relationship • Conflicts happen • Not a sign of poor relationship • Important that parents and adolescent maintain understanding and empathy while disagreeing • Confidently state opinion show empathy/understanding of other point of view. Communicating with your Child • Ask open questions (what or how) to encourage him/her to open up. • Allow conversations to revolve around what interests your child. • Spend time together, with their choice of activity. • Dinner time and Cooking together • Connections with other family members Safety • Independence but still developing good decision making skills. • Peer approval is important. • Discuss Safety and dangerous consequences of: • Motor vehicles • Substance abuse • Protective Gear in sports • Healthy Relationships • Internet Safety What helps your family stay connected? Approaches to discussing difficult or sensitive topics that have worked for your families? Local Resources & Support Lines • Wayside Youth & Family Support (508)-879• • • • 9800http://www.waysideyouth.org/ Advocates, Inc (508)-628-6300 www.adocatesinc.org National Suicide Prevention Lifeline 1-800-273-TALK (8255) Samaritans Statewide Befriending Line 1-877-870-HOPE (4673) (24 hrs) Samariteens Helpline 1-800-525-TEEN (8336) 3pm-9pm weekdays/9am-9pm weekends Additional Resources American Self Harm Information Clearinghouse • http://selfinjury.org National Mental Health Association (fact sheet) • www.nmha.org/infoctr/factsheets/selfinjury.cfm National Association of School Psychology (NASP) • http://www.nasponline.org/families/index.aspx • Questions? Thank you! References Bakken, N. W., & Gunter, W. D. (2012). Self-cutting and suicidal ideation among adolescents: Gender differences in the causes and correlates of selfinjury. Deviant Behavior, 33(5), 339-356. doi:10.1080/01639625.2011.584054 Brock, S. E. (2002). 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