The Ever-Changing Terrain of Understanding, Managing, & Treating Non-Suicidal Self-Injury



Friday, December 8, 2017
9:00 AM – 4:00 PM
Barent Walsh, Ph.D.

This clinical workshop, informed by the most current research, will focus on understanding, managing and treating diverse forms of non-suicidal self-injury (NSSI). These forms will include: 1) common, low lethality NSSI such as arm and body cutting, self-inflicted burning, abrading, skin picking, excoriation of wounds, and 2) atypical, severe NSSI such as damage requiring medical attention, harming unusual body areas (e.g. face and genitals), and ingesting foreign bodies. Self-injury will be distinguished from suicidal behavior, but will also be discussed as a major risk factor for suicide attempts. The topic of social contagion of self-injury will also be addressed. Very practical suggestions in dealing with self-injury will be provided.

As described in Walsh (2014), a “Stepped Care Approach” will be employed regarding the management and treatment of self-injury. A stepped care approach is used so that clients and families receive only as much support and targeted treatment as they need. The steps include:

Step I:

  • Responding informally and strategically to NSSI
  • Providing crisis assessment (when needed)
  • Explicating why atypical, severe NSSI should be managed differently than more common forms
  • Using standardized tools for assessing NSSI
  • Conducting a detailed cognitive-behavioral assessment

Step II:

  • Teaching effective replacement skills
  • Reviewing the increased importance of e-treatments, smart phone apps, and video game interventions
  • Employing cognitive restructuring interventions including those targeting trauma-related NSSI

Step III:

  • Managing and preventing social contagion of NSSI
  • Using multimodal treatment for those with complex self-harm configurations
  • Supporting self-care for professionals working with NSSI

Following this presentation, participants will be able to:

  • Differentiate self-injury from suicide
  • Review the research indicating that ongoing self-injury is a major risk factor for suicide attempts
  • Review how to perform a detailed assessment of NSSI
  • Discuss multi-modal forms of treatment for self-injury
  • Understand, manage, and prevent social contagion of self-injury

Barent Walsh, Ph.D. has written extensively and presented internationally on the topic of self-destructive behavior. He is the author of Treating Self-Injury: A Practical Guide 2nd edition, Guilford Press, (2014). This volume has been translated into Polish and Japanese. In addition, Dr. Walsh is co-developer (with Screening for Mental Health of Wellesley, MA) of “Act to Prevent Self-Injury,” a prevention program with DVD for high schools. Dr. Walsh has presented on self-injury in London, Edinburg, Vienna, Stuttgart, Ulm, Oslo, Dubai, Tokyo, Beijing, Montevideo, Mexico City, Montreal, Toronto, Winnipeg, and throughout the United States.

Dr. Walsh is the Executive Director Emeritus and Senior Clinical Consultant at The Bridge, a human service agency headquartered in Worcester, MA. Dr. Walsh is a Lecturer on Psychiatry, Harvard Medical School at Cambridge Health Alliance, Cambridge, MA.

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