Collaborative Strengths-Based Brief Therapy with Self-Injuring Adolescents and Their Families

Adolescent self-injury is one of the most perplexing and intimidating presenting difficulties mental health, school, and healthcare professionals will encounter in their practice settings. Janis Whitlock, Director of the Cornell Research Program on Self-Injurious Behavior in Adolescents and Young Adults, has found in her research that 5-8% of adolescents are actively cutting, scratching, pinching, burning, or severely bruising themselves in a given week (Whitlock, personal communication, September 28, 2009). In addition, many of these youth symptom switch?that is they engage in other self-destructive behaviors such as bulimia, substance abuse, and sexually risky behaviors?which makes it more challenging to treat them. For many adolescents, self-injury and other self-destructive behaviors are employed as an attempt to get quick relief from emotional distress and to soothe themselves (Selekman, 2006, 2009). In some cases, having been repeatedly invalidated by and emotionally disconnected from their parents and other significant people in their lives has led them to feeling emotionally numb inside. Thus, by cutting or burning themselves they feel something (Miller, 2005; Selekman & Shulem, 2007; Whitlock et al., 2008). This article presents a family competency-based treatment approach that capitalizes on the strengths and resources of the adolescent, family members, key people from their social networks, and helping professionals from larger systems to co-construct solutions to resolve their presenting difficulties. Throughout the article, I provide therapeutic tools and strategies that I have found effective in my clinical practice of working with self-injuring youth and their families over the past 25 years.