Working with young women who self-injure : a qualitative analysis of therapists' experiences

Williams, Jane Claudia, Curry School of Education, University of Virginia
May, Kathleen, Curry School of Education, University of Virginia
Covert, Robert, Curry School of Education, University of Virginia
Lopez-Baez, Sandra, University of Virginia
Thomas, Antoinette, Cu-Human Svcs, University of Virginia

The purpose of this study was to learn about the experiences of clinicians who work with young women who self-injure. Due to many complex emotional, legal, and ethical concerns, many therapists are reluctant to treat clients who self-injure. Accordingly, limited research is available on the therapists' viewpoint of treating young women who self-injure.

Unfortunately, an increasing number of adolescent and young women are choosing to self-injure. In fact, self-injury has been described as the "new anorexia." In order to increase the quantity and quality of mental health services provided to young women who self-injure, it is imperative to learn more about the current experiences of clinicians who are willing to work with this population.

Five participants from diverse educational and clinical backgrounds who work with young women who self-injure were interviewed. Information about their persona! and professional backgrounds was gleaned, as well as their perspectives on working with this population. Client characteristics, treatment conceptualization and decisions, legal and ethical choices, feedback from clients, and personal responses to working with young women who self-injure were explored.

The therapists' stories are shared in thick, rich descriptive case studies. A cross-case analysis reveals similarities and differences found among the participants surrounding certain themes of working with young women who self-injure. Themes that were highlighted include the importance of the relationship to the therapists, regardless of their theoretical orientation, as well as the relationship being valued as the most positive aspect of the counseling experience by their clients. Supervision was important to all of the participants, and yet some struggles existed within clinical supervision. Each therapist uses cognitive behavioral strategies and believes that long-term therapy is most effective.

All of the participants view self-injurious behavior in young women as a coping mechanism to feel or disassociate from pain. None of the participants struggle with maintaining empathy for their clients, although all have a harrowing story to share about a client. All of the participants recognize the value of practicing self-care and do so in various ways. They all promote prevention or hope to promote prevention of this behavior in their communities.

Note: Abstract extracted from PDF file via OCR.

PHD (Doctor of Philosophy)

Local Note: "[Department of] Counselor Education."

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