self harming providing positive support. background hertswood academy – 1400 students lsa in 1992...
TRANSCRIPT
SELF HARMINGPROVIDING POSITIVE SUPPORT
BackgroundHertswood Academy – 1400 students
LSA in 1992
SENCo 1994
Head of Inclusion/SENCO/DSPCP/Behaviour/Attendance 2003
Teacher
Child Protection Officer 2014
MET Child Protection Support 2014
Objectives
An understanding of self harm, who they might affect and why
Learn about the risk factors and warning signs so we can identify cases early
Share ideas for working with students, parents and external agencies
Explore practical ideas for supporting students during recovery
Changes in mental health in schools
Growing number of self-harm cases
Significant factors
Dealing with the impact
What is self-harm?Causing harm to the body, usually through physical abuse:
Cutting / swallowing tablets / burning / bruising / hair pulling / scratching / misusing alcohol or drugs
It is usually conducted at times of distress, fear, emotional worry, anger depression or low self-esteem in order to manage negative feelings
Definition
“…a deliberate act to damage yourself, without intending to die. This varies according to the situation the individual carrying out the act and is a means of getting away from intolerable thoughts or feelings”
HOTUSH
Myths
Myth: People who cut and self-harm are trying to get attention. Fact: The painful truth is that people who self-harm generally do so in secret. They aren’t trying to manipulate others or draw attention to themselves. In fact, shame and fear can make it very difficult to come forward and ask for help.
Myth: Only girls self-harmFact: Not true. Both boys and girls self-harm but it does tend to be more prevalent in girls
Myth: People who self-harm want to die. Fact: Self-harmers usually do not want to die. When they self-harm, they are not trying to kill themselves—they are trying to cope with their pain. In fact, self-injury may be a way of helping themselves go on living. However, in the long-term, people who self-harm have a much higher risk of suicide, which is why it’s so important to seek help.
Myth: If the wounds aren’t bad, it’s not that serious. Fact: The severity of a person’s wounds has very little to do with how much he or she may be suffering. Don’t assume that because the wounds or injuries are minor, there’s nothing to worry about.
helpguide.org
Risk FactorsPE
RSO
NAL
ITY… Low mood /
anxiety
Difficulty communicating
Low self-esteem
Poor problem solving skills
FAM
ILY... High
expectations
Controlling
Neglect/abuse
Looked after
Young carer
Bereavement
SOCI
AL… Sexuality
confusionBullyingLack of friendsFriends with similar problemsHighly competitive hobbies
Facts and Figures1.6m people in the UK are living with an eating disorder
Up to half of young girls fear becoming fat
1 in 3 boys aged 8-12 have dieted to try and lose weight
26% of 7-18 year olds have skipped a meal to lose weight
1 in 4 teenage boys would consider plastic surgery to look more like David Beckham, Brad Pitt or Usher
1 in 10 children will have self-harmed by the age of 18
CapitaEducation
Some of the triggers
Loss of parent
helpguide.org
Serious injury or surgery during childhood
Sexual or physical abuse
Family relationship difficulties
Depression
Poor self-image and low self esteem
Poor communication skills
Loneliness
Bullying
Exam stress
Times of change i.e. primary to secondary
Warning signs
• Self-harm and suicide lie on a continuum• Not about wanting to die
Scottish Personality Disorder Unit
Mental health scale for self harm
Self Harm SuicideSocially acceptable self-harm
How do you cope as a school?
Good communication – staff need to be vigilant
Not an easy task
Time to talk with the student
Offering sound advice
Contacting parents
Sharing the responsibility
Creating an environment where young people are not frightened to disclose
Working with agencies
Strategies: Step by step advice to student
De-escalate the intensity of self harm• A first step can be to think about trying to slowly reduce the damage caused by your
self harming behaviour (e.g. cutting less or less deeply). Then try to move to less damaging practices like writing on your skin with red felt tip instead of cutting.
• Creating a personal self harm safety plan is a useful way to remind yourself of things you can do when you feel an urge to self harm. These include ways to manage and reduce self harming behaviors in the short term, so that they are less damaging, as well as alternative ways to manage difficult feelings which can replace self harm in the longer term.
Direct the harming urge at something else• Some people find squeezing an ice cube provides an alternative that is helpful. Hit
pillows or cushions. Flick an elastic band on your wrist. Take a cold bath or shower.
Small steps…Make a list of distractions• Make a list of activities that you can use to distract yourself. Trying to be with other
people is particularly effective.Know your triggers and reduce the risks• Knowing what kinds of situations are particularly risky for you can help you plan to
reduce the risks. For example, it is harder to manage your feelings effectively when you are under the influence of drugs or alcohol. Go easy on these if you are aware that you are feeling less stable.
Learn to tune in to your feelings• In the longer-term you can start to learn how to identify the experiences and feelings
which are most likely to trigger your urges to self harm. Learning the skill of ‘mindfulness’ – being tuned in to what you are feeling in the present moment, without judgement or attempt to change it – is invaluable in the move towards being able to manage or ‘ride out’ difficult feelings, rather than trying to eliminate them.
Continued…Finding constructive outlets for feelings
• Having a good cry is the natural way to get rid of built up stress hormones and get feelings out. Experiment with different ways to express feelings when they seem to be building up inside, to see what works for you. Keeping a diary can be a useful habit for getting feelings ‘out’. Just write it all down without censorship, then close it and put it away. Or it might be helpful to do something symbolic like writing it all down then scribbling it out or tearing it up. Vigorous activity or exercise can be another helpful way to get rid of pent up feelings.
Learn how to self soothe
• Make a conscious effort to take care of yourself and comfort yourself with difficult feelings. Try out different things to see what you find most comforting. Breathing and relaxation exercises can be very useful. A relaxing soak in a bubble bath, hugs or a massage, eating something sweet (in moderation), stroking a pet, listening to uplifting music, knitting or crafts… Find what works for you!
Get support and professional help
• Having people you can talk to and a good support network is a vital protection against both self harm and suicidal thinking.
• Talking about the inner feelings that fuel your self harm is potentially useful whoever you talk to, but counsellors are professionally trained to work with self harm and will be best placed to support you in finding constructive alternatives i.e. counselling, GP, CAMHS etc.
Steps you can takeTalk to other members of staff – are
they concerned?
Pass your concerns onto
the designated member of
staff
Discretely asks peers if you should
be concerned
Encourage the pupil to speak to you
How to be
helpful
Listen
Make time
Be honest
Try to understan
d
Persevere /offer support
Remember the ‘real’
child is still there
How can we encourage reluctant students to talk?
Open Questions Third Person friend / parent
Undershoot (find a chink)
Responding to Self-Harm FadsBehavioural issue
– employ usual behaviour ladder
Address the group / school- zero tolerance
Injuries to be covered
Respond dispassionately
Talk to individuals as well as group
Follow up with individuals
Self-esteem / communication / group
identity activities if specific group
Supporting Parental GP Referrals
Behaviours causing concern / Health
ramifications
Change in personality
How long this has been going on for
History of similar problems in
family / friends
Any suspected trigger
What the school has done. Impact?
What outcome you are looking for?… spell it out
Write a lett er to support GP appointment
1• Peer Support
2• Free Pass (to leave class)
3• Bolt Hole (somewhere safe to go)
4• Regular access to a trusted adult
5• Zero tolerance of teasing or bullying
Practical Strategies
A minority of parents will respond negatively when you tell them about
their child’s difficulties
What negative responses might you encounter?
Do you have an specific experience you’d like to share?
Course 7486
Difficult Parents
Who to turn to out of school?
Golden rules
Staff to be vigilant
Time to listen/talk
Contact parents
Mentor/School nurse
Provision in school JEPECA, counsellor
Refer to SPA, CAMHS, GP, Social Service
Keep in contact with parents
Attend mental health meetings with professionals
You can only do your best!
You are not a psychologist or a therapist, you are someone who cares.
If you need help ask for it!
Finally
If a self-harmer is pleased with their friends support it’s probably because
they are enabling them.
If a self-harmer is as mad as hell with you then you are probably helping them!