Treating Self-Injury

Barent W. Walsh, PhD, The Bridge of Central Massachusetts, Inc., Worcester, MA

Part I: Definition and Contexts. Definition, Differentiation from Suicide, and Classification. An Overview of Direct and Indirect Self-Harm. Major Groups in Which Self-Injury Occurs. Body Piercing, Tattooing, Branding, Scarification, and Other Forms of Body Modification. Part II: Assessment and Treatment. A Biopsychosocial Model for Self-Injury. Initial Therapeutic Responses. Cognitive-Behavioral Assessment. Contingency Management. Replacement Skills Training. Cognitive Treatment. Body Image Work. Exposure Treatment and Resolution of Trauma. Family Treatment. Harper, Psycho-pharmacological Treatment. Managing the Reactions of Therapists and Other Caregivers to Self-Injury. Part III: Specialized Topics. Contagion and Self-Injury. A Protocol for Managing Self-Injury in School Settings. Treating Major Self-Injury. Conclusion. Afterword. Appendix A: Breathing Manual. Appendix B: Body Attitudes Scale. Appendix C: Websites Related to Self-Injury. Appendix D: Bill of Rights for People who Self-Harm.