Adolescents who self-injure: implications and strategies for school counselors

Professional School Counseling, Feb, 2004 by Victoria E. White Kress, Donna M. Gibson, Cynthia A. Reynolds

Writers on self-injury frequently address the issue of counselors' need to manage their personal reactions towards clients who self-injure. Issues such as the time and emotional investment required in working with this population, the strong reactions of counselors to self-injury, and the limits these reactions place on counselors' ability to work with clients have been noted (Levenkron, 1998; Zila & Kiselica, 2001). Self-injury is sometimes viewed as being manipulative or "attention seeking" (Simeon & Favazza, 2001). Counselors may sometimes feel frustrated with self-injury and may want to attempt to control the student by forcing him or her to stop engaging in the self-destructive behavior, or by lecturing or debating the problems associated with self-injury. A personal awareness and understanding of one's intentions when working with students who self-injure can be helpful in facilitating successful interventions. Avoiding attempts to control the student or tell him or her to stop the behavior can facilitate student empowerment as well as prevent potential power struggles. A constant monitoring of personal reactions combined with ongoing consultation and supervision can help in ensuring that counselors maintain an objective perspective when working with this population (Deiter & Pearlman, 1998).

CONCLUSIONS

Self-injury is an increasing trend that has not been adequately addressed in the literature. Preliminary research indicates that the etiology, function, and interventions associated with self-injury are diverse and varied; counselors know little and must be careful, deliberate, and thoughtful in working with this population.

Counselors can serve as powerful advocates to students who self-injure through challenging a culture that may contribute to adolescents' challenges and by hearing adolescents stories, validating their experiences, and providing a safe refuge. Counselors can also play a role in intervening and preventing self-injury; educating teachers, parents, and students; and making referrals to specialists who can help the self-injuring student. On a more macro-cultural level, counselors can serve to fight oppressive cultural systems that serve to disempower adolescents and hamper their voices by providing an environment that fosters self-expression and the use of positive coping skills (Conterio et al., 1998; Zila & Kiselica, 2001).

References

Alderman,T. (2000). Helping those who hurt themselves. The Prevention Researcher, 7(4), 43-46.

Baker, S. B. (2001). School counseling for the twenty-first century (3rd ed.). Upper Saddle River, N J: Prentice Hall.

Barstow, D. G. (1995). Self-injury and self-mutilation: Nursing approaches. Journal of Psychosocial Nursing and Mental Health Services, 33(2), 19-22.

Briere, J., & Gil, E. (1998). Self-mutilation in clinical and general population samples: Prevalence, correlates, and functions. American Journal of Orthopsychiatry, 613, 609-620.

Conterio, K., Lader, W., & Bloom, J. K. (1998). Bodily harm: The breakthrough healing program for self-injurers. New York: Hyperion.