Factors Linked With Increases in Nonsuicidal Self-Injury

Abstract

This case study explored eight clients in outpatient mental health counseling who reported engaging in nonsuicidal self-injury (NSSI) within the 90 days prior to intake. Information on client self-injury, psychological symptoms, and coping behaviors were collected from clients at intake and termination. At program termination, counselors’ treatment methods, number of sessions, and credentials were collected. To explore changes in NSSI during counseling, descriptive statistics and frequencies were used. Most clients decreased or extinguished self-injury behaviors by termination, while two clients increased. Problem-focused and avoidant coping strategies appeared to differentiate clients who decreased from clients who increased self-injurious behaviors by termination.

• nonsuicidal self-injury
• case study
• coping
• counseling

Notes

Declaration of Conflicting Interests The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/orPUBLICation of this article.

Funding The author(s) received no financial support for the research, authorship, and/orPUBLICation of this article.

Additional information

Notes on contributors

Kelly L. Wester

Kelly L. Wester, PhD, LPC, NCC is an associate professor in the Department of Counseling and Educational Development at the University of North Carolina at Greensboro. She has worked with adolescents and young adults who self-injure in outpatient, college, and correctional settings. Her main research area is understanding NSSI behaviors, including effectiveness in clinical treatment.

Holly A. Downs

Holly A. Downs, PhD, is a senior evaluation faculty member at the Center for Creative Leadership in Greensboro, NC. Her research interests have focused on the theories, processes, and technologies used in mixed methods evaluation of programs, particularly those in Leadership and in Science, Technology, Engineering, and Mathematics (STEM) fields, delivered via virtual, hybrid, and traditional learning environments.

Heather C. Trepal

Heather C. Trepal, PhD, LPC-S is an associate professor and serves as the Coordinator of the Clinical Mental Health Counseling program and the Graduate Advisor of Record for the master’s programs in the Department of Counseling. Dr. Trepal is the President-Elect of the Association for Counselor Education and Supervision (ACES). She has over 40PUBLICations in the areas of self-injurious behavior, body image resilience, bilingual counselor supervision and training, relationships/relational development, gender issues in counseling, and counselor preparation and supervision.