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Self-injurious Behaviors:

Recognition, Prevention and Intervention Strategies

Kevin J. McCarthy, Ph.D.

Louisiana State University Health Science Center

1599 Ridgecrest Dr.

Slidell, LA 70458

Crisis workers and emergency services personnel respond to a wide range of requests for assistance. Among the most challenging behaviors confronting responders, are those classified as Self-Injurious Behaviors (SIB). These are destructive acts which individuals commit against themselves. These behaviors may present in conjunction with exacerbated psychiatric symptomatology Or they may occur as a function of personality characteristics, particularly decompensation in stressful situations. These behaviors can range from withholding essential life-sustaining elements (i.e. food or sleep) to self-mutilation and suicide,

It is likely the first responders will have little advanced notice of these tendencies in individuals they serve. The awareness of these characteristics may enhance effective intervention and service delivery strategies. Persons who demonstrate these behaviors usually have a high rate of prior incidents. A detailed history will often reveal an established cycle of activities leading up to the self-destructive act, preferences for specific injurious behaviors and a pattern of behavioral abatement following the completion of the SIB.

Emergency service personnel and crisis intervention workers are likely to benefit from establishing an understanding of the individual's history through communication techniques. This type of engagement includes inquiries regarding types of current medications used, attempts to identify formal therapeutic relationships, prior hospitalizations, and preferences in emergency contact information furnished Gentle directed probes will allow the responder the opportunity to secure relevant information without triggering conflictual responses in individuals exhibiting self-destructive behaviors.

Individuals may precipitate a crisis in the absence of effective coping responses Awareness of basic psychological first aid will be helpful in identifying and assisting those with a concurrent psychiatric diagnosis or manifesting critical signs and symptoms of disturbed behaviors Crisis care personnel are often the primary responder to a variety of situations in which these individuals have inflicted harm of themselves. This workshop focuses upon recognition, prevention and intervention strategies which help to decrease or control SIB-related incidents. Activities will include interactive counseling role plays and telephone intervention methods.