I. Definition and Contexts for Self-Injury
1. Definition and Differentiation from Suicide
2. The Relationship between Self-Injury and Suicide
3. An Overview of Direct and Indirect Self-Harm
4. Major Groups in Which Self-Injury Occurs
5. Body Piercings, Tattoos, Brandings, Scarifications, and Other
Forms of Body Modification
6. A Biopsychosocial Model for Self-Injury
II. Assessment and Treatment: A Stepped-Care Model
Treatment: Step 1
7. Initial Therapeutic Responses
8. Formal Assessment of Self-Injury, Jennifer J. Muehlenkamp
9. Cognitive-Behavioral Assessment
10. Contingency Management
Treatment: Step 2
11. Replacement Skills Training
12. Cognitive Treatment
13. Family Therapy, Michael Hollander
14. Psychopharmacological Treatment, Gordon P. Harper
Treatment: Step 3
15. Body Image Work
16. Prolonged Exposure or Cognitive Restructuring for Treating PTSD
and Related Self-Injury
Treatment: Step 4
17. Treating Persons with Multiple Self-Harm Behaviors
18. Residential Treatment Targeting Self-Injury and Suicidal
Behavior in Adolescents, with Leonard A. Doerfler and Ariana
Perry
III. Specialized Topics
19. Managing Reactions to Self-Injury: A Guide for Therapists and
Other Caregivers
20. Social Contagion and Self-Injury
21. A Protocol for Managing Self-Injury in School Settings
22. Asphyxial Risk Taking (the Choking Game), Amy M. Brausch
23. Understanding, Managing, and Treating Foreign-Body Ingestion,
with Ariana Perry
24. Self-Injury in Correctional Settings, Kenneth L. Appelbaum
25. Treating Major Self-Injury
Afterword
Appendix A: Breathing Manual
Appendix B: Body Attitudes Scale (BAS)
Appendix C: Clinical Scales to Assess Self-Injury
Appendix D: Helpful Websites Related to Self-Injury
Appendix E: Bill of Rights for People Who Self-Harm
Barent W. Walsh, PhD, is Executive Director of The Bridge of Central Massachusetts in Worcester and Teaching Associate in Psychiatry at Harvard Medical School. The Bridge specializes in implementing evidence-based practice models according to protocol in public-sector settings. It comprises over 40 programs serving persons with mental health or developmental disability challenges, including special education; residential treatment; wraparound services; supported housing services; a drop-in center for gay, lesbian, bisexual, and transgender teens; and a program for homeless people. A recipient of the Lifetime Achievement Award from the Massachusetts chapter of the National Association of Social Workers, Dr. Walsh has worked with self-injuring persons for over 40 years and has conducted research, written extensively, and presented internationally on self-injury. He has consulted on this topic at numerous schools, outpatient clinics, group homes, psychiatric hospitals, and correctional facilities, and has also served on the clinical and research faculties of the Simmons and Boston College Schools of Social Work.
This clearly written and well-referenced book presents
state-of-the-art practical information on the assessment and
treatment of impulsive nonsuicidal self-injury in multiple
settings. The superb use of case histories and examples of
treatment make it an indispensable resource for therapists,
teachers, and others who are called upon to deal with
self-injurers. Highly recommended!--Armando Favazza, MD, author of
Bodies Under Siege
The second edition of Treating Self-Injury is the most up-to-date
and clinically useful resource on this extremely important public
health problem. Walsh and his collaborators are clinical experts
who are also versed in the research literature. From topics like
the 'choking game' to self-injury in correctional settings to
family approaches and beyond, the book is absolutely essential for
mental health professionals who treat any form of
self-injury.--Thomas E. Joiner, PhD, The Robert O. Lawton
Distinguished Professor of Psychology, Florida State University
Walsh combines extensive clinical expertise and knowledge about
self-injury with an accessible writing style and careful attention
to the latest research. It is clear that Walsh cares genuinely and
deeply about the people he seeks to help. Treating Self-Injury,
Second Edition, is one of the most important volumes on nonsuicidal
self-injury. The book is distinguished by its practical and
thoughtful guidance regarding the intricate, often messy clinical
realities that treatment professionals encounter every day.--E.
David Klonsky, PhD, Department of Psychology, University of British
Columbia, Canada
There are a number of books about understanding and treating
self-injury. This is by far the best one. Walsh has been a pioneer
in the field for decades, and this second edition expertly
incorporates recent research advances and translates them into
useful assessment and intervention practices. If I could have only
one book to guide me in the treatment of self-injury, it would
undoubtedly be this one.--Matthew K. Nock, PhD, Department of
Psychology, Harvard University
In this second edition, Walsh solidifies his status as one of the
foremost experts in the treatment of self-injury. Combining a
nonjudgmental and compassionate understanding of self-injury with
practical strategies for treating this increasingly common
behavior, this book is a 'must' for anyone who works with clients
who self-injure.--Kim L. Gratz, PhD, Department of Psychiatry and
Human Behavior, University of Mississippi Medical Center
I described the first edition of this book as wise, thoughtful, and
sound. Now I need to add 'brilliant' to reasonably describe the
second edition. Not only has Walsh incorporated lessons learned
from the explosion of research in this area, but he has also woven
in the insights of additional well-chosen chapter authors. As the
subtitle says, this is a practical guide--but beyond that, it is
the definitive treatise on what is known and how to intervene in
this most significant of pathologies, and an essential addition to
every clinician's resources.--Alan L. Berman, PhD, ABPP, Executive
Director, American Association of Suicidology
Walsh has done it again! This is an incredible resource for those
supporting individuals who self-injure--and the second edition is
even more comprehensive. New content includes updates on
psychosocial and pharmacological interventions, which inform
clinicians on the most effective supports; a stepped-care model of
service delivery that offers targeted strategies to address each
client's unique needs; and chapters on issues unique to various
treatment settings. I recommend this practical guide to working
professionals as well as students preparing to enter the mental
health field.--Melissa M. Pearrow, PhD, School Psychology Program
Director, University of Massachusetts Boston-
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