BACP CYPF Conference 9th February 2019 RESPONDING THERAPEUTICALLY TO YOUNG PEOPLE WHO SELF-HARM Jeanine Connor, MBACP, MSc, BSc (Hons) Child & Adolescent Psychotherapist
This poses dilemmas for the counsellor/therapist Introduction Working with a child or young person who self-harms is always about working with risk This poses dilemmas for the counsellor/therapist Today we will explore the risk and think about how to manage the dilemmas…
Session aims Explore fantasies Dispel fears Reframe thinking Assess and manage risk Reflect on professional obligations Enable us to respond confidently, safely and therapeutically
Explore fantasies What are the common beliefs/fantasies about children & young people who self-harm?
Common fantasies Self-harm is attention-seeking Self-harm is a fad they will grow out of People who self-harm have usually been abused It’s mostly girls who self-harm People self-harm because their friends do it All young people self-harm; it’s normal Self-harm is a precursor to suicide
Dispel fears What are the common fears about working therapeutically with children & young people who self-harm?
Common fears I might not be able to get them to stop They might seriously hurt themself It will be my fault if they do I will have to tell their parent/carer It’s too risky for me to work with They might die I will be responsible for their safety
Reframe thinking Self-harm is a communication about a child or young person’s state of mind What might they be trying to say?
Communication I am hurting I have been hurt I deserve to be hurt I don’t have the words Help me Notice me I want to be looked after I want to live
Managing risk Working therapeutically with children & young people who self-harm involves a balance between holding risk and exploring meaning
Professional obligations Ethical dilemmas Safeguarding Confidentiality
Ethical dilemmas Can I manage the risk? Am I professionally competent? What if I’m shocked by what I see/hear about? Who should I tell? What should I say? What if I make things worse? What if I damage the therapeutic relationship?
Safeguarding Assess ‘here-and-now’ risk Assess context Assess ordinary age-appropriate behaviour Apply knowledge Access support Apply clinical decision making Explain your decision
Confidentiality Is the information confidential? Do I have/need consent to share it? What is the purpose of sharing the information? Is sharing information in the best interests of the child or young person? Is there a legal requirement to share information? What is the most appropriate way to share the information?
BACP ethical framework Work to professional standards by: working within our competence, and … collaborating with colleagues Act in the best interests of the child When the safeguarding of our clients from serious harm takes priority over our commitment to putting our clients’ wishes and confidentiality first, we will usually consult with our client (in the first instance) We will use our supervision and any other available professional resources to support and challenge how we respond We will take responsibility for considering how best to act and will be ready to explain why we decided to respond in the way we did
Our response Respond confidently Respond safely Respond therapeutically
Final review Have your fears been dispelled? Have you reframed your thinking? Do you feel better equipped to manage risk? Are you aware of your professional obligations? Do you feel more able to respond confidently, safely and therapeutically to children & young people who self-harm?
Presentation prepared by Jeanine Connor All images copyright free Goodbye and thank you Presentation prepared by Jeanine Connor All images copyright free