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Cutting and Self Injury A Review For School Counselors

Cutting and Self Injury A Review For School Counselors. James G. Wellborn, Ph.D. Outline. What it is (and isn’t) What it looks like What we know What makes kids do it What works What School Counselors can do. www.DrJamesWellborn.com. What it is. Non-suicidal self injury.

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Cutting and Self Injury A Review For School Counselors

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  1. Cutting and Self Injury A Review For School Counselors James G. Wellborn, Ph.D.

  2. Outline • What it is (and isn’t) • What it looks like • What we know • What makes kids do it • What works • What School Counselors can do www.DrJamesWellborn.com

  3. What it is

  4. Non-suicidalself injury • Deliberate self harm • Self-harm • Self Injurious Behavior • Self inflicted violence • Self mutilation • Cutting www.DrJamesWellborn.com

  5. NSSI Defined • Intentional, non-life-threatening, self-effected bodily harm or disfigurement of a socially unacceptable nature, performed to reduce and/or communicate psychological distress www.DrJamesWellborn.com

  6. NSSI • Cutting or carving • Scratching or rubbing • Hitting self or punching objects • Burning • Scalding • Picking at the skin • Breaking bones • Other (biting, pulling hair, running into walls, throwing body into sharp objects) www.DrJamesWellborn.com

  7. What it looks like

  8. Trigger Warning

  9. Typical Cutting

  10. Typical Cutting

  11. Severe

  12. Severe

  13. Severe

  14. Burns

  15. Burns

  16. Eraser abraisons

  17. Eraser abraisons

  18. Hitting a wall

  19. What about . . . • Parasuicide • Tattoos • Trichotillomania. • Body piercing • Scarification www.DrJamesWellborn.com

  20. What about . . . • Tattoos • Trichotillomania • Body piercing. • Scarification www.DrJamesWellborn.com

  21. What about . . . • Tattoos • Trichotillomania • Body piercing • Scarification. www.DrJamesWellborn.com

  22. What we know

  23. Danish High School Self Injury Study (2014) • N=5650 • 6-19 years old • 21% Lifetime • Female: 23% • Male: 19%) • 16.2% Annual FIGURE 1. Types of self-harm. Percentage of type within the group of self harmers Bo Møhl, Peter la Cour, Annika Skandsen. Non-Suicidal Self-Injury and Indirect Self-Harm Among Danish High School Students. Scandinavian Journal of Child and Adolescent Psychiatry and Psychology, Vol. 2(1):11-18 (2014)

  24. Barrocas et al NSSI Study (2012) • N=665 • Ages 7-16 • NSSI=8% Overall • 3rd-7.6% • 6th-4% • 9th-12.7% (19% Female/5% male) • Girls=cutting Boys=hitting • DSM V Criteria 1.5%

  25. NSSI Stats • Lifetime prevalence • Childhood (grade 3) 7% • Preadolescents (grades 6-8) 4% to 8% • Adolescents (grades 9-12) 12% to 23% • College >38% • Adults: 5.9% • Typical Age of Onset 11-15 years old • Gender Differences: emerge in adolescence • No significant increase in the past 5 years www.DrJamesWellborn.com

  26. NSSI Stats • Correlations • Suicide attempt • Strongest predictors of suicide attempts (Victor and Klonsky, 2014) • Suicidal ideation • NSSI frequency • Number of methods • Hopelessness • Suicidal ideation • Eating disorder • Borderline Personality Disorder • Depression • Anxiety • Impulsivity • Existing mental health problems www.DrJamesWellborn.com

  27. NSSI Stats • Correlations (cont.) • Antisocial behavior • Emotional Distress/dysregulation • Anger Problems • Health Risk Behaviors • Decreased Self-esteem • (Low level body regard: perceives, experiences and cares for the body) • Lack of perceived meaning in life (hopelessness) • Poor family support/fewer people to seek advice from www.DrJamesWellborn.com

  28. NSSI Stats References *Muehlenkamp, J., Claes, L., Havertape, L. & Plener, P. L. (2012). International prevalence of Adolescent non-suicidal self-injury and deliberate self-harm. Child and Adolescent Psychiatry and Mental Health, 3/12; 6:10 **Washburn, J. J., Richardt, S. L., Styer, D. M., Gebhardt, M, Juzwin, K. R., Yourek, A. & Aldridge, D. (2014). Psychotherapeutic approaches to non-suicidal self-injury in adolescents. Child and Adolescent Psychiatry and Mental Health, 6:14. ***Bo Møhl, Peter la Cour, Annika Skandsen. Non-Suicidal Self-Injury and Indirect Self-Harm Among Danish High School Students. Scandinavian Journal of Child and Adolescent Psychiatry and Psychology, Vol. 2(1):11-18 (2014) Laye-Gindhu, A & Schonert-Reichl, K. A. (2005) Nonsuicidal self-harm among community adolescents: Understanding the “Whats” and “Why’s of self-harm. Journal of Youth and Adolescence, v. 34:5, pp 447-457 Barrocas, A. L., Hankin, B. L., Young, J. F. & Abela, J. R. Z. (2012). Rates of Nonsuicidal Self-injury in Youth: Age, Sex and Behavioral Methods in a Community Sample. Pediatrics, 130:39 http://pediatrics.aappublications.org/content/130/1/39.full.pdf Victor, S. E. & Konsky, E. D. (2014) Correlates of suicide atttempts among self-injureres: a meta-analysis. Clinical Psychology Reviewu, 34, 282-297) Sutton J. (2007) Healing the Hurt Within: Understand Self-injury and Self-harm, and Heal the Emotional Wounds. Oxford: How To Books; 2007 www.DrJamesWellborn.com

  29. What Makes Kids do it

  30. NSSI Theories • Attack on the self • Modeling • Identity • Control • Communication • Toughness • Distraction • Self-punishment • Release endorphins • Dissociation • Reenacting abuse • JGW Personal observations www.DrJamesWellborn.com

  31. NSSI Theories • Attack on the self • “I am such a disgusting loser I deserve to suffer.” www.DrJamesWellborn.com

  32. NSSI Theories • Modeling • “Yeah, I cut too when I’m upset.” www.DrJamesWellborn.com

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