Identifying, Assessing, and Treating Self-Injury at School

142 Pages·2010·1.077 MB·English

by  David N. Miller, Stephen E. Brock (auth.)

Developmental Psychopathology at School
SeriesEditors
StephenE.Brock
CaliforniaStateUniversity,Sacramento,CA,USA
ShaneR.Jimerson
UniversityofCalifornia,SantaBarbara,CA,USA
Forfurthervolumes:
http://www.springer.com/series/7495
·
David N. Miller Stephen E. Brock
Identifying, Assessing,
and Treating Self-Injury
at School
123
DavidN.Miller StephenE.Brock
UniversityatAlbany DepartmentofSpecialEducation
StateUniversityofNewYork Rehabilitation,SchoolPsychology
andDeafStudies
1400WashingtonAvenue
CaliforniaStateUniversity,Sacramento
Albany,NY12222
6000JStreet
USA Sacramento,CA95819-6079
[email protected] USA
[email protected]
ISBN978-1-4419-6091-7 e-ISBN978-1-4419-6092-4
DOI10.1007/978-1-4419-6092-4
SpringerNewYorkDordrechtHeidelbergLondon
LibraryofCongressControlNumber:2010929849
©SpringerScience+BusinessMedia,LLC2010
Allrightsreserved.Thisworkmaynotbetranslatedorcopiedinwholeorinpartwithoutthewritten
permission of the publisher (Springer Science+Business Media, LLC, 233 Spring Street, New York,
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Printedonacid-freepaper
SpringerispartofSpringerScience+BusinessMedia(www.springer.com)
WithloveandgratitudetomywifeKris;tothe
memoryofmymother,MaryJ.Miller;andin
honorofmyfather,DonaldA.Miller(D.N.M.).
TothememoryofChristineJaneBibbesBrock
(S.E.B.).
Andtoallstudentsandtheirfamilieschallenged
byself-injuryandtheschool-basedprofessionals
committedtohelpingthem.
Acknowledgments
Asauthorsofthisbook,wewouldliketoacknowledgeandthankthemanyindivid-
ualswhocontributedtooureffortsandmadeourworkmucheasierintheprocess.
First and foremost, David Miller would like to thank his spouse, Kristin Miller of
SienaCollege,forprovidinghelpfulsuggestionsthroughoutthewritingofthisbook.
Withoutherconstantencouragementandunwaveringsupport,thisbookwouldnot
have been written. He would also like to acknowledge his friend and colleague
RichardLieberman,schoolpsychologistandcoordinatoroftheSuicidePrevention
Unit of the Los Angeles Unified School District, for his school-based writings on
self-injuryandhiscontributionstoChapter2ofthisbook;RyanR.Lindsay,Clinical
DirectoroftheSt.LouisCenterforFamilyDevelopment,forhisrecommendations
regarding useful Web sites on self-injury; and Nancy L. Heath, Mary K. Nixon,
and Barent W. Walsh, all nationally recognized authorities on self-injury, whose
publicationsonthistopicsignificantlyinfluencedthecontentsofthisbook.Inaddi-
tion,hewouldliketothankDonaldA.Millerforatimelynewspaperarticle;Brad
ArndtforhisinformationonLesch–NyhanDisease;thestudents,faculty,andstaffat
CentennialSchoolofLehighUniversity,particularlyMichaelGeorge,forproviding
himwithexcellenttrainingopportunities;andUniversityatAlbany,SUNYschool
psychologygraduatestudentsKristinDarius-Anderson,JeannetteEllis,CaraPharr-
Gottheim, Erin Pinto, Jaime Savoie, and Kevin White for their assistance. Finally,
he would like to acknowledge Stephen Brock and Shane Jimerson, editors of the
DevelopmentalPsychopathologyatSchoolSeries,fortheirinterestinaddingabook
onself-injurytothisdistinguishedseries.StephenBrockdeservesspecialthanksfor
hissupportofthisbookandhiswillingnesstoserveassecondauthoronit.
Stephen Brock would also like to thank his good friend and colleague Richard
Lieberman as well as Linda Kanan, Jennifer Finger, and Amy Plog of the Cherry
Creek School District in Colorado, for their groundbreaking work applying self-
injuryscholarshiptotheschoolsetting.Inaddition,hewouldliketoacknowledge
the superior scholarship of lead author David Miller and the editorial support of
Dr. Shane Jimerson. Dr. Brock would also like to thank Drs. Miller and Jimerson
for their understanding and patience during what was a very difficult final year of
thisbook’spreparation.Itwasanhonorandapleasureworkingwiththemonthis
project.
vii
viii Acknowledgments
Finally, both Drs. Miller and Brock would like to acknowledge the many
researchersandpractitionerswhoprovidedthefoundationforthematerialpresented
inthisbook.
Contents
1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2 Causes(withRichardLieberman) . . . . . . . . . . . . . . . . . . . . 9
3 PrevalenceandAssociatedConditions. . . . . . . . . . . . . . . . . . 23
4 CaseFinding,Screening,andReferral . . . . . . . . . . . . . . . . . 35
5 DiagnosticAssessment . . . . . . . . . . . . . . . . . . . . . . . . . . 51
6 PsychoeducationalAssessment . . . . . . . . . . . . . . . . . . . . . . 75
7 Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
Appendix:Self-InjuryInternetResources . . . . . . . . . . . . . . . . . 111
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
SubjectIndex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131
ix
About the Author
Stephen E. Brock, Ph.D., NCSP, is an associate professor at California State
University,Sacramento.Previously,heworkedfor18yearsasaschoolpsychologist
withtheLodiUnifiedSchoolDistrict(thelastsixofwhichincludedassignmentsas
leadpsychologist).HisprofessionalpreparationincludesaPh.D.attheUniversity
ofCalifornia,Davis.Dr.Brockcurrentlyservesontheeditorialboardsofbothstate
and national school psychology association newsletters and was an associate edi-
torofTheCaliforniaSchoolPsychologist(apeer-reviewedjournalwiththesecond
largestdistributionofschoolpsychologyjournalsintheUnitedStates).Heispast-
president of the California Association of School Psychologists and was member
of the National Association of School Psychologists’ Delegate Assembly and its
Executive Council. Dr. Brock has authored more than 150 publications (includ-
ing nine books) and has made more than 100 refereed or invited state/national
conferencepresentations.Hisacademicworkhasincludedthestudyofschoolcri-
sisresponse,suicideprevention,ADHD,autism,behavioralinterventions,violence
prevention,threatassessment,childdevelopment,andreadingcomprehension.
DavidN.Miller,Ph.D,isanassistantprofessorintheDepartmentofEducational
and Counseling Psychology at the University at Albany, State University of
NewYork. He received his Ph.D. in school psychology from Lehigh University.
Acertifiedschoolpsychologist,hehasextensiveexperienceworkingwithstudents
with emotional and behavioral problems in both public and alternative school set-
tings,includingservingasthedirectorofthePredoctoralInternshipinProfessional
PsychologyatCentennialSchoolofLehighUniversity.Hehasmorethan30profes-
sionalpublicationsandbookchaptersandhasconductedmorethan40nationaland
statepresentationsonvarioustopics,includingself-injuryandsuicidalbehaviorin
children and youth. He was also co-chair of the Suicide Prevention/Intervention
Workgroup of the National Association of School Psychologists School Crisis
PreventionandInterventionTaskForce.Dr.Millercurrentlyservesontheeditorial
advisory board of School Psychology Review, Psychology in the Schools, School
PsychologyForum,andtheDivision16(SchoolPsychology)BookSeries.
xi
Chapter 1
Introduction
Self-injuryreferstotheintentional,purposeful,andsociallyunacceptableinfliction
of bodily harm without suicidal intent (Klonsky, 2007; Nixon & Heath, 2009a;
Walsh, 2006). Also known as non-suicidal self-injury (NSSI; Nock, 2009), it is a
puzzling,disturbing,andoftenpoorlyunderstoodbehaviorprevalentinallcultures
andacrossallsocioeconomiclevels(Lieberman&Poland,2006).Althoughthefirst
recordedaccountofNSSIoccurredover2,400yearsago(Favazza,1998),ithasonly
been in recent decades that this condition has received widespread attention from
professionalsandthegeneralpublic.ThemostcommonformofNSSIappearstobe
skincutting(Klonsky&Muehlenkamp,2007),andmostindividualswhoengagein
ittypicallycutontheirforearms,althoughitisnotnecessarilyrestrictedtothatarea
(Nixon&Heath,2009a).NSSImaytakeotherformsaswell,includingsevereskin
scratching,pickingatwounds,insertingobjectsintothebody,orbangingone’shead
(D’Onofrio,2007).Thislastbehavior,however,ismoretypicallyobservedamong
studentswithseveredevelopmentaldisabilities(Brock,Jimerson,&Hansen,2006)
andisdifferentfromthetypeofNSSIexaminedinthisbook.
NSSIhasbeenreferredtobyavarietyofdescriptors,includingself-mutilation,
deliberate self-harm, non-suicidal self-harm, parasuicide, self-wounding, wrist-
cutter syndrome, self-carving, self-cutting, repetitive non-suicidal self-injurious
behavior, self-inflicted violence, and self-abuse (Favazza, 1996; Nixon & Heath,
2009a; Walsh, 2006). Additionally, because the most prominent method of body
tissue self-destruction among individuals who engage in NSSI appears to be skin
cutting with a knife or other sharp objects, these students often are colloquially
referred to as “cutters” (Lieberman, 2004). The term self-injury is currently the
most widely used and accepted designation for these behaviors (D’Onofrio, 2007;
Nixon&Heath,2009b;Walsh,2006)andistheonethatisusedinthisbook.Both
individualswhoengageinNSSIandthosewhotreatthemhaveadvocatedthatthe
term“self-mutilation”–previouslythemostcommondescriptor–bediscontinued
becauseittypicallyistooextreme,pejorative,andultimatelyinaccurate(Simeon&
Favazza,2001;Walsh,2006).
Althoughitmayoccuratanyage,NSSIisassociatedwithadolescencebecause
ittypicallyemergesduringthisdevelopmentalperiod(Nixon&Heath,2009a).As
aresult,ithasbecomeamajorconcernamongadultswhoworkwithchildrenand
youth,particularlyschool-basedprofessionals.Infact,schoolshaveemergedasthe
D.N.Miller,S.E.Brock,Identifying,Assessing,andTreatingSelf-InjuryatSchool, 1
DevelopmentalPsychopathologyatSchool,DOI10.1007/978-1-4419-6092-4_1,
(cid:2)C SpringerScience+BusinessMedia,LLC2010