ADOLESCENT SELF-INJURY BEHAVIOR
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Transcript of ADOLESCENT SELF-INJURY BEHAVIOR
ADOLESCENT SELF-INJURYBEHAVIOR
Rhonda Lesniak, RN, BSN, MA, NCSNChristine E. Lynn College of NursingFlorida Atlantic University
Key Terms
Self-injury behavior (SIB) Self-inflicted violence (SIV) Self-harm Self-mutilation Cutting Self-abuse
Definition
Adolescent self-injury behavior is a call for nursing through the deliberate infliction of a wound to oneself in an attempt to seek expression of and immediate relief from intolerable feelings.
Self-Injury is
A coping mechanism A deliberate act Repetitive Private and personal An act of expression Non verbal communication A survival strategy A cry for help A call for nursing
Self-Injury is not
Attention seeking For pleasure A group activity A failed suicide attempt Manipulation A tattooing or body piercing trend
Who is Self-Injuring?
1 in 10 teenagers More females than males Age of onset pre-teen to teenage May last well into their thirties
Difference Between SIB and Body Decoration Body piercing and tatooing are forms of
body decoration which are not used to seek immediate relief from intolerable feelings.
Body decoration can originate from a desire for peer approval.
High Risk Indicators
Childhood history of physical, emotional, mental, verbal, or sexual abuse
Lacks validation Feelings of inadequacy Low self esteem Poor self image
Calls for Nursing
Expression may be realized through: Poetry Creative writing Artwork Frequent school clinic visits Frequent absenteeism Student just wants to talk
Antecedents to SIB
Feels helpless, powerless Feelings of isolation and abandonment Feelings of worthlessness, emptiness,
numbness Depression Frustration Anxiety Anger Tension
Why Inflict Physical Pain?
Physical pain distracts from emotional pain Means of communicating distress To disassociate from intolerable feelings To transfer emotional pain into physical pain To regain control over self Physical pain is easier to deal with than
emotional pain To gain control IT WORKS
Immediate Consequences of SIB
Feels alive, functioning, able to act Clears the mind, helps to focus Release of endorphins Tension reduction Relief from stress or feelings Calmness Relaxation Sleep
The Cycle of SIB
SELF-INJURY
RELIEF
CALMNESS
RELAXATION
SHAME
STIGMAABANDONMENT
FRUSTRATION
TENSION
ANGER
ANXIETY
CALLFOR
NURSING
ADOLESCENT SELF-INJURY BEHAVIOR
DELIBERATE SELF-HARM
EXPRESSION
INTOLERABLEFEELINGS
SHORT-TERMRELIEF
CALL FORNURSING
Adolescent Self-Injury Behavior is a call for nursing through the deliberate infliction of a wound to oneself in an attempt to seek expression of and
immediate relief from intolerable feelings.
What To Look For
Unexplained cuts, scratches, burns, or bruises
Excuses such as, “my cat scratched me” Clothing inappropriate for the weather Reluctance to dress out for physical
education class or swimming Dressing to fit in with the Goth crowd
What To Do Once You Have Identified a Student as a Self-Injurer Offer nonjudgmental, unconditional
acceptance Provide quiet, private place to talk Assure confidentiality Establish a trusting relationship Above all, listen, listen, listen Do not tell student to stop SIB at this time
Implications for Practice
Explain to the student that you must notify parents of the SIB
Assure student you will provide assistance, encouragement, and support
Always keep an “open door” policy Establish your school clinic as a “safe place” Assure that wounds are not infected Teach wound care to student
Implications for Practice
Encourage the student to come to the clinic as needed (when feelings are beginning to escalate)
Intervene at any point during the SIB cycle to disrupt the cycle as needed
Encourage healthy coping mechanisms (drama, writing, art, sign language)
Keep open communication with parents
Referrals
Assist parents with referrals to community resources, therapists, counselors, etc.
Arrange for parents and students to meet with guidance counselor, if desired.
The school nurse is the facilitator of this interdisciplinary approach and is the main resource person for the family.
Therapeutic Regimens
Diagnosed mental disorders (depression, bipolar, anxiety, compulsive disorder) will be treated traditionally with medication.
Implications for school nurse – become familiar with medications and potential adverse reactions
Report any adverse reaction to parents
Therapeutic Regimens
Counseling and talking therapies Psycho-Dynamic therapy Cognitive behavioral therapy Person centered therapy Group therapy, self help, empowerment
What About Suicide?
Determine if student has suicidal ideations:
1. Are you having suicidal thoughts? Have you ever considered suicide?
2. Are you harming yourself in any way? Have you hurt yourself recently?
3. Do you have the intention to hurt yourself in the future?
If Student is Suicidal
Use the SLAP method:
1. Does the student have a plan and how Specific is the plan?
2. How Lethal is the plan?
3. How Accessible is the plan or method?
4. In what Proximity could help be found?
Suicide Prevention
If you believe the student may be of serious harm to self or others, you must notify the school authorities, and follow the policy of your school district.