SELF MUTILATING ADOLESCENTS

Self Mutilating Adolescents

Table of Contents

Chapter One: Introduction4

Introduction4

The Importance of Understanding Self-Injury4

Approaches to Intervention5

Strategies for Implementation7

Challenges to Treatment9

Depression and Anxiety10

Depression in Teenagers11

Role of Depression in Self Mutilation13

Defining and Recognizing Depression13

Diagnosis15

Alcohol, Drugs and Depression17

Treatment and Management18

Psychotherapy18

Cognitive Behavioral Therapy19

Medication20

Teenagers and Self-Mutilation20

Types of Self-Mutilation21

Causes Self-Mutilation21

Role of Parents in Counseling23

Chapter Two: Literature Review27

Reporters of Information32

Timing of Measurement33

Criteria for Treatment Outcomes34

Analysis from Psychological Perspective38

Reasons for Mutilation44

Comparison between Male & Female45

Campaign47

Present Day Situation48

Chapter Three: Methodology51

References53

Chapter One: Introduction

Introduction

Self-injury has become a topic of intense study and controversy in clinical and school settings. Controversy exists from treatment techniques to descriptive terminology. As Laye-Gindhu and Schonert-Reichl (2005) point out, little consensus exists among practitioners and researchers on how to define and conceptualize the phenomenon thus confusing assistance options for a self-injuring youth. This digest offers a conceptualization of self-injury that may empower counselors to offer support and make appropriate referrals.

The Importance of Understanding Self-Injury

School counselors and fellow school professionals have reported that self-injury in the school environment has grown at an alarming rate. A recent study indicated that 13.9% of 440 adolescents sampled participated in self-injurious behavior (Ross & Heath, 2002). While statistics vary, the prevalence of self-injurious behavior in schools and among the adolescent population raises concerns for those who must work with the behavior.

The phenomenon is easily misunderstood and often difficult to identify. Ineffective techniques of dealing with the self-injuring student can ultimately result in wasting the counselor's time and damaging the relationship with the student. With this said, accurate conceptualization is imperative if healing is to be facilitated (Coy & Simpson, 2002).

Approaches to Intervention

To work with self-injury, a single definition of the phenomenon is important. Conterio and Lader (1998) define it as "the deliberate mutilation of the body or body part, not with the intent to commit suicide but as a way of managing emotions that seem too painful for words to express" (p.16).

Moderate/superficial self-injury is the most common type of self-injury in school settings. Spanning social class, gender, ethnicity, and race, this form of self-injury is one in which the individual cuts to avoid painful or intolerable feelings. A variety of diagnoses may be consistent with this form of selfinjury including personality disorder, eating disorders, and posttraumatic stress disorder (Conterio & Lader, 1998).

Moderate or superficial self-injury is performed with intent.

The person committing the act seeks out the pain associated with self-harm. Additionally, self-injury is a means of managing feelings. The self-injurer specifically intends to avoid inevitable feelings of fear, anger, anxiety, shame, guilt, or any other feeling that might be perceived as negative.

A connection has been identified between self-injury and sexual, emotional, and/or physical abuse in childhood. There does appear to be a strong correlation between the existence of abuse in the individual's background and the use of selfinjury.

However, when conceptualizing the self-injurer, it is important to note that other possibilities for the behavior may exist (Conterio & Lader, 1998; Levenkron, 1998). Levenkron (1998) suggests a means of dividing the behavior into two dimensions: nondissociative and dissociative.

The nondissociative self-injurer usually experiences a childhood in which ...