Journal of Psychiatry

Maximizing hope and minimizing harm: Researching and working with children and adults who self-harm and self-injure

Euro Global Summit and Medicare Expo on Psychiatry

July 20-22, 2015 Barcelona, Spain

Sam Warner

Scientific Tracks Abstracts: J Psychiatry

Abstract:

Children and adults who self-harm and self-injure present a major challenge for social care and mental health services and numerous serious case reviews in the UK and beyond have identified many areas for improvement in respect of children and adults who are at risk of suicide. Such children and adults represent a highly stigmatized, and too often misunderstood and mistreated group. I will argue that clinical research in this area has suffered from a too narrow understanding of what constitutes evidenced-based practice and this has led to an over-reliance on pre-determined outcomes; reductive behavioral goals; and an undue focus on treatment techniques. In this paper, I argue for clinical research that is flexible, user-centered and practice-based. Drawing on theory, research and clinical case studies I demonstrate the utility of triangulating knowledge from multiple data sources in understanding self-harm and self-injury. Using this triangulated knowledge-base, I identify key factors associated with self-harm and self-injury. I build on this analysis to consider what is needed in developing and delivering effective practice with children and adults who use self-harm and self-injury to cope, communicate and/ or as a means to end life. I identify key factors in determining suicide risk. I then contrast harm stopping approaches with positive risk taking and harm reduction strategies, elaborating how and when to use them. Finally, I consider the emotional cost of working with self-harm and self-injury, and the need for policy and research which embeds principles for practice, rather than fetishizes techniques.

Biography :

Sam spent 20 years at Manchester Metropolitan University, UK first as a PhD student and then as a research fellow, leaving in 2015 to concentrate on clinical work and strategic development. Sam is a consultant clinical psychologist, qualifying nearly 25 years ago. As an academic and practitioner, Sam has always specialized in child abuse, sexual violence and domestic abuse, and their impact on mental health: from dissociation to self-harm. She has written books, reports and papers on these issues. Sam has worked for the British Department of Health as a national advisor on sexual violence and mental health. Currently Sam provides clinical oversight to Barnardos Safer Futures services, North West, UK.