The price this family pays is that the daughter now has to deal with adult emotions that she is not equipped to handle. She now has to navigate a relationship with both of her parents that does not feel safe, secure or stable. The parents also are unable to build healthy lines of communications while this is happening because the anxiety and tension is getting played out between a parent and daughter instead of getting resolved between them.
One of the antidotes to minimizing triangles within a family system is by working on broadening lines of communication and establishing healthy lines of communication. In the above example, if the parents improve their relationship with each other and establish healthy lines of communication they improve their relationship with their daughter and enhance their ability to have influence as her parents.
An appropriate intervention for this family would be for them to go to counseling together to work out their tension and anxiety with each other instead of using their daughter a tension reducer. A communication skill we teach families in residential treatment is to hold a community meeting once a week so members of the family have a structure to air concerns with each other and facilitate open lines of communication. For families that use this effectively, they know that they will never have more that seven days go by without something getting addressed openly.
—
By Brian McElligott, Executive Clinical Director at New Haven Residential Treatment Center
]]>After the account of their story, I discussed with them the concept of a therapeutic outdoor wilderness program and how being in a distraction free environment away from social media and all the buzz of daily life would help Mariah reset physically and emotionally from the trauma she experienced. Mariah would be able to work with a licensed therapist, journal on assigned topics and get the validation and peer support she so desperately needed. Mariah would also have the opportunity to do family work through her journaling, which would be a way for her to release any of the shame she may be still harboring from the trauma experienced. Her therapist, parents and I would speak on a weekly basis to assess the work that Mariah was doing and also assess the appropriate next steps. Would Mariah be able to return to her home school? That would take sensitivity and cyberbullying education on the part of the school leadership that Mariah’s parents and I were willing to assist in providing. Would Mariah’s needs be best served in a therapeutic boarding school or would she be better served in a small supportive boarding school? These are all discussions that will take place on a weekly basis with her therapist, her parents and myself during the 8-10 weeks she is in the program. I might also suggest a complete psychoeducational evaluation to assess her learning and emotional needs.
I was able to meet with Mariah, and she actually decided to attend a wonderful small therapeutic wilderness program and did some amazing work on herself and with her parents. Her testing showed that she was a bright capable student with just some mild executive functioning deficits and would benefit from a nurturing, emotionally supportive boarding community. Her therapist and I suggested to her parents a couple of small supportive boarding schools with wonderful dance programs and Mariah is dancing at one right now. (No internet in the dorms after 9pm!)
]]>As a residential staff, one of the biggest ways we can help our girls grow is to help them recognize those opportunities. But in order to teach this, we need to be able to be able to do it ourselves. Outside of a stressful situation this is a pretty easy task. However, in times of high stress, practice and intentional effort are needed to respond. This fosters growth and creates an example of constructive responses to the challenges that arise in everyone’s lives.
On a daily basis this often looks like residential staff coaching a girl through a conflict, whether it is with her peers, another staff, or a family member. Each of our staff does this many times a day, and this is one of the areas where we (as residential staff) have the biggest impact on our girls. We are able to show them alternate ways of meeting situations. We are able to show them that their past ways have been unhealthy enough to lead them to the kind of supports a school like Chrysalis can offer.
A large part of our ability to do this is to see past the behaviors and address our student with their motivations. This helps them achieve what they really need through healthier means. Perhaps she is resistant to boundary holding from a particular staff. Another staff may talk with her about this and explore what is behind the resistance. It might come out that the particular staff has a way of framing the boundary that reminds her of a teacher she struggled with prior to treatment. We can then help her express this in a healthy manner, and help them problem solve a way to still hold the boundary, but in a way that is easier for her to hear.
Rare occasions can bring much larger challenges, or the chance to make lots of lemonade. Sometimes issues test all of our abilities to see the opportunity in the moment. And when we can see the opportunity, it can be the vehicle for program wide change, and the greatest benefit to the whole community.
I recently had the privilege of working with our girls through such a situation, it was an honor to see them show up and take ownership of their community. They were surprised to not be “in trouble” and rose to the occasion to meet the challenges laid out before them. The result is our entire community moving in a positive direction that supports each of our girls in achieving their highest self. It is incredibly moving to be a part of such an event and is one of the many privileges of doing the work we do.
]]>When Sarah shared her trauma story with her parents, everyone’s emotions were palpable in our session. Richard immediately went into “fix it” mode. Fueled by his rage, he sought justice and revenge – convinced that if her attacker were in jail, this would finally bring Sarah peace. Laura was overcome by the sadness and pain of knowing what her daughter had been through. This soon turned into intense shame and guilt – she became paralyzed by the thoughts of what she could have done differently as a mom.
These thoughts and emotions intensified throughout Sarah’s journey for both Richard and Laura. As Sarah began her own trauma work, she had her ups and downs. She would push away at times; fall back into old unhealthy relationship patterns and ways to cope. As her parents watched this, at times, they felt hopeless. They came to the realization quickly that they had to do their own emotional work along with Sarah, if their family was going to truly be able to heal.
Richard and Laura’s experience is not uncommon. Every Sunrise parent, regardless of their daughter’s treatment concerns, goes through their own emotional journey along with their daughter. These are a few tips and skills from our work with DBT and shame resiliency that can also help as you work on your own healing alongside your daughter’s.
“The curious paradox is that when I accept myself just as I am, then I can change.”
– Carl Rogers
One of the most difficult, yet most profound, DBT skills is radical acceptance. This is exemplified in the Carl Rogers quote above. As we begin to accept ourselves AND our situation as they are, then we are able to grow and change. The first step towards healing and growth is learning to radically accept your situation as it is.
When I was a sophomore in high school, one of my best friends lost her dad to a battle with cancer. I was only fifteen at the time, and I was struck by how completely and totally unfair this whole situation was. And worst of all, I had NO idea what I was supposed to say or do to help my friend. I wanted to take away her pain. I wanted to bring her dad back. Yet, nothing I could do could change the situation we were in.
This was one of my earliest and most profound experiences with radical acceptance (though I didn’t know this was a DBT skill at the time). While I was fighting my situation, I felt helpless and hopeless. There was nothing I could do to help my friend. When I finally accepted that this was our situation, and there was nothing I could do to change it, I could move away from being stuck. I was angry, sad, and confused! And this was okay. But, perhaps, the biggest thing that changed by radically accepting was that I was able to connect with my friend who was hurting. When I stopped trying to fix things, I could actually love and support her – and it was that connection that actually helped in the healing process.
“The truth is, rarely can a response make something better. What makes something better is connection.”
– Brene Brown
This weekend we recently finished our Sunrise family weekend, where parents and other family members join their daughter in the therapeutic process at Sunrise. In one group, we spent some time with one girl and her parents. We talked about her parents’ desire to buy excessive things for their daughter, in an effort to help ease her pain and depression. I was struck by the emotions of this girls’ father, when, discussing the matter, he said, “I would take any small chance to help make my daughter happy, even if I know it probably won’t help. When presented with even a tiny chance, I’m like “Where do I sign?””.
Like this Dad, many parents are looking to “fix it”. You want more than anything to find anything that will help your daughter to heal. The reality is, however, that sometimes, despite our best intentions, we can’t take away the pain. Your daughter will struggle throughout her journey, and you will not be able to take away the pain. You will likely say the wrong thing sometimes. “The truth is, rarely can a response make something better. What makes something better is connection”. The best thing you can do is to be there with your daughter as she works on her own healing journey. Love her. Cry with her. Use empathy and validate, but don’t try to fix it. Healing is a process, and she will learn how to “fix” herself throughout her Sunrise journey.
“Happiness is a direction, not a place.”
– Sydney J. Harris
The lie we begin to tell ourselves, to believe with intensity, is that changing our circumstances will make us happy. I will be happy when my daughter is back home with me. I will be happy when my daughter can cope with her depression. I will be happy when my daughter just stops using drugs. As counterintuitive as it seems, happiness is not a destination, nor is it dependent on your daughter’s well-being. The research shows that if I knew everything about your external circumstances (your job, your relationships, etc.), I could only predict your level of happiness with 10% accuracy – meaning the majority of one’s happiness is determined not by their circumstances, but their internal ability to cope and find joy. There are things you can do RIGHT NOW to bring happiness, joy and peace. Notice things that you are grateful for. Take 5-10 minutes to stop and breathe. Do something you enjoy. Take up art or yoga or join a gym or whatever it is that you love doing. Healing does not occur at the same rate as your daughter; you can take the steps towards your own healing while your daughter is still on her own.
One of the most poignant healing moments in Sarah’s journey came towards the end of their time at Sunrise. As Sarah was getting close to graduating the program, we planned an aftercare visit where I came to their home in order to plan for her transition back. Part of the schedule was to do some of Sarah’s trauma work by visiting locations that had been very triggering to her at home. Sarah took us and her parents to the location where she had been assaulted. Naturally, it brought up a lot of emotions for Sarah and her parents’ anger, sadness, hurt and eventually peace. Sarah was able to talk about her journey towards peace – to sit in that place and talk about how she knew she was enough and loved – and to share that with her parents. That moment of strength, healing and ultimately connection came as they all did their own work to heal and to grow.
]]>“You may encounter many defeats, but you must not be defeated. In fact, it may be necessary to encounter the defeats, so you can know who you are, what you can rise from, how you can still come out of it.”
-Maya Angelou
In order to understand how you can allow your children to fail, it is important to understand why parents protect their children from failure.
No parent wants to see their child fail. Failing hurts. Babies bang a lot of foreheads and skin many knees before they learn to walk on their own. The same goes for our teenagers. It is hard to see your daughter pour her heart into studying for a Math test, only to get a C. You want them to succeed, but most of all you want to protect them from pain.
You have all been taught that success is a formula and that happiness rides on succeeding right now. You may think that if our kids mess up in the moment, somehow the formula won’t turn out. That means kids have to do well in high school just to get into college. Then they have to do well in college to get the right job. And they have to get the right job to live happily ever after. This is the script that runs through every parent’s head:
These are parents who are so caught up in the script that runs through their heads about how to “do right” by their children that they can’t see when the excesses of keeping up, bulking up, getting a leg up and generally running scared send the whole enterprise of ostensible care and nurturing right off the rails.
– Judith Warner, How to Raise a Child, New York Times
The world often sees children as a reflection of their parents. The common belief is that when your teen fails, it reflects poorly on you. By the same measure, when your children succeed it is an indication that you’re doing something right. No one wants to be judged.
Whatever the reason, it becomes second nature to protect your children from failure. But failure is a part of growing. Even though you have the best intentions, you have to let your kids fail.
It is a central paradox of contemporary parenting, in fact: we have an acute, almost biological impulse to provide for our children, to give them everything they want and need, to protect them from the dangers and discomforts both large and small. And yet we know – on some level, at least – that what kids need more than anything is a little hardship: some challenge, some deprivation that they can overcome, even if just to prove to themselves that they can.
– Paul Tough, How Children Succeed
Most parent/child relationships more closely resemble the manager/employee dynamic. If children fail at anything, they are seen as incapable and should be “fired”. The message is often implied or even stated that failure is not an option. As a result, parents slowly take over the responsibility of “managing” academics, athletics and relationships to prevent failure and pain.
Try viewing “failure” as an opportunity to empower your daughter and strengthen your relationship with her. If she fails, be there to listen, support and validate her feelings. Then when she feels supported, ask her what she wants to learn from the situation. Help her work through any disappointment and help her prepare herself to do better next time. Let her try again and fail again. Through this process, she’ll learn that:
Failures, repeated failures, are signposts on the road to achievement. One fails forward toward success.
– (C. S. Lewis)
Teaching your children about failure changes your relationship from a “Responsible for” mindset to one of “Responsible to”. Rather than feeling responsible for your daughter and her actions, you feel responsible to teach and empower her.
Never confuse a single defeat with a final defeat.
– F. Scott Fitzgerald
Feeling “responsible for” children’s actions can lead to parents overcompensating for real or perceived deficits. Just like crawling, walking and language are important developmental markers for babies, skills like conflict resolution, problem-solving and dealing with authority figures are important development markers for teenagers. When parents overcompensate for children’s deficits they rob teens of opportunities to improve developmental skills.
Feeling “responsible to” teach, guide and empower children allows parents to create space for failure and challenges. Teenagers can then use this space to hone these important developmental skills. Over time, the deficits become strengths.
If your daughter is going to feel comfortable failing, she needs to know that your relationship isn’t dependent on her success. Build a strong relationship with a safe environment. That means evaluating other relationships, too. Healthy relationships between parents, regardless of your family situation (married, separated or divorced), help provide the structure and communication necessary for a safe environment.
Teenagers often use small disagreements or lack of communication between parents as a way of splitting them. This helps them avoid accountability for failure. If you find yourself being frustrated with your children:
At the end of the day, nothing matters more than your relationship – not grades, not whether they made the traveling team or their SAT scores. Because in adolescence, when kids can do whatever they feel like, if you don’t have a good relationship, you’re in trouble.
– -Dr. Madeline Levine, Psychologist & Founder of Challenge Success, a project of the Stanford Graduate School of Education.
You don’t have to lower your standards for your kids, but you may have to change expectations. Remember, when you feel responsible to empower your children, it changes how you approach failure. Failure becomes a stepping stone to success rather than something to be avoided.
Treating your children as if they are too fragile to handle failure is weakening their sense of self-worth, ability to self-regulate and capacity to maintain healthy relationships. It increases their entitlement and conditions them to see others as responsible for their health, wellbeing and successes/failures. Parents need to let their children fail. Then can parents teach, “Without struggle, there can be no progress”.
If you want to learn more about the benefits of letting kids fail, we recommend the following resources:
Since ADHD afflicts three times more boys than girls (Ohan, 2007), the majority of research on ADHD has focused on males. Because of this focus on ADHD in boys, girls as a population have tended to be under-diagnosed. Additionally, girls tend to experience broader and deeper symptomology related to their ADHD than do boys, so the symptoms associated with male ADHD are not always adequate to describe female ADHD.
While boys with ADHD tend to externalize their acting out behaviors through aggression and substance abuse, girls, by contrast, tend to internalize their symptoms through mood symptoms and eating disorders.
Even more so than their male counterparts, girls with ADHD tend to have a high incidence of peer difficulties. These difficulties include:
Not only are the symptoms of ADHD exaggerated in girls, but the consequences of these symptoms are exacerbated by basic differences in how girls and boys socialize. The social deficits caused by ADHD may be more destructive in the context of a girl’s tighter, more intimate social milieu than they are in a boy’s looser, more active social network (Crick, 1996; Maccoby, 1998).
Girls with ADHD also struggle with higher rates of separation anxiety, generalized anxiety disorder, and depression than boys with ADHD.
Again, girls even more than boys, experience a high rate of difficulty with executive functioning. These cognitive functions include some basic abilities critical to day to day social, academic, and work activities. Girls experience a high rate of difficulty with:
Girls with ADHD are more likely to go undetected than their male counterparts because their symptoms are less obvious. They tend to exhibit, for instance, inattention rather than outward hyperactivity. Girls are also less likely to be identified and treated for ADHD because their “acting-in” behaviors are less frustrating to parents and teachers than a boy’s acting-out behaviors. Girls are more likely to be diagnosed for ADHD when comorbidity is present; in other words, when one or more secondary issues capture the attention of parents, educators, and/or professionals. It is, therefore, when a girl is being diagnosed and treated for a secondary condition that the primary condition of ADHD is typically detected.
Ohan & Johntson (2006) What is the Social Impact of AHDH in Girls? A multi-Method Assessment Journal of Abnormal Child Psychology, 35:239-250
Ascribe Newswire: Health (2008) Adolscent Girls With ADHD at Increased Risk for Eating Disorders
Woosely, L (2006) ADHD Ignores Gender: Neurological disorder also proves debilitating to girls Tulsa World
Mikami & Patterson (2008) Eating Pathology Among Adolescent Girl With Attention-Deficit/Hyperactivity Disorder Journal of Abnormal Psychology, Vol. 117, No.1. 225-235
Bauermeister, J (2007) ADHD and Gender: are risks and sequela of ADHD the same for boys and girls? Journal of Child Psychology and Psychiatry 48:8
]]>The vast majority of children with divorced parents and/or stepfamilies develop into competent individuals well within the normal range on all measures of adjustment (Kelly, 2007).
As a divorcing parent, it’s important to think through the reality that – especially when children are involved – a divorce changes, but doesn’t end, your relationship with your heretofore spouse. How will you, as divorced parents, manage future weddings, graduations, and holidays with your children?
As you think through the implications of a changed relationship, it is important to find ways to foster hope for a positive parenting experience. If you have been divorced for some time, remember that it is never too late to improve your relationship with your ex spouse and create a good divorce (Ahrons 2006). It is vital for both parents to look at potential power struggles with their former spouse and the potential this creates for painful loyalty conflicts in your children.
This kind of rational forethought and planning is incredibly difficult to achieve in the throes of a painful divorces. It is, therefore, most important to create a supportive network of friends and family, as well as to engage the services of a therapist who can give you objective, third party advice and support.
Research reveals that divorce has more of a tendency to negatively impact the fathers’ relationships with his children than the mothers’. Fathers who pursue role models for positive post-divorce parenting along with parent coaching have been shown to have more positive relationships with their children than those who do not engage these opportunities (Athrons 2006). Fathers do well to pursue parenting support in the form of therapy, groups, parenting programs, and friendships with other single or divorced fathers whom they respect.
It has been shown that divorce has less of an impact on the relationship between mothers and their children. It is, however, important for a divorced mother to know that the quality of her relationships with her children is profoundly impacted by the quality of her relationship with her children’s father. Mother’s better serve their children and improve their own parenting relationships when they honor their children’s need for a continued relationship with their father (Ahrons, 2006).
Generally speaking, the better your child’s relationship with your former spouse, the better your parenting relationships, and your children, will be.
Continued parental sparring not only impacts your relationship with your children, but it also negatively impacts your children’s relationships with extended family and family friends. Children often feel the need to choose sides in an attempt to create or maintain consistency and predictability in their environment. Good divorces are those in which the children can comfortably maintain relationships with both parents and their extended kin networks (Akron, 2006). It has been theorized that conflict among divorced parents threatens a child’s emotional security by causing them to worry that their parents will no longer care for them (Fabricius & Luecken 2007). We are becoming more aware that conflict between former spouses has a significant impact on the long term health of their children. The lack of emotional security that this causes has been shown to create dysregulation in the child’s physiological stress response, promoting pathology in the brain and body (McEwen & Wingfield, 2003).
Frequently, conflict among divorced parents stems from difficulty letting go of old resentments. Ex spouses sometimes resist letting go of anger, pain, or hurt for fear of invalidating their own pain and allowing their ex-spouse off the hook for the pain they have caused. Revenge is sometimes used to produce the feeling of mastery that comes from moving from a passive to an active position, thus enhancing self-esteem (Bernstein, 2007). In addition, research has shown that maintaining anger toward the other parent can be a strategy to ward off depression and grief. These strategies are usually short sighted, however, and can perpetuate dysfunction in the family system. It is vital to your child’s emotional and physical well-being, therefore, that parents resolve old resentments towards their ex spouse.
It is vital that parents and children understand and engage the challenges that remarriages and family blending can create. Developing realistic expectations for these new relationships is critical (Akrons, 2006). Divorced families and blended families are forced to rethink and re-conceptualize what a family is. It is often an idealized pre-divorce view of family that sets parents and children up for failure and unhealthy expectations.
Each family member has a separate and important opinion and perception of the divorce. It is vital to create space for every family member’s perception rather than projecting one’s own views onto the children. Often the child’s voice is smothered-especially during very difficult divorces. Allowing, hearing, and validating your child’s experience can increase positive outcomes in coping with divorce.
Finally, it is important to empower children in divorce situations; children who see themselves as victims in a divorce situation can struggle more than those who do not. Language that promotes the notion that they are victims or damaged goods is best avoided, as should labels that anthologize divorce, such as ACOD (Adult Children of Divorce). This type of language can send a message to children that they are victims (Bernstein, 2007).
Remember, it is the parents’ behavior in response to divorce, rather than the divorce itself, that has the greatest and most long-term impact on children.
Ahrons (2006) Family Ties After Divorce: Long-Term Implications for Children Family Process Vol. 46, No. 1
Bernstein, A (2006) Re-visioning, Restructuring, and Reconciliation: Clinical Practice With Complex Postdivorce Families Family Process Vol. 46, No. 1
Fabricius & Luecken (2007) Postdivorce Living Arrangements, Parent Conflict, and Long-Term Physical Health Correlates for Children of Divorce Journal of Family Psychology Vol. 21, No. 2
With up to 84% of all US teens using the internet to communicate, it’s the social applications of the internet that youth tend to access the most and that represent both the greatest opportunities for good and for harm. Since teens are the largest users of the internet, it’s easy for parents and educators to feel a few steps behind as we attempt to manage the internet hazards for the young people in our care. Following are a few of the hazards the internet poses along with some tips to help adults guide young people toward positive internet use.
Ironically, adolescents whose use the internet to seek primary support during times of difficulty tend to experience more loneliness than other teens in crisis. Adolescents who spend a large amount of time maintaining relationships online are also more likely to have unrealistic perceptions about those relationships, which can lead to disillusionment, misunderstanding, and misperceptions about relationships in general. As a result, research is finding that adolescents who rely primarily on the internet to build and maintain relationships experience a decrease in overall psychological well-being. Adolescents who feel lonely and attempt to seek support online may exacerbate their loneliness.
Teens that access the Internet primarily for information, however, have less of a tendency to experience the negative drawbacks of the Internet. So the specific applications that teens utilize have a significant bearing on whether the internet is a positive or negative resource.
It is terrifying to think of your teen giving free access to your home to anyone who wants it. Unfortunately, this is exactly what many young people do every day by not filtering their online contacts and by providing personal information online. Lonely young people who do not tightly manage their social networks (e.g. Facebook account) can end up victims of cyber predators who use the internet to extract personal or family information, or to lure young people into dangerous face to face meetings.
It doesn’t take much surfing to realize that no topic and no type of information is off limits online. Adolescents are increasingly using the internet to exchange information regarding drugs and alcohol. It has been reported that 10% of all exchanges between adolescents involves advice on how to take illicit drugs without getting caught. In addition, there are websites, blogs, and social networking pages dedicated to promoting teen use of illegal substances.
What happens in Vegas may stay in Vegas, but what happens online can haunt a young person for years. In recent years, students have had their college acceptances retracted and jobs denied as a result of online postings that may have been from months or years prior. Young people have also been expelled from school and subjected to legal or criminal investigations due to what they considered casual or flippant communications online. The internet is a public place, so adolescents must be coached to publish information responsibly. Once comments, photos and information are online they can be impossible to retract.
Sources:
Eijnden R. (2008) Online Communication, Compulsive Internet Use, and Psycholgical Well Being Among Adolescents: A Longitudinal Study Developmental Psychology Vol. 44, No. 3, 655-665
Subrahmanyman & Lin (2007) Adolscent On the Net: Internet Use and Well-Being Adolescence Vol. 42, No. 168
Recent research indicates that up to 46% of teens report having engaged in self-injurious behavior. This high surge in cutting behaviors may be due in large part to recent high-profile cutting cases. The media has made much recently of cutting behaviors described by such celebrities as Princess Diana, Angelina Jolie, and Johnny Depp. Like other coping or anxiety-based behaviors, cutting can spread as a copycat phenomenon. Many teens even seek validation and encouragement for self-harming from popular blogs and websites devoted to self-mutilation.
For a person who has had no experience with intentional self-harm, it is a confusing and frightening phenomenon. Most of us avoid pain and seek pleasure, but the cutter seems to avoid pain by seeking pain. Self-harming typically acts as a form of emotional avoidance and escape from unwanted unpleasant emotions. It is often an attempt to drown out emotional pain by engaging in more manageable physical pain. Many teens report relaxation and emotional numbness after self-harming. Self-harming can also serve as a tool to express strong negative emotions towards others or as an attempt to elicit help or attention from others.
With the exception of those individuals whose cutting has an attention-seeking dimension, most cutters attempt to hide their cutting behaviors. Parents, educators, friends, and healthcare providers can, however, be alert to signs of cutting that include:
In most cases, cutting itself is just a symptom of underlying emotional distress. It is easy for loved ones to become so distracted by the cutting itself that efforts go toward controlling the behavior instead of addressing the problems underneath. Because cutting represents both a physical danger and a deeper mental health issue, the involvement of a mental health professional is always an imperative. If cutting leads to infection or if cutting goes beyond superficial physical harm, medical attention should be sought immediately. Deep cutting may indicate that the young person dissociates during the act of self-harm; even if the intent is not suicide, this kind of cutting is extremely dangerous and can lead to permanent tissue damage or death.
Cutting can be an indicator of many mental health issues, including:
Mental-health professionals experienced with adolescent issues and self-harming behaviors favor a variety of approaches in the context of a safe therapeutic relationship and/or milieu. These approaches include:
If you suspect your child of cutting or other self-harm it is vital to consult with a mental health professional. Your child’s self-harming behavior is a warning sign of an underlining mental-health problem that needs immediate professional attention.
Linehan, Marsha (1993) Cognitive Behavioral Treatment of Borderline Personality Disorder, The Guilford Press Miller, Alec (2007) Dialectical Behavioral Therapy with Suicidal Adolescents, The Guilford Press
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