Non-Suicidal Self-Injury Throughout the Lifespan: A Clinician's Guide to Treatment Considerations PDF
Preview Non-Suicidal Self-Injury Throughout the Lifespan: A Clinician's Guide to Treatment Considerations
Non-Suicidal Self-Injury Throughout the Lifespan A comprehensive guide for clinicians working with patients engaging in self- injury, this book provides information on clinical conceptualization, risk and protective factors, ways to assess for NSSI, treatment approaches and strategies, and early intervention and prevention strategies. Focusing on ethical and cultural considerations unique to schools, clinical agencies, and private-practice settings, the authors provide a practical and in-depth discussion of clinical theory. Procedures for determining risk and the potential problems with risk assessment, especially concerning suicide risk, are addressed. In addition to numerous exercises, examples, and suggestions for practical interventions, the book includes a variety of detailed worksheets and resources to expand readers’ level of understanding, monitor emerging trends, and provide a context for extended training. Several case studies are discussed and analyzed in order to highlight specific aspects of clinical conceptualization and treatment strategies. Drawn from a wide range of treatment populations and issues, this book is a valuable resource for clinicians and supervisors. The authors integrate outcomes- based research strategies and evidence-based tools to help clinicians work with clients from diverse backgrounds. Kelly Emelianchik-Key, PhD, LMHC, NCC, ACS, is a licensed clinical mental health counselor and assistant professor in the counseling department at Florida Atlantic University. She has completed extensive research and training in teen dating violence, non-suicidal self-injury, and sexuality issues. Amanda La Guardia, PhD, LPCC-S, NCC, is a licensed professional clinical counselor supervisor and assistant professor for the counseling program at the University of Cincinnati. She has completed extensive research and training in the areas of non-suicidal self-injury and suicide, gender-related issues, and professional development. “This book is a vital addition to the literature on non-suicidal self-injury (NSSI). Our profession has been riddled with misunderstanding about this behavior in clients we serve. This text offers clarity on the subject and also offers us multiple treatment plans and interventions. It outlines NSSI across life development stages, which offers a unique perspective in the discussion of self-injurious behaviors. The case studies provide information and assistance that will be vital in working with clients who have a relationship with NSSI. I applaud these authors and have deep appreciation for what they have added to the literature in our field.” — Patricia E. Robertson, EdD, professor emerita, East Tennessee State University, USA “Emelianchik-Key and La Guardia have produced thorough and timely guide for practitioners and students who need effective guidance in treating the com- plicated issue of non-suicidal self-injury. With practical tools, detailed case stud- ies, and thorough treatment strategies, this guide will become an important reference tool for any clinician.” — Paul R. Peluso, PhD, LMHC, LMFT, pro- fessor and chair of the Department of Counselor Education, Florida Atlantic University, USA “NSSI is one of the most pervasive and destructive activities among adolescents and young adults, so you would think that there would be a ton of useful information on the people and processes, both individual and systemic, that are affected by this problem. Sadly, this was not the case—until now. This book brings all of us up to date on the problem and its treatment in a very readable text that is loaded with case studies. As a person who has experienced this with a family member, I can say without hesitation that I wish this book had been available ten years ago.” — James Robert Bitter, EdD, NCC, past president of the North American Society of Adlerian Psychology, professor of counseling and human services, East Tennessee State University, USA “Emelianchik-Key and La Guardia expertly guide readers through the com- plexities of NSSI, weaving in available best practices, resources, and scholar- ship from across the helping professions. The authors provide an innovative, thoughtful, and case-based approach for assessing and treating diverse clients across the lifespan with NSSI. This text is a must-have clinical resource!” — Danica G. Hays, PhD, professor of counselor education and executive asso- ciate dean, University of Nevada, Las Vegas, USA Non-Suicidal Self-Injury Throughout the Lifespan A Clinician’s Guide to Treatment Considerations Kelly Emelianchik-Key and Amanda La Guardia First published 2020 by Routledge 52 Vanderbilt Avenue, New York, NY 10017 and by Routledge 2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN Routledge is an imprint of the Taylor & Francis Group, an informa business © 2020 Kelly Emelianchik-Key and Amanda La Guardia The right of Kelly Emelianchik-Key and Amanda La Guardia to be identified as author of this work has been asserted by him in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. All rights reserved. The purchase of this copyright material confers the right on the purchasing institution to photocopy pages which bear the photocopy icon and copyright line at the bottom of the page. No other parts of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. British Library Cataloguing-in-Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging-in-Publication Data A catalog record has been requested for this book ISBN: 978-0-8153-7134-2 (hbk) ISBN: 978-0-8153-7135-9 (pbk) ISBN: 978-1-351-20359-3 (ebk) Typeset in Goudy by Nova Techset Private Limited, Bengaluru & Chennai, India Kelly—This book is dedicated to all of the clients I have worked with over the years. Your bravery to share your stories and the courage you show is inspirational in more ways than you will know. I am appreciative of the amazing colleagues and mentors that I continue to learn from and work with, especially my co-author and friend Mandy. One of my favorite Robert Frost poems has a line that says, “Two roads diverged in a wood, and I, I took the one less traveled by, and that has made all the difference.” To my husband and family, thanks for always giving me support, love, and encouragement to take the road less traveled. Thank you to my kids; your presence and love motivate me to make a difference. Mandy—This book would not be possible without the tireless efforts of my co-author and the experiences I’ve had with colleagues and clients over the years. I hope this book honors the stories of the clients I have had the distinct privilege of working with and learning from. Special thanks to Patricia Robertson, who helped me to understand the importance of self-reflective empathy and cultural humility when working with self-injurious clients; thank you for encouraging me to grow as a practitioner and, foremost, as a person. Thank you to my daughter Aria, with whom I get to practice being my better self. Contents Preface ix List of figures, tables, cases, and textboxes xi Key terminology xiii Ethics statement xix Authors xxi PART I Introduction to client case scenarios 1 Non-suicidal self-injury in childhood 3 KELLY EMELIANCHIK-KEY 2 Non-suicidal self-injury in adolescents and young adults 23 AMANDA LA GUARDIA 3 NSSI in adulthood and aging populations 41 AMANDA LA GUARDIA PART II Assessment and screening for non-suicidal self-injury 4 Risk and protective factors 57 KELLY EMELIANCHIK-KEY 5 Assessment and diagnosis 75 KELLY EMELIANCHIK-KEY 6 Gender and cultural considerations 103 KELLY EMELIANCHIK-KEY viii Contents PART III Ethics and treatment of non-suicidal self-injury 7 Ethical considerations when working with NSSI 121 KELLY EMELIANCHIK-KEY AND MARIAH DERN 8 Non-suicidal self-injury and suicide 141 AMANDA LA GUARDIA 9 Prevention and treatment strategies in educational settings 153 ELLEN K. CHANCE 10 Treatment in community settings 167 ADRIANA LABARTA AND BRIDGET GLASS 11 Future research and directions 189 KELLY EMELIANCHIK-KEY AND AMANDA LA GUARDIA PART IV Worksheets and resources Appendix A: Resource list 201 Appendix B: Elementary safety plan 205 Appendix C: Narrative storyboard 207 Appendix D: Cognitive mapping 209 Appendix E: Adapted DBT youth meditation 211 Appendix F: Bronfenbrenner worksheet 215 Appendix G: Chain analysis of NSSI behavior 217 Appendix H: Checklist for working with youth 219 Appendix I: Building support circles 223 Appendix J: Taking your emotional temperature 225 Appendix K: Voice of reason 227 Appendix L: My impulse control log 229 Appendix M: My life of purpose and meaning 231 Appendix N: Wheel of influence 233 Appendix O: Self-care wheel 235 Appendix P: My house 237 Index 239 Preface We decided to write this book in response to a growing need for clinically focused, easily understood guide for treating individuals engaging in non-suicidal self-injury (NSSI) that includes an interdisciplinary perspective. Through our work, we have noticed the increasing need for more practical ways to approach NSSI and to help clinicians working with challenging cases that can be difficult to conceptualize. NSSI is a complex issue, and no two cases are identical. Due to this diversity, it can be challenging to produce consistent findings in research studies, which means evidence-based practices are difficult to pinpoint. Through this book, we hope to offer some information that will be helpful for clinicians as they attempt to address the concerning treatment issues related to self-directed violence to include NSSI and suicidal behaviors. In this preface, we intend to define important constructs related to self-directed violence that will give you some background information on the terminology that is important in NSSI research. This book will be broken up into three main sections. Each section intends to highlight issues that may intersect with specific developmental concerns across the lifespan. Many complex client issues are presented in cases within the first three chapters of this book, which we will follow throughout the other chapters.
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