Self-Injury

Background Information

Non-suicidal self-injury, also known as self-harm, self-mutilation, or self-abuse is the act of deliberately harming one’s body, such as cutting or burning in a way that is impulsive and not intended to be lethal. It is typically not meant as a suicide attempt; rather, this type of self-injury is a harmful way to cope with emotional pain, intense anger and frustration. According to The Journal of the American Board of Family Medicine, research indicates that self-injury occurs in approximately as many as 4% of adults in the United States. Rates are higher among adolescents, who seem to be at an increased risk for self-injury, with approximately 15% of teens reporting some form of self-injury. Studies show an even higher risk for self-injury among college students, with rates ranging from 17%-35%.

The most common methods are:

• Skin cutting (70-90%)
• Head banging or hitting (21%-44%)
• Burning (15%-35%)

Most people who self-injure are teenagers and young adults, although those in other age groups also self-injure.

Self-injury often starts in the preteen or early teen years, when emotions are more volatile and teens face increasing peer pressure, loneliness, and conflicts with parents or other authority figures. Although life-threatening injuries are usually not intended, with self-injury comes the possibility of more-serious and even fatal self-aggressive actions.

Getting appropriate treatment can help learn healthier ways to cope.

Best Practices and Implications for Professional Practice

a. Create a positive classroom culture poster to display in the room. Have students play an active role in creating the norms for a welcoming, positive and safe environment.
b. Create a classroom procedure to allow students to address grievances to avoid conflicts making sure all students have safe and positive peer connections.

• Make sure all students are connected with a trusted adult.
• Create opportunities for students to share their feelings. Discuss how those feelings interfere with their decisions and/or choices. This can be a private or public opportunity.

Suggested Resources

Safe2Help Illinois Website Resources:

• Self-Injury This resource lists alternatives for help getting through difficult times.
• Self-Injury: Learning to Ride the Wave This resource suggests coping strategies that replace self-harming behaviors.

Other Resources:

• Mayo Clinic Gain a better understanding of self-harm and the symptoms, forms and causes leading to self-harm. Learn how to help others that self-harm, when to seek professional help, and complications of and prevention strategies for self-harm.
• National Association of School Psychologists A variety of mental health podcasts can be found at this link.
• Self-Injurious Behavior This resource includes recommendations for teachers and school psychologists on responding to self-injurious behavior.
• Mental Health America provides insight into prevalence of, causes, warning signs, and diagnosis of self-injurious behavior. This resource includes possible treatment for and additional resources for self-injury and suicide.
• S.A.F.E Alternatives (Self Abuse Finally Ends) Classroom intervention tips are included here for intervening with students who self-injure.

Sample Classroom Strategies

IL SEL Standards:

• Goal 1: Develop self-awareness and self-management skills to achieve school and life success.
  Goal 3: Demonstrate decision-making skills and responsible behaviors in personal, school, and community contexts.

Activities:

These activities can be used to address the Illinois SEL Standards.

a. On Edge: Learning about Self Harm from Mindreel incorporate aspects of the following lessons to enhance student understanding of self-harm and introduce coping skills.
o Understanding the Meaning of Self-Harm: Students will understand the meaning of self-harm and recognize life events that can lead to self-harm.
o Dealing with Difficult Feelings: Students will recognize different feelings. Students will identify difficult and painful feelings. Students will understand that those feelings can lead to self-ham.
o Exploring Stereotypes: Students will understand the meaning of the word stereotype. Students will identify who is at risk for self-harm. Students will understand that individuals use different coping skills.
o Getting Help: Students will know how to help someone who self-harms. Students will know how to access professional help.
b. Controlling Your Urges--- with the 15 Minute Rule This exercise can help students with having a plan in place when faced with an urge that should be avoided.
c. Introduce communication exercises to encourage students to use communication to express emotions.
d. Use journals to express emotions through writing.
e. Introduce a Trigger Log – student tracks each time he or she engages in SI and the events leading up to it.
f. Teach Stress Management and Tension Release. Stay grounded.
g. Teach diaphragmatic and controlled breathing.
h. Teach and model meditation and visualization.