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Self-Injury and Suicide Prevention 1 Module Five Table of Contents Teen Self-Injury: Self-Mutilation and Cutting Linda Mintle, Ph.D. ......................................................................................................................................................... 2 Teen Crisis and Suicide: Issues and Intervention Glen Havens, M.D., Jim Nelms, and George Ohlschlager, J.D. ........................................................................ 7 Self-Injury and Suicide Prevention

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Page 1: Self-Injury and Suicide Prevention · 2019-08-20 · Self-Injury and Suicide Prevention 3 Introduction A rising number of teens, especially girls, regularly engage in self-injury

Self-Injury and Suicide Prevention 1

Module Five

Table of Contents

Teen Self-Injury: Self-Mutilation and Cutting Linda Mintle, Ph.D. ......................................................................................................................................................... 2

Teen Crisis and Suicide: Issues and Intervention Glen Havens, M.D., Jim Nelms, and George Ohlschlager, J.D. ........................................................................ 7

Self-Injury and Suicide Prevention

Page 2: Self-Injury and Suicide Prevention · 2019-08-20 · Self-Injury and Suicide Prevention 3 Introduction A rising number of teens, especially girls, regularly engage in self-injury

Self-Injury and Suicide Prevention 2

Course Description This course will provide an overview of self-injury so that counselors will be able to better understand the thinking and behavior of those who engage in self-harm. Specifically, students will learn how to define self-injury, the methods used, know who is at risk, recognize the warning signs and risk factors, learn what function or role self-injury plays in a teen’s life, and which type of treatment works best. Therapeutic goals are identified as well as the interventions needed to stop self-injury. Self-injury is treatable and should be addressed on a physical, emotional, interpersonal, and spiritual level.

Learning Objectives: By the end of this lesson, students:

1. Will be able to define self-injury and list the methods used to engage in self-harm.

2. Will be able to list three categories of functions that self-harm serves, as

well as being able to list warning signs or risk factors for self-injury.

3. Will be able to know what the importance of family and/or group therapy is in a teen’s healing, as well as being able to list several treatment interventions that are effective with this population.

TEEN SELF-INJURY:

SELF-MUTILATION AND CUTTING Linda Mintle, Ph.D.

Page 3: Self-Injury and Suicide Prevention · 2019-08-20 · Self-Injury and Suicide Prevention 3 Introduction A rising number of teens, especially girls, regularly engage in self-injury

Self-Injury and Suicide Prevention 3

Introduction

A rising number of teens, especially girls, regularly engage in self-injury as a

way to escape emotional pain and feel alive. As bizarre as it may sound, self-

injury functions as a relief for emotional distress. Pressure and stress from

school, peers and family problems combined with feelings of self-hate can

throw those predisposed to a low tolerance for frustration into acts of self-

harm. Self-injury is a cry for help, not a suicide attempt. It is a survival

response for those who believe there is no other way to express what hurts on

the inside. The work is to help these teens know the truth. They are loved,

accepted and valued by God and in need of healthy coping mechanisms. It is

possible to be healed of emotional hurts, learn new coping skills and find

better solutions to the problems related to emotional pain.

I. Introduction II. What is Self-Injury? III. What Self-Injury is NOT

IV. The Progression of a Teen who Injures

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V. Facts and Statistics about Teens who Self-Injure

VI. Methods Used to Self-Injure

VII. Functions of Self-Injury

A. Affect Regulation

B. Communication

C. Control and Punishment

VIII. Warning Signs

IX. Treatment

A. Resistance

B. Therapist/Helper’s Response

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C. Family Therapy

D. Group Therapy

E. Individual Work Treatment goals

Use of Dialectical Behavior Therapy (DBT)

Specific interventions

F. Medication Use

X. Spiritual Help and Hope Bibliography/Suggested Readings S.A.F.E. Alternatives S.A.F.E.(Self-Abuse Finally Ends) Alternatives is a nationally recognized leader in the treatment of self-injurious behavior such as cutting. Resource line: 1(800) DONT CUT or 1(800) 366-8288

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Claes, L. Vandereycken, W. & Vertommen, H. (2003). Eating disordered patients with and without self-injurious behaviours: A comparison of psychopathological features. European Eating Disorders Review, 11, 379-396. Bodies Under Siege: Self-mutilation and Body Modification in Culture and Psychiatry by Armando Favazza (Baltimore: Johns Hopkins UP, 1996). Academic and comprehensive. The Scarred Soul: Understanding & Ending Self-Inflicted Violence by Tracy Alderman (Oakland: New Harbinger, 1997). Good for the person who self-injures. A Bright Red Scream: Self-Mutilation and the Language of Pain by Marilee Strong (New York: Penguin, 1998). Recommended for family and friends who want to better understand. Adolescent Self-Injury: A Comprehensive Guide for Counselors and Health Care Professionals by Amelio A. D'Onofrio, (Springer Publishing Company, 2007) Making Peace With Your Thighs by Dr. Linda Mintle (Thomas Nelson, 2006). This book focuses on body acceptance, a universal issue for every teen girl. Negative body image, especially as it relates to eating disorders and sexual abuse can be a risk factor for self-injury. Soul Care Notes Deuteronomy 14:1-2 1 Corinthians 6:19-20 Psalm 32:8

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Course Description When a teen experiences a crisis, it can have a devastating impact on the family and community in which they reside. What can helpers do to help teens avoid these serious consequences, and when they do occur, what can they do to help restore balance to life for all involved? This lesson looks at some difficult issues as it relates to teens; some that are difficult to face, but nevertheless occur in the lives of young people. Helping to make sense of these times is extremely important to their mental health and future relationships.

Learning Objectives: By the end of this lesson, students:

1. Will be able to understand how to recognize and evaluate teens in crisis. 2. Will be able to understand the proper response to teens in crisis.

3. Will be able to understand suicidal tendencies and prevention issues.

TEEN CRISIS AND SUICIDE:

ISSUES AND INTERVENTION Glen Havens, M.D., Jim Nelms, &

George Ohlschlager, JD.

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Self-Injury and Suicide Prevention 8

Introduction

It seems as if teens always have a crisis they are consistently dealing with,

whether it is real or not .What about those systemic issues of crisis that occur?

Teaching teens how to respond properly is important to their lives and those

around them.

I. How to Evaluate Teens in Crisis

A. What is Crisis? Any Event that has Potential to Overwhelm a Person’s Ability to Cope

B. Teen’s Crisis is Usually More Dramatic

C. Helpers Need a Plan and Method to Respond to Crisis Situations

D. A Standardized Approach

Adds consistency Bring stability in chaos to organization and individuals Simple, brief methods

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E. Example – Hurricane Katrina Resiliency

Resistance

Recovery

F. Younger children seem to adapt easier, especially when an adult is involved to help make sense of the situation.

II. Proper Response to Crisis

A. Meet with the Core Support Team

Provide a method of referral

Don’t forget the parents

Social withdrawal of teens is a concern – isolation

B. Get kids in smaller groups of peers with adult intervention.

Be a grounding force

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Recognize their own agenda’s

C. Parents and educators need to get help and training themselves.

D. Teens need to be facilitated by an adult in a time of crisis – not themselves or a peer group.

III. PTSD Issues

A. Should be Mental Health Facilitated

B. Failure of Vietnam Re-entry Good Example

C. Brain Issues with PTSD IV. Suicidal Behavior

A. Black Box Warning – Must Be Really Careful

Anti-depressants in early childhood years issues

Increase in suicidal issues

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Prozac or drug issues

1. Increased thoughts and behavior – Feelings

2. 20-30% of completed suicides are in untreated depression

B. Why Suicide Happens

Physical disorders 1. People live in a fallen world – Illness exists

2. Sometimes hereditary Mental health/Illness

1. Everyone wants to be perfect

2. Neurological problem with a medical basis

3. Not a character fault

4. Generic issue – cannot will oneself not to be this way

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Depression doesn’t reveal itself in teens the same as it does in adults

1. Anger

2. Be with friends – escape negative emotions

3. Neurological signs

4. Depression is painful – may see no other way out

C. Prevention

Need to talk about it with teens

Provide hooks of hope

D. Differences Between Planned and Impulsive Suicide

Small line between the two

Helps teens over emotional issues

Planned suicide usually not preventable

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Accidental or impulsive

A severe attempt to get attention to emotional issues that are

E. Intervention Outcomes

Helpers can experience emotional issues

Contagion issues

Separation and identity issues

Validate emotions

Acknowledge teens’ emotions and validate them

Empathize and attempt to understand

Don’t leave victim family by themselves after crisis is over

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F. Seek out resources that are available to churches.

V. Homicide

A. Homicide/Suicide Connection

B. Significant Planning Taken Place

C. Some Exposure to Someone Else VI. Conclusion Soul Care Notes Romans 14:7-8 Proverbs 22:6