Tony L. Sheppard – Suicide and Self-Harm in Adolescents: Effective Assessment and Intervention Strategies for Young People in Crisis

Outline

Suicide and NSSI

• The relationship between suicide and self-injurious behavior
• When clients present with depression, anxiety, trauma
• Confidentiality, documentation, and legal considerations

Assessment Tools for Adolescents

• Formal assessment tools for NSSI
  • Recency and frequency
  • Severity
  • Triggers
  • Who’s aware
• Suicide risk assessment
  • SAFE-T
  • C-SSRS
  • Ideation, plan, means, intent
  • Level of risk, intervention and when to hospitalize

Motivational Interviewing Techniques That Engage Young People in Treatment

• Tips to quickly establish rapport
• Using the Stages to Change/Motivational Interviewing Model in Treatment
• Overcome therapy interfering behaviors
• When parents are ready for change NOW!

Adapt DBT for Use with Adolescents

• Track suicidal and self-harming urges with diary cards
• Reduce emotional reactivity and improve distress tolerance
• Identifying emotions and triggers
• Mindfulness practices and relaxation techniques
• Reproducible handouts and checklists

CBT Interventions to Build Coping Skills and Manage Crisis

• ”Thought flipping” to maintain positive focus
• Address body image issues
• Create opportunities to build resilience, self-efficacy and self-control
• Handle suicidal crisis – self-soothing and distraction techniques

Effectively Work with Parents, Peers and Schools

• Interpersonal effectiveness skills for adolescents
• Training exercises to convey feelings/read the feelings of others
• Integrate parents into treatment
  • Parental behaviors that can do more harm than good
  • Means restriction strategies for safe home environments
• Involve schools and peers
  • Learn to build “Trusted Adult” support networks
  • Peer education approaches that create support
  • Minimize the impact of bullying