Consulting with churches for adolescents who self-injure (SIB)

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Consulting with churches for adolescents who
self-injure (SIB)
Chris Buckingham Ashleigh Bruns Susan
Childers Jonathan Impellizzeri Sara Wood
Regent University School of Psychology and
Counseling CES 763 Supervision and
Consultation Consultation Project April 23, 2009
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Psycho-educational Component

• Definition of Self Injury Behavior (SIB)
• Any self harming or injuring behavior whose
  intention is not suicide but whose origins are in
  the attempt to ground, to ameliorate emotional
  pain, or to manage affect. This can include
  behaviors such as cutting, burning, carving words
  or pictures into skin, excessive tattooing and
  piercing (Derouin, A. Bravenda, T., 2004
  Whitlock, J., Powers, J. Eckenrode, J., 2006).
• Developmental Issues of Adolescents and Teens A
  time of increased feelings of distress more
  ways to cope with stress independent of parents
  (Arnett, 1999 Compas, 1987 Petersen, Kennedy
  Sullivan, 1991) Whitlock ,et al. . Life stage
  stressors include establishing caring,
  meaningful relationships, finding acceptance and
  belonging in social groups ,and establishment of
  interpersonal intimacy
• Eriksonian Adolescence stage (identity vs. role
  confusion), increased decision making
  responsibility ranging from risky to competent
  (Berg, 2005 Erikson)
• Freudian psychosexual Genital stage Includes
  puberty, with sexual interest in opposite sex,
  sexual pleasure through genitals (Freud)
• Responsible for self, pushes for independence
  from parents (Erikson)
• Develops sexual identity, the ability to love,
  and the desire to work (Erikson Freud)

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Identifying at Risk Teens Psycho-educational
Procedures

• What to look for
• Adolescents who engage in SIB tend to defy easy
  categorization
• Teenagers who are at a higher risk are
• 1. females
• 2. those who have experienced sexual abuse or
  trauma
• 3. those with eating disorders
• 4. personality disorders
• 5. teenagers who have friends who self injure
  (Plante, 2007)
• Empowering the church to address SIB
• (1) Clergy
• (2) Youth Group Leadership
• (3) Youth Group

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Church SIB ProtocolHow to handle teens who are
engaged in SIB

• First Line of Prevention
• Student Waiver Form Signed by Parents
• Youth Workers Being First Aid Trained
• Delegate a church member outside of the Youth
  Ministry to serve as a point of contact (POC)
  i.e. Minister of Pastoral Care and Counseling
• Suspicion and Reporting Protocol
• Report all suspicions to the POC and Youth
  Minister
• POC will contact parents/guardians and provide
  referrals
• POC will handle the mandated reporting when
  applicable
• Actively Engaging and Reporting Protocol
• Complete a safety check and contact emergency
  services if necessary
• DO NOT LEAVE YOUTH ALONE
• Contact POC to handle parent/guardian contact,
  referrals, and any mandated reporting
• Youth Group Participation Protocol (for those
  actively engaging)
• Employ a 3 month probationary period and Safety
  Contract (including a release for POC and
  counselor) overseen by POC
• Utilize adult chaperones as designated by
  parents/guardians

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Issues of Disclosure Limits of Confidentiality

• Our church is located in Colorado as an example,
  Colorado clergy are not required to report
  privileged communication without consent from
  both the clergy and the parishioner. (Colorado
  Revised Statute (CRS) Ann. ? 13-90-107(1)(c) and
  Colo. Stat. Ann. ? 19-3-304(2)(aa))(Pike, 2008).
  You would need to check your states codes to
  determine the state by state variations.
• CRS 27-10-103 would inherently exclude a church
  counselor (MA in Counseling or Social Work) from
  being a person able to provide counseling to a
  minor 15 years of age without informing the
  parents first of their actions. In the case of
  SIB the appointed person (Pastor of Pastoral Care
  and Counseling) would need to inform the teens
  parents immediately (Lane, 2007).
• Mandated reporting will be handled by the POC
• ACA Code of Ethics
• (B.1.b.) - Respect for privacy-Counselors respect
  client rights to privacy. Counselors solicit
  private information from clients only when it is
  beneficial to the counseling process.
• (B.1.c.) - Respect for Confidentiality-Counselors
  do not share confidential information without
  client consent or without sound legal or ethical
  justification
• (B.2.a.) - Danger and Legal Requirements-The
  general requirement that counselors keep
  information confidential does not apply when
  disclosure is required to protect clients or
  identified others from serious and foreseeable
  harm or when legal requirements demand that
  confidential information must be revealed.
  Counselors consult with other professionals when
  in doubt as to the validity of an exception.
  Additional considerations apply when addressing
  end-of-life issues.

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Christian Integration

• Possible relationship between self-injurious
  behavior, sexual self-concept, and spirituality
  (Wagner Rehfuss, 2008).
• During SIB, the emotion of shame, originating
  from family of origin, is reenacted to cause harm
  to the individual
• The self is deceived into thinking not even God
  could love me
• Impacts self-worth, sexuality, and relationship
  with God (Watts, 2000).
•  
• What is the church to do?
• SIB believers - have own responsibility (Eph. 4,
  Romans 122, James 516) the church has the
  responsibility to treat the individual with
  gentleness and compassion (Eph. 42, Col. 312, 1
  Thes. 27, 1 Peter 38, Eph. 432)
• SIB unbelievers - the church needs to reach out
  in love, move towards healing spiritual
  reconciliation, and witness if given the chance
  (Mark 1228-31, 1 Peter 224, John 146, Acts
  412, Eph. 28-9, Romans 56-11)
• 7 points for Christian response to self-injurers
  (Watts, 2000)
• 1. Eyes of Understanding witness to suffering
  and counter invisibility
• 2. Ears that can hear listen as a way to move
  silence into speech
• 3. A need for re-membering and remembering walk
  alongside to remember
• 4. A need for Christian story telling learn to
  love and co-create a new story
• 5. Liturgy, ritual, and sacrament suggest
  expressiveness through the Body
• 6. Develop other ways of binding teach
  centering prayer
• 7. A need to counter isolation through a caring
  network develop support

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References

• American Counseling Association. (2005). ACA code
  of ethics. Alexandria, VA American Counseling
  Association.
• Berg, C. (2005). Commentary Lessons from a
  life-span perspective to adolescent decision
  making. In J. E. Jacobs P. A. Klaczynski
  (Eds.), The
• development of judgment and decision
  making in children and adolescents. (pp.
  241-249). Mahwah, NJ Lawrence Erlbaum Assoc.
  Publishers.
• Best R. (2006). Deliberate self-harm in
  adolescence a challenge for schools. British
  Journal of Guidance counseling, 34(2), pp.
  161-175.
• Child Welfare Information. (2008). State statutes
  results. Retrieved April 6, 2009, from Child
  Welfare Information Gateway Web Site
• http//www.childwelfare.gov/systemwide/l
  aws_policies/state/index.cfm?eventstateStatutes.p
  rocessSearch
• Derouin, A., Bravender, T. (2004). Living on the
  edge the current phenomenon of self-mutilation
  in adolescents. MCN The American journal of
• maternal child nursing 29(1), pp.
  8-12.
• Eriksons Psychosocial Stages Summary Chart.
  Retrieved April 4, 2009, from http//psychology.a
  bout.com/library/bl_psychosocial_summary.htm.
• Freud's Psychosexual Stages of Development Oral,
  Anal, Phallic, Latency, Genital Retrieved April
  5, 2009, from
• http//wilderdom.com/personality/L8-5Fre
  udPsychosexualStagesDevelopment.html.
• Lane, D. K. (2007). The legal guide for
  practicing psychotherapy in Colorado. Denver, CO
  Bradford Publishing Company.
• Levenkron, S. (1998). Cutting Understanding and
  overcoming self-mutilation. New York, NY W.W.
  Norton and Company.
• McKerchar, T. L., Kahng, S. W., Casioppo, E.,
  Wilson, D. (2001). Brief Report function analysis
  of self-injurious maintained by automatic
• reinforcement exposing masked social
  function. Behavioral Interventions, 16, 59-63.
• Nock, M. K., Prinstein, M. J.
  (2005). Contextual features and behavioral
  functions of self-mutilation among adolescents.
  Journal of Abnormal
• Psychology, 114(1), 140-146.
• Plante, L. G. (2007). Bleeding to ease the pain
  Cutting , self-injury, and the adolescent search
  for self. Westport, CT Praeger Publishers.
• Pike, C. W. (2008). Colorado Revised Statutes,
  Retrieved April 18, 2009, from