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Managing self harm in the Community

Managing self harm in the Community. Dr Steve Kingsbury Lorraine Weiner. Workshop Plan. Present some facts about self harm and depression An extended case example Management suggestions Summary of issues. Behaviours. Self Harm Overdose Suicidal statements Acts. Depression.

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Managing self harm in the Community

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  1. Managing self harm in the Community Dr Steve Kingsbury Lorraine Weiner

  2. Workshop Plan • Present some facts about self harm and depression • An extended case example • Management suggestions • Summary of issues

  3. Behaviours • Self Harm • Overdose • Suicidal statements • Acts

  4. Depression • Psychological • Despair, sadness, hopelessness, guilt • Loss of concentration, pleasure and interest • Physiological • Loss of energy, appetite, poor sleep • Behaviours • Tearful, self harm • Suicidal intent

  5. When is it depression? • Does it make sense? • Out-of proportion • Depression • More biological • In proportion • Sadness

  6. Overdose I • Many teenagers think about overdose • Big difference between thinking and planning • Not a “cry for help” • Measure of distress • Range from • Being like crying on your own / getting drunk • Suicide attempt

  7. Overdose II • Most od’s are impulsive (<15 minutes) • Most problems are relationships • Parents, boyfriend • Precipitants • Conflict; actual or anticipated • Planning a key variable

  8. Cutting • Relatively common • Not for “attention” • Reasons to • Escape from difficult feelings • Express anger at self • To feel something • Works…

  9. Predicament • Psycho-social “wet bar of soap” Psychological factors: Disorders and strengths Life: events & relationships Family: Supports and conflict SELF Bullying OVERDOSE

  10. Case History • You are a community worker • 15 year old girl; school asks you to see her • Troubled, some bullying, conflict with best friend • When you see her you notice a recent cut on your arm • What are you going to do? • In session • After the session

  11. Part II • Think about the coroners court • What do you want to have done? • Leads you to orthodox care • Think about your manager • What will they want you to have done? • Think about the girl • What will she want you to do? • As a person?

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