Subject/Topic:
This course offers an exciting, fresh perspective for working with clients who engage in what is otherwise known as a challenging symptom; self-abusive behavior. Participants will be provided with a clear framework that helps them makes sense of the meaning and intent of this mysterious behavior. They will learn to differentiate between self-abuse and suicidal ideation. Participants will be provided with the concrete tools necessary for managing and alleviating this provocative, challenging symptom. This course will help clinicians avoid the power struggles and burnout that so often arises when working with a client who engages in self-harming behavior. It teaches participants about the defense used most frequently by those who self-abuse, projective identification. This allows participants to expand their skill set by using their own feelings to better understand what is happening in treatment. Participants will come away from the course feeling more confident and hopeful in their ability to intervene where previously they have felt overwhelmed and confused. Participants will finally be able to help their client reduce and eliminate self-harming behaviors.
Name and Qualifications of the Presenter:
Ellen Blaufox, LCSW-R is Clinical Director of Linden Hill RTF (Jewish Board of Family and Children’s Services) the largest psychiatric, residential treatment facility in New York State. She has been working with adolescents, adults and families who live with chronic stress, histories of trauma and mental illness for almost twenty years. During her time at Linden Hill, Ellen has had the opportunity to participate as a Core Team Member (for JBFCS) in the National Child Traumatic Study Network Learning Collaborative with the founders of TF-CBT. She has been practicing TF-CBT for nearly eight years and has provided consultation and supervision for TF-CBT clinicians. Additionally, Ellen was a Core Team Member of the implementation of the Sanctuary Model on the Westchester Campus of JBFCS. She participated in the adaptation and implementation of the Sanctuary Model from an adult modality to the adolescent population.
Ms. Blaufox has been an Adjunct Professor at New York University Silver Graduate School of Social Work for four years, where she teaches Diversity, Racism, Oppression and Privilege. She has also taught Trauma and Resilience at Iona College. Ellen is the Founder of True Edge Workshop whose mission is to empower girls and women by challenging their cognitive distortions and increasing their practice of self-compassion. She is a well-respected authority and has been presenting workshops on such topics as white privilege, self-abuse, trauma, depression, feminism and self-care for the last ten years. In addition, she is a contributor to Mary Pender Greene’s chapter Family and Children’s Services in the publication Encyclopedia of Social Work with Groups. Ms. Blaufox is in private practice in Westchester County. She is a graduate of Circle in the Square Theater Summer School and NYSSA (Julliard).
Description of Course:
Session amounts may vary based on the individual needs of the organization.
For individuals, please contact us for more information.
This course sets the stage for therapeutic change by providing a trauma framework that helps clinicians better understand and treat clients who engage in self-abusive behavior. The course teaches clinicians how to provide the necessary structure for their clients with contracting and the clarification of boundaries. Participants will begin to reframe self-abusive behavior by better understanding the purpose it serves for the client. There will be a description and clarification of stages of change that allow clinicians to anticipate and prepare for relapse in treatment. The course will provide hope for clients and the worker by incorporating a strength perspective. There will be clarification around the definitions of suicidal, masochistic and self-harming behavior. Participants will learn how to make risk assessments, so they can better understand what constitutes an emergency situation in the their particular clinical milieu (i.e. school versus hospital or clinic settings).
There will be a review of trauma theory, as well as the normative responses to chronic trauma; the adaptive purpose they serve and how it relates to self-harm. This includes clear explanations and examples of how the following are manifested: fight or flight, learned helplessness, loss of volume control, dissociation, addiction to trauma, identification with the aggressor, etc.
Countertransference will be discussed, as well as an explanation of projective identification and how it works as a key defense. There will be discussion around pejorative labeling (such as: “manipulative”, “attention-seeking”) and a redefinition and shifting of perspectives allowing clinicians to deal with the shame, blame and guilt from which their clients suffer. Participants will develop empathy without playing a role in the traumatic re-enactment and learn to avoid burnout when working with challenging clients.
Multiple concrete interventions will be explained, reviewed and practiced (where applicable) within the context of case examples.
Such as:
- Non-violence stance: How to staying non-judgmental and avoiding power struggles.
- Boundaries: How to set limits for both workers and clients.
- Contracting: How to remain pro-active instead of crisis driven.
- Emotional Regulation Skills: Techniques for increasing distress tolerance
- Cognitive Processing: Evidence-based CBT methods for shifting thinking patterns that trigger and perpetuate self-abuse cycles.
- Avoiding Reenactment: Creative tools that incorporate the five senses to identify triggers and create safety plans.
- Re-experiencing: Grounding techniques that help with flashbacks, dissociation and nightmares.
- Charting: Mapping frequency, intensity and duration of incidents to encourage and foster hope.
- Future Focus: Enhancing social supports and decreasing isolation for both worker and client.
Teaching Methods:
This course is geared toward adult learners. It will be taught with a combination of methods. Didactic lecture and the use of power point will outline in a step-by-step, sequential manner the components of the model. Interactive activities such as role-play and practice time for skills and techniques will allow the participants to begin to internalize the tools and techniques taught in the course, as well as to be prepare for challenges, resistances and avoidance. Video clips are used to stimulate conversation and serve as case examples.
They will be utilized to discuss both theory and intervention techniques. Discussion of how to apply the model to specific cases, as well as case examples will occur throughout.
Learning Objectives:
- Participants will understand how to define self-abusive behavior what it is and what it is not.
- Participants will learn how to use tools to assess risk and differentiate between self-abusive behavior and suicidal ideation and suicidal intent.
- Participants will review normal responses to trauma such as: fight or flight, learned helplessness, dissociation and traumatic re-enactment.
- Participants will understand how a trauma framework sheds light on the purpose self-abusive behavior serves for the client.
- Participants will recognize how the helping professional’s counter-transference can provide insight into the client’s experience, as well as clues for treatment interventions.
- Participants will understand how self-abusive behavior is an attempt to regulate affect and maintain or achieve a sense of control with video clips from films, as well as real life clinical case examples.
- Participants will learn and then practice myriad treatment interventions.
- Participants will learn how to integrate treatment interventions with case examples.
Teaching Methods:
The course is geared to adult learners and will use verbal and PowerPoint presentation of material by the instructor; interactive large group discussion of concepts and of participants’ practice; small group work involving experiential exercises and discussion of handouts of resources and tools. Additionally, this workshop uses video clips as case examples and creative exercises that equip participants to assess and decrease risk for clients. Participants will explore and practice a variety of creative and effective techniques with an experienced and accomplished instructor. They will practice interventions for grounding, emotional regulation, cognitive reprocessing and learn how to chart progress, create real-life safety plans and enhance community supports.