Assessment and Treatment of Non-Suicidal Self-Injury : A Clinical Perspective

Assessment and Treatment of Non-Suicidal Self-Injury: A Clinical Perspective is the ideal primer for anyone who works with people who self-injure. Profiling who is affected as well as what their behaviour includes, the book explores the range of factors behind why people self-injure, from the influence of social media to the need for self-regulation, and offers recommendations for both assessment and outpatient treatment. Throughout, the book is permeated by profound respect for those who use self-injury in an attempt to live a good life, while conveying a deep understanding of the challenges that self-injury presents for family members and treatment professionals. It recognizes that the behaviour can spread in hospital wards or other institutional setting, introducing the concept of self-injury by proxy, and assesses the range of therapies available, including CBT, MBT, ERGT and family therapy. Each chapter is complemented by clinical vignettes. In an era when a great number of professionals will come into contact with someone who self-injures – including teachers, social workers and nurses as well as therapists – The Assessment and Treatment of Non-Suicidal Self-Injury is an invaluable resource that examines both the causes and the treatments available. Cover Half Title Title Copyright Contents List of illustrations Introduction 1 What is non-suicidal self-injury? Direct self-injury Indirect self-injury Self-injury by proxy Digital self-harm Terminology Typologies of self-injury 2 Non-suicidal self-injury - an autonomous diagnosis? Categorizing self-injurers in non-clinical populations Autonomous diagnosis in DSM-5 Differential diagnoses 3 Epidemiology and gender differences Prevalence in different age groups Onset, course and prognosis Gender differences Women cut; men hit themselves A literary example of a man who self-injures 4 Self-injury as a sign of the times? Historical descriptions of self-injury Skin Late modern society When perfect becomes the new normal Self-injury as social pathology Demedicalizing and normalizing self-injury Social media 5 Historical theories and new models for understanding non-suicidal self-injury Historical theories Emotion dysregulation and three theoretical models The Benefits and Barriers Model Vulnerability and resilience factors for the development of self-injurious behaviour Risk factors Resilience factors 6 Attachment, affect regulation and growing up in an invalidating environment Attachment Internal working models The Strange Situation and patterns of attachment Mind in mind and affect regulation Congruent and marked mirroring The alien self Mentalizing Mentalizing, mindfulness and validation Developing a mentalizing capacity Failure of mentalizing and NSSI Good mentalizing Dissociation Dissociation and self-injury The biosocial theory and the impact of an invalidating childhood environment 7 From meaning to function A functional model of NSSI Functions of NSSI Model of perpetuating self-injuring behaviour 8 Pathophysiology and neurobiological perspectives on self-injury The role of neurotransmitters in NSSI Adrenalin, noradrenalin and cortisol The low road and the high road Endogenous opioids Serotonin Other neurotransmitters 9 Assessment of patients with non-suicidal self-injury Therapeutic contact with the self-injuring patient Assessing patients with self-injury Assessment instruments Motivation for treatment Levels of treatment Prioritizing treatment focus 10 Treatment of non-suicidal self-injury - an overview Problem-Solving Therapy (PST) Manual-Assisted Cognitive Therapy (MACT) Emotion Regulation Group Therapy (ERGT) Mobile apps Family therapy Physical exercise Medical treatment Core elements in the psychotherapeutic treatment of NSSI 11 Dialectical Behaviour Therapy Dialectical dilemmas Treatment structure The five stages of DBT Validation Change strategies Crisis card Contact between patient and therapist Effect of DBT on NSSI 12 Mentalization-Based Therapy - keeping mind in mind Treatment structure Case formulation Treatment principles General intervention Intervention hierarchy Elements of MBT Effect of MBT on NSSI 13 Treating self-injury during hospitalization Emotional dysregulation during hospitalization Sedatives Self-injury by proxy - mechanical restraints The spiral of self-injury - the 'tacit dialogue' Reactions that may exacerbate self-injuring behaviour NSSI and peer influence Principles of a non-confrontational culture The practical organization of the treatment 14 When a loved one self-injures Walking on eggshells Accepting the difficult situation Survivor's guilt Neutral topics Talk about it Educate yourself online and via the literature Parental burnout Parental relations — GIVE Scars References Index "[This work is a] primer for anyone who works with people who self-injure. Profiling who is affected as well as what their behaviour includes, the book explores the range of factors behind why people self-injure, from the influence of social media to the need for self-regulation, and offers recommendations for both assessment and outpatient treatment. Throughout, the book is permeated by profound respect for those who use self-injury in an attempt to live a good life, while conveying a deep understanding of the challenges that self-injury presents for family members and treatment professionals. It recognizes that the behaviour can spread in hospital wards or other institutional setting, introducing the concept of self-injury by proxy, and assesses the range of therapies available, including CBT, MBT, ERGT and family therapy. Each chapter is complemented by clinical vignettes. In an era when a great number of professionals will come into contact with someone who self-injures - including teachers, social workers and nurses as well as therapists - The Assessment and Treatment of Non-Suicidal Self-Injury is a ... resource that examines both the causes and the treatments available."--Provided by publisher "Assessment and treatment of non-suicidal self-injury. A clinical perspective is the ideal primer for anyone who works with people with people who self-injure. Profiling who is affected as well as what their behaviour includes, the book explores the range of factors behind why people self-injure, from the influence of social media to the need for self-regulation, and offers recommendations for both assessment and outpatient treatment. Throughout, the book is permeated by profound respect for those who use self-injury in an attempt to live a good life, while conveying a deep understand of the challenges that self-injury presents for family members and treatment professionals. It recognizes that the behaviour can spread in hospital words or other institutional setting, introducing the concept of self-injury by proxy, and assesses the range of therapies available, including CBT, MBT, ERGT and family therapy. Each chapter is complemented by clinical vignettes."--Page 4 de la couverture This book is the ideal primer for anyone who works with people who self-injure. Profiling who is affected as well as what their behaviour includes, the book explores the range of factors behind why people self-injure and offers recommendations for both assessment and outpatient treatment.