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Talking to young people about self-harm Dr. Bridie Gallagher

Clinical Psychologist

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Outline • Why do young people self-harm • Why we think rates are increasing • How to sensitively approach young people • do's and don'ts from young people

• Managing risk in school settings

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Non Suicidal Self Injury, Self Injurious Behaviour • Deliberate act that is intended to damage tissue but not to end life • • • • •

Cutting Scratching Eating harmful substances Overdosing on prescription medication Tying ligatures

• What is it not? • “Parasuicide”

• Relationship of self-harm to suicide is that most people who complete suicide have not self-harmed but young people who self-harm are at increased risk of suicide (approx. 2-3x more likely).

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Why? All behaviour is a communication: “Attention seeking” and “manipulating” unhelpful language • “To see if anyone cared” • “To feel something” • “Physical pain is easier to deal with” • “To punish myself” • To not feel or help to manage emotional pain • Grounding when dealing with traumatic flashbacks or high levels of anxiety • Seeking the love and care that they need

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• They have experienced trauma that they have not been supported to overcome (e.g. domestic violence, loss, sexual abuse) • They do not have the coping skills to deal with their emotions • Double disability

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Self-harm – a thoroughly modern problem? • 14-24% estimates in adolescent population • Higher rates in females, LGBT community, BME communities. • Also associated with adolescent identity (emo/goth) • Increasing rates? Not enough/good enough data • Just more talked about?

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Why might it be increasing? • Socially accepted – social media • Rising inequality • Less connected • Shame and social media • Child abuse

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How to approach it… • Self-harm is letting you know that a young person cannot cope and doesn’t have another person to help them calm down/feel OK • All about building trust and letting them know this is a safe relationship • If they have let you know, then they want your help, they might not know what help. • By being curious and empathic you are already intervening in a helpful way

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Do’s • Take your time and choose your place • Listen carefully • Write things down if you need to • Seek support from colleagues • Think “child protection” • Keep calm - pay attention to your own level of anxiety • Just be with them

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Helpful questions… • How often is this happening? • When did it start? • Are there other ways you have hurt yourself? • Have you told anyone else? • Are you using any chat groups or forums for support or information? • Is there anything that you need help with? • Is there anyone hurting or scaring you?

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Don’ts • Ask why (but don’t forget to be curious) • Try to “cheer them up” thinking about positives • Say their worries are “silly” or not true e.g. “of course your parents love you!”

• Try to scare them into stopping • Try to do “deals” to get them to stop • Agree to keep any secrets

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Risk management… • All about relationships… a curious empathic person at school can reduce the need to self-harm • Accept the feelings and the pain… it WILL NOT make them harm more • If no support from CAMHS… • Offer a key person for support • Check in every day

Safety planning • What should we look out for? (Warning signs)

• What helps? What doesn’t help? (Do’s and Don’ts for staff at school) • What can you do to soothe yourself? E.g. take time out, colouring, call your auntie, go to the school nurse for a hug) • What can you say to yourself? “I got through this before I can do it again” • Who can you approach/talk to? Named person.


Strong feelings... Young people who self-harm have often experienced abuse and neglect They have well developed ways of managing their relationships that have kept them safe in the past e.g. • Making people pay attention and be worried about them • Keeping people at arms length and relying only on themselves • Pushing people away when they get too close • Testing whether adults care about them These behaviours can make it hard to be close to the young person and make you feel angry, rejected, or as if you are the only person in the world who can help.

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Building resilience and wellbeing through positive psychology Dr. Rachael King Educational and Child Psychologist

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Outline • What is wellbeing? • Wellbeing in schools • An introduction to positive psychology • Techniques for building resiliency in young people

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Wellbeing

• 'Subjective Well-being’ is the Scientific Term for Happiness


10 keys to happier living • Everyone's path to happiness is different, but the research suggests ten things consistently tend to have a positive impact on people's overall happiness and well-being. • What are they?

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Benefits of wellbeing Social Work Health Personal Meta-analysis by Lyubomirsky, King & Diener (2005)

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Challenges to Wellbeing Rise in mental health problems Social media and technology Increased fear Family/community breakdown, increase of divorce, social isolation • Increased expectations and pressures on young people • • • •

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What is positive psychology? • The study of positive emotions and positive character traits. • Broad aims  Increasing positive emotions.  Reducing the impact of negative emotions. the subject: thinking about others rather than ourselves and  Changing engaging in purposeful activity.  Finding meaning in one’s life. Visit: www.hsrpsychology

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Wellbeing and resilience • Wellbeing is a psychological state at a point in time • Resilience is dynamic, taking into account the past and the future • Wellbeing is strongly correlated with resilience • How we feel today can prepare us for what is coming • How resilient we are can impact on our sense of wellbeing


Techniques for building resiliency  Strengths

Individual

 Mindfulness

Groupwork

 Gratitude  Extra acts of kindness

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Whole class/school

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Strengths Generates optimism Sense of direction Fulfillment Achieve goals Build self esteem Carry out the VIA Character Strengths assessment (takes up to 30 minutes): www.viacharacter.org/www/the-survey • Strength cards • • • • • •

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Mindfulness • Paying attention to the present moment • Can improve awareness and regulation of thoughts and feelings • Can boost concentration • Mindfulness games, snacktime, apps (eg. Smiling Mind), mindful breathing • You can follow a free 10-day daily guided meditation on the Headspace website: www.headspace.com/register/free-trial Visit: www.hsrpsychology

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Gratitude • Three Good Things • Gratitude Diary -Write about 2-3 things that you are grateful for:  Make them recent (e.g., last 24hrs)  Make them specific (e.g., morning coffee, walked the dog, chat with my sister)  Online gratitude diary and challenge www.thnx4.org

• Letter of thanks • App ‘The gratitude garden’ Visit: www.hsrpsychology

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Extra Acts of Kindness "if you want to feel good, do good" • Such as, a smile, offer your seat on a bus, thank someone, help a neighbour • Studies found significant increases in well-being after 6 weeks of 5 random acts of kindness a week (Lyubomirsky et al., 2004) • Kindness UK day November 13th http://kindnessuk.com/world_kindness_day_kindness_day_uk.php


Resources • Action pack http://www.actionforhappiness.org/media/80216 /happiness_action_pack.pdf • Test your happiness https://www.authentichappiness.sas.upenn.edu/t estcenter • Resources for schools http://kindnessuk.com/schools/resources.php • Self esteem journal (handout)


Self care • Many of these techniques and strategies can be used for yourself and your team • Prevent burnout • Identify stressors • Maximise personal resources • Reignite passion and energy for your job • Self care assessment Visit: www.hsrpsychology

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Thank You! References available on request Rachael@hsrpsychology.co.uk

“Happiness is always here, it is always now.”

Osho


References • • •

MacConville, R. & Rae, T. (2012). Building Happiness, Resilience and Motivation in Adolescents: A Positive Psychology Curriculum for Well-Being. Jessica Kingsley Publishers. Mguni, N, Bacon, N. & Brown, J.F. (2012). The wellbeing and resilience paradox. Young Foundation. Seligman, M. (2003) Authentic Happiness: Using the New Positive Psychology to Realize Your Potential for Lasting Fulfilment. New York: Free Press

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References • • •

MacConville, R. & Rae, T. (2012). Building Happiness, Resilience and Motivation in Adolescents: A Positive Psychology Curriculum for Well-Being. Jessica Kingsley Publishers. Mguni, N, Bacon, N. & Brown, J.F. (2012). The wellbeing and resilience paradox. Young Foundation. Seligman, M. (2003) Authentic Happiness: Using the New Positive Psychology to Realize Your Potential for Lasting Fulfilment. New York: Free Press

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The End

Thanks for listening!

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Profile for HSR Psychology

HSR Psychology Powerpoint presentation - Self-harm and positive psychology  

The powerpoint from our CPD event which included the following topics: 'Talking to young people about self-harm' by clinical psychologist, D...

HSR Psychology Powerpoint presentation - Self-harm and positive psychology  

The powerpoint from our CPD event which included the following topics: 'Talking to young people about self-harm' by clinical psychologist, D...

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