Nonsuicidal Self-Injury: Management on the Inpatient Psychiatric Unit

2019 ◽  
Vol 26 (1) ◽  
pp. 10-26
Author(s):  
Laurie M. Timberlake ◽  
Linda S. Beeber ◽  
Grace Hubbard
Keyword(s):  
Dialectical Behavior Therapy ◽  
Behavioral Therapy ◽  
Management Strategies ◽  
Models Of Care ◽  
Inpatient Setting ◽  
Self Injury ◽  
The Individual ◽  
Effective Models ◽  
The Impact ◽  
Nonsuicidal Self Injury

BACKGROUND. Between 4% to 70% of inpatients engage in self-harming behaviors and effective interventions are needed to address this population. AIM. This article reviews literature from 2007 to 2017 to address treatment and management strategies specific for the treatment of nonsuicidal self-injury in the inpatient psychiatric setting. METHODS. Cochrane, PsycINFO, PubMed, and CINAHL were searched for relevant articles with 34 studies reviewed for applicability to the question, and 9 parsed into a summary of Findings table. RESULTS. Therapeutic approaches that show promise include cognitive behavioral therapy, dialectical behavior therapy, and mentalization as well as medications that act on the serotonergic, dopaminergic, and opioid systems. Effective models of care aim toward enhancing therapeutic relationships with staff, providers, and most important, encouraging the internal shift toward recovery within the patient. CONCLUSIONS. More research with controlled designs in the inpatient setting is needed, however, regardless of which approach is used, the impact of the individual caregiver on the patient’s recovery is key.

A Review of Empirical Treatment Studies for Adolescent Nonsuicidal Self-Injury

2012 ◽  
Vol 26 (1) ◽  
pp. 3-18 ◽  
Author(s):  
Amy M. Brausch ◽  
Sarah K. Girresch
Keyword(s):  
Problem Solving ◽  
Dialectical Behavior Therapy ◽  
Empirical Studies ◽  
Behavioral Problem ◽  
Specific Treatment ◽  
Cognitive Behavioral ◽  
High Risk Population ◽  
Problem Solving Skills ◽  
Self Injury ◽  
Nonsuicidal Self Injury

Nonsuicidal self-injury (NSSI) is a concern in the adolescent population given its relationship to suicidal behavior, pointing to the serious need for adequate treatments for this high-risk population. This review examined empirical studies that evaluated treatments for NSSI among adolescents, and evaluated how the components of each treatment address common underlying and concurrent factors of NSSI. Among the available treatments, cognitive-behavioral therapy (CBT) interventions that integrate a problem-solving component and dialectical behavior therapy (DBT) have received the most empirical attention. However, studies examining the utility of cognitive-behavioral problem-solving interventions for adolescents, and randomized controlled trials examining the efficacy of DBT are lacking. Overall, CBT-based treatments improved underlying or maintaining factors of NSSI, such as depression, hopelessness, and problem-solving skills. DBT was effective for reducing hospitalizations. No existing studies evaluated treatment effectiveness for NSSI exclusively, and few studies used a purely adolescent sample. This review highlights the gap in knowledge regarding adolescent NSSI—there is no strong evidence for the efficacy of any specific treatment.

Ecological Momentary Assessment and Intervention in Nonsuicidal Self-Injury: A Novel Approach to Treatment

2012 ◽  
Vol 26 (4) ◽  
pp. 299-317 ◽  
Author(s):  
Michael F. Armey
Keyword(s):  
Behavior Therapy ◽  
Dialectical Behavior Therapy ◽  
Ecological Momentary Assessment ◽  
The Novel ◽  
Self Injury ◽  
Novel Approach ◽  
Regulation Function ◽  
Ecological Momentary ◽  
Momentary Assessment ◽  
Nonsuicidal Self Injury

This study provides an introduction to ecological momentary assessment (EMA) methods and the potential use of ecological momentary intervention (EMI) for nonsuicidal self-injury (NSSI). The novel use of EMA and EMI are discussed within the context of the emotion regulation function of NSSI, the ability of these approaches to complement established treatments (i.e., cognitive behavior therapy & dialectical behavior therapy), and the specific areas in which an EMI treatment approach can augment traditional treatment. Based on established EMA findings in general and specific applications of EMA to the NSSI, a model EMI for NSSI is proposed.

Drought relief schemes for the 'Pastoral Zone'.

1982 ◽  
Vol 4 (2) ◽  
pp. 67 ◽  
Author(s):  
IB Robinson
Keyword(s):  
Land Tenure ◽  
Management Strategies ◽  
Government Policies ◽  
Primary Industry ◽  
The Subject ◽  
Consensus View ◽  
Spatial Diversification ◽  
The Individual ◽  
The Impact

In this article I have attempted to firstly provide a consensus view of graziers to sound drought strategies; secondly, outline Government policies or action directed towards assisting graziers affected by drought; and finally, address the subject of drought policy as it relates to conservation of the rangeland resource. Drought strategies discussed include pre-drought (e.g. fodder reserves, conservative stocking), longer term (e.g. increasing property size, spatial diversification of grazing blocks) and in-drought (e.g. reduce stock numbers early in drought). Grounds for Government intervention and aid for drought affected producers are analysed with regard to both the individual farmer's needs and the impact nationally of low return from a drought-affected primary industry. Aspects discussed include provision of better infrastructure (e.g, new roads), taxation concessions, a National Drought Fodder Reserve, land tenure policy, the Rural Adjust- ment Scheme and credit and freight concessions. From the conservation viewpoint, it is pointed out that officially declared 'droughts' occur too frequently and there are no incentives for graziers to either act early before a drought becomes firmly established or to delay re-stocking after the drought has broken. It is concluded that a balance between in-drought assistance and long term assistance needs to be struck, and that drought policies should be directed towards 'good' management strategies. If this can be achieved then primary producers should be less dependent on relief schemes.

Review of Common Management Strategies for Fatigue in Multiple Sclerosis

1999 ◽  
Vol 1 (2) ◽  
pp. 23-31 ◽  
Author(s):  
A Chan
Keyword(s):  
Multiple Sclerosis ◽  
Management Strategies ◽  
Active Role ◽  
World Health ◽  
Common Symptom ◽  
Promotion Strategy ◽  
Fatigue Management ◽  
Health Organization ◽  
The Individual ◽  
The Impact

Abstract Fatigue is the most common symptom experienced by individuals with multiple sclerosis (MS), regardless of their disability level or the severity of the disease. The Fatigue Severity Scale and the Fatigue Impact Scale are standardized tools designed to measure the impact of fatigue on an individual's life. In addition to the use of medications, other fatigue management strategies include education, modification of activities and environment, compensation, and participation in physical exercises. Because the patient is required to take an active role in the implementation of these fatigue management strategies, his or her sense of control in disease management is enhanced, resulting in empowerment of the individual. According to the World Health Organization (WHO), empowerment is a health-promotion strategy for the individual and for populations. Therefore, having options and control in fatigue management is empowering and promotes health for individuals with MS.

scholarly journals The Impact of Adverse Childhood Experiences on Therapy Outcome in Adolescents Engaging in Nonsuicidal Self-Injury

2020 ◽  
Vol 11 ◽  
Author(s):  
Alexandra Edinger ◽  
Gloria Fischer-Waldschmidt ◽  
Peter Parzer ◽  
Romuald Brunner ◽  
Franz Resch ◽  
...  
Keyword(s):  
Adverse Childhood Experiences ◽  
Therapy Outcome ◽  
Childhood Experiences ◽  
Self Injury ◽  
Adverse Childhood ◽  
The Impact ◽  
Nonsuicidal Self Injury

scholarly journals Managing the transition to non-driving in patients with dementia in primary care settings: facilitators and barriers reported by primary care physicians

2019 ◽  
Vol 32 (12) ◽  
pp. 1419-1428 ◽  
Author(s):  
T. L. Scott ◽  
J. Liddle ◽  
N. A. Pachana ◽  
E. Beattie ◽  
G. K. Mitchell
Keyword(s):  
Primary Care ◽  
Health Professionals ◽  
Primary Care Physicians ◽  
Management Strategies ◽  
Cost Effective ◽  
Driving Cessation ◽  
Major Life ◽  
The Individual ◽  
Primary Care Practices ◽  
The Impact

ABSTRACTObjectives:This research addresses dementia and driving cessation, a major life event for affected individuals, and an immense challenge in primary care. In Australia, as with many other countries, it is primarily general practitioners (GPs) who identify changes in cognitive functioning and monitor driving issues with their patients with dementia. Qualitative evidence from studies with family members and other health professionals shows it is a complicated area of practice. However we still know little from GPs about how they manage the challenges with their patients and the strategies that they use to facilitate driving cessation.Methods:Data were collected through five focus groups with 29 GPs at their primary care practices in metropolitan and regional Queensland, Australia. A semi-structured topic guide was used to direct questions addressing decision factors and management strategies. Discussions were audio recorded, transcribed verbatim and thematically analyzed.Results:Regarding the challenges of raising driving cessation, four key themes emerged. These included: (i) Considering the individual; (ii) GP-patient relationships may hinder or help; (iii) Resources to support raising driver retirement; and (iv) Ethical dilemmas and ethical considerations. The impact of discussing driving cessation on GPs is discussed.Conclusions:The findings of this study contribute to further understanding the experiences and needs of primary care physicians related to managing driving retirement with their patients with dementia. Results support a need for programs regarding identification and assessment of fitness to drive, to upskill health professionals and particularly GPs to manage the complex issues around dementia and driving cessation, and explore cost-effective and timely delivery of such support to patients.

Adverse childhood experiences and their impact on frequency, severity, and the individual function of nonsuicidal self-injury in youth

2013 ◽  
Vol 206 (2-3) ◽  
pp. 265-272 ◽  
Author(s):  
Michael Kaess ◽  
Peter Parzer ◽  
Margarete Mattern ◽  
Paul L. Plener ◽  
Antonia Bifulco ◽  
...  
Keyword(s):  
Adverse Childhood Experiences ◽  
Childhood Experiences ◽  
Self Injury ◽  
Individual Function ◽  
Adverse Childhood ◽  
The Individual ◽  
Nonsuicidal Self Injury
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