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.
Part I: Definition and Contexts for Self-Injury. Definition and Differentiation from Suicide. The Relationship between Self-Injury and Suicide. An Overview of Direct and Indirect Self-Harm. Major Groups in Which Self-Injury Occurs. Body Piercings, Tattoos, Brandings, Scarifications, and Other Forms of Body Modification. A Biopsychosocial Model for Self-Injury. Part II. Assessment and Treatment: A Stepped-Care Model. Treatment: Step 1. Initial Therapeutic Responses. Muehlenkamp, Formal Assessment of Self-Injury. Cognitive-Behavioral Assessment. Contingency Management. Treatment: Step 2. Replacement Skills Training. Cognitive Treatment. Hollander, Family Therapy. Harper, Psychopharmacological Treatment. Treatment: Step 3. Body Image Work. Prolonged Exposure or Cognitive Restructuring for Treating PTSD and Related Self-Injury. Treatment: Step 4. Doerfler, Perry, Treating Persons with Multiple Self-Harm Behaviors. Residential Treatment Targeting Self-Injury and Suicidal Behavior in Adolescents. Part III: Specialized Topics. Managing Reactions to Self-Injury: A Guide for Therapists and Other Caregivers. Social Contagion and Self-Injury. A Protocol for Managing Self-Injury in School Settings. Brausch,Asphyxial Risk Taking (the Choking Game). Perry, Understanding, Managing, and Treating Foreign-Body Ingestion. Appelbaum, Self-Injury in Correctional Settings. 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.