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This trusted practitioner resource is acclaimed for its clear, compassionate, and hopeful approach to working with clients who self-injure. Barent Walsh and his associates provide current, evidence-based knowledge about the variety and causes of self-injurious behavior, its relationship to suicidality, and how to assess and treat it effectively. Illustrated with detailed case examples, chapters review a wide range of cognitive-behavioral interventions. Essential guidance is provided on tailoring the intensity of intervention to each client's unique needs. Reproducible assessment tools and handouts can be downloaded and printed in a convenient 8 1/2" x 11" size. New to This Edition: incorporates up-to-date research and clinical advances now uses a stepped-care framework to match interventions to client needs chapters on the relationship between suicide and self-injury, formal assessment, family therapy, and residential treatment for adolescents special-topic chapters on "the choking game," foreign body ingestion, multiple self-harm behaviors, and self-injury in correctional settings.
Barent W. Walsh, PhD, is Executive Director of The Bridge of Central Massachusetts, headquartered in Worcester, Massachusetts, which comprises over 40 programs serving persons with mental health or developmental disability challenges. The Bridge specializes in implementing evidence-based practice models according to protocol in public sector settings. A recipient of the Lifetime Achievement Award from the Massachusetts chapter of the National Association of Social Workers, Dr. Walsh has worked with self-injuring persons since the 1970s and has conducted research, written extensively, and presented internationally on self-injury. He has served on the clinical and research faculties of the Simmons and Boston College Schools of Social Work and is currently a Teaching Associate in Psychiatry at Harvard Medical School.
Table of Contents
I. Definition and Contexts for Self-Injury 1. Definition and Differentiation from Suicide 2. The Relationship between Self-Injury and Suicide 3. An Overview of Direct and Indirect Self-Harm 4. Major Groups in Which Self-Injury Occurs 5. Body Piercings, Tattoos, Brandings, Scarifications, and Other Forms of Body Modification 6. A Biopsychosocial Model for Self-Injury II. Assessment and Treatment: A Stepped-Care Model Treatment: Step 1 7. Initial Therapeutic Responses 8. Formal Assessment of Self-Injury, Jennifer J. Muehlenkamp 9. Cognitive-Behavioral Assessment 10. Contingency Management Treatment: Step 2 11. Replacement Skills Training 12. Cognitive Treatment 13. Family Therapy, Michael Hollander 14. Psychopharmacological Treatment, Gordon P. Harper Treatment: Step 3 15. Body Image Work 16. Prolonged Exposure or Cognitive Restructuring for Treating PTSD and Related Self-Injury Treatment: Step 4 17. Treating Persons with Multiple Self-Harm Behaviors 18. Residential Treatment Targeting Self-Injury and Suicidal Behavior in Adolescents, with Leonard A. Doerfler and Ariana Perry III. Specialized Topics 19. Managing Reactions to Self-Injury: A Guide for Therapists and Other Caregivers 20. Social Contagion and Self-Injury 21. A Protocol for Managing Self-Injury in School Settings 22. Asphyxial Risk Taking (the Choking Game), Amy M. Brausch 23. Understanding, Managing, and Treating Foreign-Body Ingestion, with Ariana Perry 24. Self-Injury in Correctional Settings, Kenneth L. Appelbaum 25. Treating Major Self-Injury Afterword Appendix A. Breathing Manual Appendix B. Body Attitudes Scale (BAS) Appendix C. Clinical Scales to Assess Self-Injury Appendix D. Helpful Websites Related to Self-Injury Appendix E. Bill of Rights for People Who Self-Harm