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Understanding and Working with Self-Injurious Behavior (SIB)

December 13 Breakfast 8:30am-8:45am   Training 8:45am-4:00pm $159, 6 CEUs Presenter: Lisa Ferentz, LCSW-C DAPA Doubletree Hilton Hotel, 1726 Reisterstown Road Baltimore, MD 21208 United States + Google Map

Many clinicians are challenged and frightened by adolescents and adults who engage in self-harming behaviors. In an effort to decrease helping professionals’ anxieties and increase their knowledge base, this workshop will integrate information gathered from an extensive review of the literature with clinical anecdotes taken from the presenter’s work with clients who engage in self-injury. We will process categories, definitions, and manifestations of self-injurious behaviors, and address issues of co-morbidity.

We will explore the myriad of reasons why clients hurt themselves with a special focus on the onset of self-injury as it relates to the developmental challenges of adolescence and the impact of neglect, trauma, and abuse. Participants will learn about a specific “cycle of self-harm” which emphasizes the impact triggering events, negative cognitions and affect, dissociation, and anxiety have on self-harming behavior. It also provides helping professionals with a concrete model for intervention.

Treatment Strategies Offered

A variety of creative and effective treatment strategies will be offered to help reduce and eventually extinguish the behavior. These strategies are also applicable to other manifestations of self-harm including eating disorders and addictions. Helping professionals will learn specific ways to “work with” self-injury without engaging in power struggles, increasing the behavior, or relying on ineffective “safety contracts.” A more effective, alternative contract, called CARESS, will be presented. Clinical case examples, video, clients’ writings and artwork will be incorporated into the workshop.

Learning Objectives

  • Identify three categories and at least five characteristics of self-harming behavior.
  • Understand the onset of SIB and its relationship to trauma, parental absence, and the developmental challenges of adolescence.
  • Understand the cycle and perpetuation of self-injury, and the ways in which dissociation and anxiety influence the process.
  • Identify at least 6 reasons why clients hurt themselves.
  • Identify at least 5 intervention strategies, including CARESS, designed to avoid “power struggles” and eventually extinguish the behavior.


8:45-10:30 am

  • Processing inter-regulation and auto-regulation
  • Understanding the four attachment styles: secure, dismissive, ambivalent, and disorganized
  • Videos
  • The optimal window of arousal
  • The challenge of attaching to abusive caretakers
  • Shifting the locus of control
  • Video: Still Face Experiment
  • 10:30-10:40 BREAK

10:40- 12:00

  • Developmental challenges and stressors of adolescence
  • The adolescent brain
  • Tipping point factors that lead to self-destructive behaviors
  • The Strengths-based approach to treatment
  • Definitions and manifestations of self-harm
  • Why clients engage in self-destructive behaviors
  • The meta-communication, re-enactment and re-storying of self-harming behaviors

12:00- 1:00 LUNCH

1:00 –2:30 pm

  • The cycle of self-destructive behaviors/intervention
  • Triggering events /Journaling
  • Negative cognitions / Re-framing
  • Negative affect / Safe places and containment

2:30- 2:40pm  BREAK

2:40-4:00 pm

  • Tension and anxiety/ Breath work
  • Dissociation/ flashback halting protocol,
  • Self-harm / Incorporating CARESS/ artwork
  • Positive and negative outcomes/endorphins
  • Emotional vulnerability/ Remembered resources


Sad woman leaning against a wall