David G. Kamen – Child and Adolescent Self-Injury: Practical Assessment and Treatment Approaches

Outline

The Theory, History and Cultural Origins of Youth Self-Injury

• History of youth self-injury, with cross-cultural comparisons of the problem
• Cognitive-behavioral, psychodynamic, family systems, feminist and neuropsychological perspectives on youth self-injury
• Comparative analysis of suicidal, para-suicidal and non-suicidal self-injury

Empirical Review on Youth Self-Injury

• Epidemic facts on the incidence and prevalence of youth self-injury
• Psychiatric and medical comorbidity associated with youth self-injury, including:
  • Reactive Attachment disorder
  • Obsessive-Compulsive Disorder
  • Post-Traumatic Stress Disorder
  • Major Depressive Disorder
  • Disruptive Behavior Disorders
• Case study review

Signs of Self-Injury

• Types of self-injurious behaviors in children and adolescence
• Behaviors that should be a “red flag”
• Who is most at risk of developing self-injurious behaviors?
• Clinical onset, development and prognosis of injurious behaviors
• Individual emotional and cognitive causes of self-injurious behavior
• Deep psychological sources of self-injury, including masochism and narcissism
• Family conflict, peer pressure and social contagion that causes self-injury

The Clinical Assessment of Youth Self-Injury

• General diagnostic interview and mental status examination
• Suicidal and lethality risk assessment
• Personality assessment
• Norm-referenced youth self-injury inventories for:
  • objectively measuring self-injury risk and protective factors
  • suicidal thoughts, emotions and attitudes
• Collateral interviews with parents, teachers and other health care professionals

Diagnosing self-injurious behavior

• Mood Disorders
• Obsessive-Compulsive Disorder
• Post-Traumatic Stress Disorder
• Attachment Disorder
• Borderline Personality Disorder
• Bipolar Disorder

The Treatment of Youth Self-Injury

• Ethical considerations, including confidentiality and duty-to-warn policies
• Treating the behavior as an addiction and as an obsessive-compulsive feature
• The 4-Step Assessment and Treatment Approach
  • emergency triage and case conceptualization
  • functional analysis of self-injury behaviors and reinforcements
  • Motivational Interviewing—to treat self-injury as an addiction
  • Exposure Therapy—to treat obsessive-compulsive features of self-injury
• Counseling Techniques
  • “No talk” Play therapy
  • cognitive-behavioral
  • psychodynamic
  • family systems counseling
  • group psychotherapy approaches
    • dynamic
    • existential
    • cognitive-behavioral
• Pharmacotherapy
  • commonly prescribed medications
  • when to send out a referral
  • contraindications
• Coordination of care with educators, medical and mental health care professionals
  • developing a collaborative team of professionals
  • relapse prevention
• Tips for professional self-care—to prevent you from getting vicarious traumatization
• Examination of community resources and references

What You Will Learn

• Learn the epidemic facts on youth self-injury
• Examine the historical, cultural and theoretical perspectives on youth self-injury
• Outline the spectrum of self-injurious behaviors in children and adolescents
• Recognize and be able to distinguish between suicidal, para-suicidal and non-suicidal self-injurious behavior in children and adolescents
• Discuss self-injury etiology, assessment and intervention/prevention issues
• Understand the psychiatric disorders of the children who self-injure
• Examine evidence-based reviews and practical approaches for the hospital, therapy room, school, and community
• Discover how to use play therapy, including art therapy, sand-tray therapy, journaling methods, music and crafts to build self-esteem and confidence in youth who self-injure
• Discover Internet resources to further develop self-injury assessment and therapy skills demonstrated during this seminar
• Discover ethical risk-management methods, to effectively advocate for youth who self-injure, to minimize professional risks and maximize outcome for your clients
• Discuss case studies relevant to the treatment of self-injury